The Flu Vaccine

It’s that time of year again. Cold and Flu season are upon us, and so resumes the age-old debate: should one or should one not get a flu shot? Influenza vaccination, commonly known as the flu shot, is a preventive measure designed to reduce the risk of contracting the influenza virus and its associated complications. Although seemingly straightforward in its intended effect, the subject of whether or not to get a flu shot each year can be a very contentious matter. At the end of the day the flu shot is a medical intervention, and just like any other medical intervention, it is important to weigh the potential risk versus benefits that it offers. In order to facilitate discussion, the pros and cons of the flu shot have been broken down into sections below.

Pros:

1. Reduced Risk of Infection: The primary benefit of getting an influenza vaccine is a reduced risk of contracting the flu. It helps your immune system recognize and fight the virus more effectively.

2. Prevention of Complications: Influenza can lead to serious complications, especially in vulnerable populations such as the elderly, young children, and individuals with compromised immune systems. Vaccination can help prevent these post-viral complications, including pneumonia, sinusitis, ear infections, and others.

3. Herd Immunity: Widespread vaccination in a community can create herd immunity, protecting those who cannot be vaccinated, such as individuals with certain medical conditions or allergies.

4. Lower Healthcare Costs: Fewer flu cases mean reduced healthcare costs associated with doctor's visits, hospitalizations, and medications. One recent study in JAMA in 2022 actually showed that influenza vaccination is associated with a 34% reduction in risk for major adverse cardiovascular events, with an even greater reduction in risk (45%) if the individual recently had an acute coronary event/heart attack.

5. Less Time off Work/School: By reducing the incidence of the flu, vaccination can lead to fewer sick days and less disruption in workplaces and schools. Keeping yourself healthy and able to work is an important benefit.

6. Efficacy Updates: Influenza vaccines are updated annually to match the most prevalent strains, increasing their effectiveness against the current strains of the virus.

Cons:

1. Side Effects: Some people may experience mild side effects after receiving the flu vaccine, such as soreness at the injection site, low-grade fever, achiness, or fatigue. These side effects are usually short-lived and mild.

2. Allergic Reactions: While rare, severe allergic reactions to flu vaccines can occur. People with known allergies to vaccine components should consult their healthcare provider for guidance.

3. Limited Coverage: The flu vaccine may not protect against all strains of the influenza virus. The effectiveness varies from year to year and may not be 100% in preventing infection. There is also always more than 1 circulating strain of influenza virus at any given time, which further contributes to reduced protection offered by the flu vaccine.

4. Need for Annual Vaccination: The flu vaccine's protection wanes over time; so, individuals need to get vaccinated annually to maintain immunity. This can be inconvenient for some people and also give the impression that the vaccine does not work very well.

5. Misconceptions and Mistrust: Some individuals may be hesitant to get vaccinated due to concerns about the flu vaccine's safety or effectiveness, which can contribute to lower vaccination rates with the flu vaccine.

6. Cost: For those without insurance coverage, the cost of the vaccine may be a barrier preventing access for some individuals.

Six Myths about the Influenza vaccine

1. Influenza is not a serious illness and thus vaccination is unnecessary. In any given year there can be as many as 650,000 deaths related to the flu. Even if the individual recovers from the initial illness there can still be post-viral pneumonias, sinus/ear infections, heart/brain inflammation, among other complications. Healthy people can get sick with the flu, but immunocompromised individuals are at even greater risk.

2. “The flu shot gave me the flu.” There is no live flu virus in the flu shot. It only contains inactivated virus particles; thus, it is not possible to get active or live influenza virus from a flu shot. Feeling achy with chills for a day or two is a normal response and is indicative that one’s immune system is responding appropriately to the vaccine.

3. Severe side effects are common. Serious side effects are extremely rare. Guillain-Barre Syndrome, perhaps the most severe of all potential side effects, at most only occurs every 1 out of a million people that get the vaccine.

4. “I still got the flu despite getting the flu shot, so it must not work.” There are multiple flu virus strains in circulation at any given time, thus it is still possible to get sick with a strain of flu virus different from the formula contained in the vaccination.

5. The flu shot is not safe for individuals with egg allergies. The likelihood of having a serious reaction to the small amount of egg protein in most flu vaccines is very low. Individuals with egg allergies are safe to get any flu vaccination at any time.

6. The flu shot is not safe for pregnant women. The flu shot is safe at any stage in pregnancy and is recommended for pregnant women since their immune system is often slightly suppressed.

Ultimately, the decision to get an influenza vaccination should be made after considering your individual health status, age, and risk factors, as well as consulting with a healthcare professional who can provide personalized advice based on your circumstances. The benefits of influenza vaccination, particularly in high-risk populations, often outweigh the potential drawbacks. By using the information above, hopefully it will be easier than ever to make an informed decision about whether or not to get vaccinated for the flu this year.

Dr. Johnson is a resident physician who sees patients of all ages and provides obstetrical services at Lone Star Family Health Center, a non-profit 501©3 Federally Qualified Health Center operating facilities in Conroe, Spring, Willis, Grangerland, and Huntsville, and serving as home to a fully integrated Family Medicine Residency Program to increase the number of Family Medicine physicians for Texas and our community.

References:

1. https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm.
2. https://www.medicalnewstoday.com/articles/flu-shots-pros-and-cons.
3. https://www.cdc.gov/flu/prevent/keyfacts.htm.
4. https://www.cdc.gov/flu/prevent/general.htm.
5. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2791733.
6. https://www.who.int/news-room/spotlight/influenza-are-we-ready/5-myths-about-the-flu-vaccine.
7. https://www.mayoclinic.org/diseases-conditions/swine-flu/expert-answers/flu-vaccine-egg-allergy/faq-20057773#:~:text=Yes%2C%20you%20can%20get%20a,in%20flu%20vaccines%20are%20unlikely.
8. https://www.cdc.gov/flu/prevent/egg-allergies.htm.