BUST­ING THOSE DEADLY FLU SHOT MYTHS

Doc­tors say the vac­cine won’t make you sick, and it’ll lessen com­pli­ca­tions if you do catch the virus

The Morning Call - - FRONT PAGE - By Emily Sohn

Ev­ery year as flu sea­son emerges, so too do myths and mis­con­cep­tions about the flu shot.

Some peo­ple avoid get­ting the vac­cine be­cause they don’t think it works well enough to be worth it. Some think they are too healthy to need it. And some worry it will make them sick, pos­si­bly re­mem­ber­ing a time when they got the shot and fell ill soon af­ter.

“That’s the one I al­ways hear from the taxi driver and the per­son at the gro­cery store: ‘The flu vac­cine is go­ing to give me the flu,’ ” says Mark Thomp­son, an epi­demi­ol­o­gist at the Cen­ters for Dis­ease Con­trol and Pre­ven­tion in At­lanta. “That is a per­sis­tent myth.”

De­spite years of con­sis­tent mes­sages from health care providers about the dan­gers of the flu and the pro­tec­tive power (and safety) of the flu shot, many peo­ple still hold false be­liefs about both. One rea­son is that the flu, tech­ni­cally called in­fluenza, en­com­passes a com­pli­cated and ev­er­chang­ing group of viruses, says Wil­liam Schaffner, an in­fec­tious dis­ease spe­cial­ist at Van­der­bilt Univer­sity School of Medicine in Nashville, Tenn.

Some strains cause rel­a­tively mild cold­like ill­nesses. Oth­ers in­duce world­wide pan­demics. (And plenty of res­pi­ra­tory viruses — even bad ones and oth­ers that strike soon af­ter peo­ple get a flu shot — aren’t in­fluenza at all.)

In­fluenza viruses also mu­tate con­stantly

and with­out warn­ing, which means that peo­ple’s ex­pe­ri­ences don’t ap­ply from one year to the next.

“As we say in flu, ‘If you’ve seen one flu sea­son, you’ve seen one flu sea­son,’ ” Schaffner says. “It’s like fight­ing a new fight ev­ery year.”

Some years are less suc­cess­ful than oth­ers, de­spite con­stant vig­i­lance by a world­wide sur­veil­lance net­work that works year-round to iso­late and an­a­lyze which in­fluenza strains are cir­cu­lat­ing. Dur­ing the months af­ter ex­perts de­cide which strains to in­clude in the an­nual flu shot, viruses can mu­tate and new strains can show up, mak­ing the vac­cine less ef­fec­tive than orig­i­nally planned.

That hap­pened last year, when the flu shot was about 40 per­cent ef­fec­tive, over­all, but only 25 per­cent ef­fec­tive against H3N2, a par­tic­u­larly vir­u­lent strain. The re­sult was a record-break­ing num­ber of hos­pi­tal­iza­tions and deaths among chil­dren.

Some ex­perts worry that these ef­fec­tive­ness num­bers cause con­fu­sion and un­nec­es­sary dis­trust of the vac­cine. In years with a good match, peo­ple who get the flu shot are 40 to 60 per­cent less likely to have to go to the doc­tor for an in­fluenza in­fec­tion, the CDC says.

It may not sound like much if peo­ple ex­pect the flu vac­cine to ri­val vac­cines for measles or po­lio. But a vac­cine that is 40 per­cent ef­fec­tive has a 40 per­cent chance of com­pletely pre­vent­ing in­fec­tion, Schaffner says, adding up to mil­lions of peo­ple pro­tected from a se­vere ill­ness and hun­dreds of thou­sands kept out of hos­pi­tals. And com­plete pro­tec­tion isn’t the only use­ful mea­sure.

Even when peo­ple get the flu, new re­search shows, they are bet­ter off if they’ve had the flu shot. In one 2018 study, Thomp­son and col­leagues an­a­lyzed data on more than 3,000 pa­tients ad­mit­ted to two hos­pi­tals in New Zealand be­tween 2012 and 2015. Among pa­tients with in­fluenza, those who had been vac­ci­nated were 59 per­cent less likely to be ad­mit­ted to the in­ten­sive care unit. And even if they did end up in the ICU, vac­ci­nated pa­tients spent an av­er­age of four fewer days in the hos­pi­tal.

“As you get fur­ther and fur­ther along on the con­tin­uum of sever­ity, this study sug­gests that the vac­cine con­tin­ues to pro­vide pro­tec­tion,” Thomp­son says. “This gives us some ex­tra am­mu­ni­tion to talk about peo­ple’s wor­ries.”

Other re­cent stud­ies have shown that:

Adults are as much as five times

more likely to die of in­fluenza if they’re un­vac­ci­nated.

Chil­dren are half as likely

to die of in­fluenza if they’re vac­ci­nated.

Preg­nant women are less likely

to be hos­pi­tal­ized if they get a flu shot, which also of­fers pro­tec­tion to their new­borns.

The flu vac­cine ap­pears to also

pro­tect peo­ple from long-last­ing in­fluenza com­pli­ca­tions, such as heart at­tacks and strokes, which be­come more likely dur­ing a pe­riod of in­flam­ma­tion that can fol­low an ini­tial in­fec­tion, Schaffner says. And the vac­cine re­mains es­pe­cially im­por­tant for older peo­ple who are frail or on the edge of frailty. For them, the flu can be like the first domino in a se­ries of bad health con­se­quences.

So far, this year’s flu sea­son

is start­ing off slowly and look­ing fairly con­ven­tional, with spo­radic cases and small out­breaks start­ing to oc­cur around the coun­try. The H1N1 strain is cir­cu­lat­ing, and for now, the vac­cine ap­pears to be a good match, says Gre­gory Poland, di­rec­tor of the Mayo Clinic’s Vac­cine Re­search Group in Rochester, Minn.

But cases tend to peak in Fe­bru­ary,

and there is still plenty of time for things to go hay­wire. That’s a les­son Poland learned in win­ter 2000, when he was on the com­mit­tee that de­cided which strains to put in the vac­cine. That year, the flu sea­son started out look­ing tame. Then, in early Novem­ber, a new vari­ant showed up in the United States and spread rapidly, lead­ing to a par­tic­u­larly bad flu sea­son.

Hun­dreds of mil­lions of new in­fluenza mu­tants

form ev­ery few min­utes, Poland says. “Peo­ple tend to think of the flu as a static virus, but it is an in­ces­tu­ous cesspool of viruses,” he says. “Pre­dic­tion is im­pos­si­ble.”

Stud­ies con­sis­tently show the most ef­fec­tive mo­ti­va­tor is an in­sis­tent rec­om­men­da­tion from a health care provider. But fewer than half of Amer­i­cans got the shot last year.

Sci­en­tists are work­ing on

a uni­ver­sal vac­cine that would cover all strains. Oth­ers are try­ing to make the flu vac­cine eas­ier to de­liver with patches or other meth­ods that don’t re­quire nee­dles.

For now, there are nine op­tions,

Poland says, in­clud­ing a ver­sion for older peo­ple, a newly re-ap­proved nasal mist, a vac­cine made in cells in­stead of eggs, and one that can be de­liv­ered by jet in­jec­tor, a high-pres­sure stream of liq­uid. Poland rec­om­mends that peo­ple talk with their health care providers about which is best.

As for the worry that the flu shot might give you the flu, Thomp­son of­fers re­as­sur­ance. “This is a vac­cine made with a killed virus,” he says. “It is lit­er­ally im­pos­si­ble for it to give you the flu.”

Peo­ple who get the flu shot are up to 40 to 60 per­cent less likely to have to go to the doc­tor for an in­fluenza in­fec­tion, says the CDC.

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