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The FLU Confusion

October 11, 2011

By now I am sure you have seen plenty of visual and radio advertisements about getting your flu shot. Every drug store seems to be in on it. We physicians are called, e-mailed and faxed weekly about stocking up on flu vaccines. I got a call in June from a pharmaceutical rep pushing the sale of flu vaccines and encouraging me to start giving the shots in the summer. Wow!

Influenza (also called the flu) is an illness that usually starts in the winter and can continue until next spring. The majority of times the illness last for 5-7 days and is characterized by fever, malaise, body aches, headache and the typical cold symptoms of nasal congestion and cough. The majority of times people recover without problems. People who are at risk for complications are the very young (under 2 years of age) and the elderly.

When pharmaceutical companies make the vaccine (which is done for every year) they are guessing what strain of virus is going to be present that year. Sometimes they are right; sometimes they are wrong. It is clear that the flu virus changes every year- this is called changing the strain- If one gets a flu shot and it is not the particular strain that arrives in the winter then the shot is of no value. Generally, the side effects of the vaccines are minimal. There will always be the potential for someone to get severe side effects such as damage to heart muscle, allergic reactions and neurologic problems such as Gullain-Barre and Reye’s syndrome but these are rare. This poses a dilemma for the individual if they realize the shot may not work and there are possible side effects. Focus has been on encouraging the young and old to get the vaccine but this is the age category that is at greater risk for further morbidity if a serious complication arises.

The vaccine is available in a nasal spray for those over 2 years of age. This type of vaccine is what I encourage because of ease of administration, better protection of the blood and mucous membranes and fewer side effects. The time to get the vaccine is obviously close to the time of the disease. It takes about two weeks for the body to develop antibodies to fight the disease so any shot or spray given two weeks prior to winter is fine.  In our area of Greater Washington D. C., our winter usually kicks in during late December or January. I generally don’t start giving flu vaccines until late October; getting a flu shot very early may weaken one’s antibody level to fight the disease.

Of practical concern are the measures one can do to prevent getting the flu.

These include:

  1. Focusing on good nutrition;
  2. Increasing sleep time an additional hour more than usual;
  3. Airing  out your home or office or daycare center weekly for 15 minutes by opening windows and allowing for fresh air if possible;
  4. Using  HEPA filters in daycare centers and the work place would be great;
  5. Practicing good hand hygiene with good hand washing and use of sanitizers.

Fortunately the cost of the vaccine is not too expensive. The average cost around the country is about $30.00

I’ll talk to you again in December!!     Happy Thanksgiving!!

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