Straight Talk - Flu ShotsNov 20, 2013
If you research flu shots on the Internet, chances are you’ll find a lot of scary and often wrong information. Some websites suggests they don’t work, others say they’re more dangerous than the flu itself. Do the benefits outweigh the risks of flu shots? Dr. Tom Miller discusses the facts and myths about flu shots and how they work to tame the influenza virus. He also talks about the possible side effects and whether you should get a flu shot this season.
Scot: Get some straight talk on flu shots from Dr. Tom Miller. Do the benefits outweigh the risks? That's coming up next on The Scope.
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Scot: You know if you spend about five minutes on the internet, trying to do some research on flu shots, you'll probably end up a little freaked out. Some sites say they don't work, others say they're dangerous, even more dangerous than getting the flu. It's time to get little straight talk from Dr. Tom Miller. Dr. Tom, do flu shots really work?
Dr. Tom Miller: Scot, have you had your flu shot?
Scot: I have not.
Dr. Tom Miller: Why not?
Scot: Because I am freaked out right now. Have you seen what they have on the internet about flu shots? Are these just a bunch of crazy people?
Dr. Tom Miller: You can find terrible stuff about anything on the internet, you know that.
Scot: That is true.
Dr. Tom Miller: It's the greatest source of misinformation known to man.
Scot: So let's get some straight facts on the flu shots. Sounds like you are a proponent of it. You think I should have already got mine.
Dr. Tom Miller: Well, if you haven't gotten it yet, there is plenty of time and you should get it. Influenza, that's the flu. What is it? It's a viral illness that's responsible for serious illness and it's not a head cold. It's been around for a very long time and at times, it's been responsible for high rates of death among people who get it. Remember the influenza epidemic of 1918?
Scot: No, I do not.
Dr. Tom Miller: Well, in history books, 18 million people died worldwide.
Scot: Wow. Because of the flu?
Dr. Tom Miller: Because of the, they called it the Spanish flu at that time. It was responsible for people dying right and left. It was a bad, bad deal.
Scot: Is that kind of when this thought changed on, this is a serious thing and we need to do something about it or have not come until later?
Dr. Tom Miller: They didn't have vaccinations back in those days but the flu has been around for a very long time. Every so often, you have a year where you have a very bad strain and that's what results in high rates of death. But in between, it's a pretty bad annoyance but also kills about 50,000 of our senior citizens every year. So it's still a very serious illness and it's responsible for pneumonia and sometimes cardiac problems and you feel terrible. It's not a head cold, Scot.
Scot: So just beyond the symptoms of the flu, it can cause other serious things?
Dr. Tom Miller: Absolutely. I mean, why does it change every year? It has a very high rate of mutation as far its okay. That's why they have to come up with new vaccine every year. They have to develop a new vaccine and anticipation of the new strains and it's always a bit of a guessing game. So the virus basically starts in birds and sometimes farm animals, that mutates and hops into humans, and it continues to mutate. So every year, you need to find a suitable vaccine that represents your best guess of what's going to be out there, circulating around.
Fortunately, that year that we had H1N1, that big scare and that big problem, we had a vaccine to treat that. It's important for people to get vaccinated. Why? How effective is the vaccine?
Scot: Yeah, do they work? That's the bottom question and then we will talk about dangers.
Dr. Tom Miller: That's a really good question. Let's talk about its effectiveness. It's not as effective as some of our vaccines. So most years, it is about 40 to 60% effective in targeting those flu viruses that are most prevalent. So obviously, not a 100% but it's even lower in the elderly. In the elderly, only 9% respond to the vaccine. So, that's why it's important that we vaccinate everybody and the recommendation now is to vaccinate everybody above six months old.
Scot: Okay. So the elderly actually, when they get their shot, they are still more likely to get the flu than the average person? It's not working as well on the elderly as with that 6% number was?
Dr. Tom Miller: The vaccine does not work as well on the elderly because their immune system is not quite as good.
Scot: So that's why the rest of us should get it.
Dr. Tom Miller: Right. The right of us should get it to prevent it from transferring. It's highly infective. It spreads by droplets, from sneezing, from coughing and that's why it's so effective in transferring from one person to another. And that's why if everybody gets vaccinated, it likely cuts down the risk of spreading influenza to those folks who are at high risk to have bad things happen. So not only the elderly but those who pulmonary illness, who have lung disease, who have heart disease or other medical debilities that might be exacerbated by the flu and result in a higher rate of death. So everybody should get vaccinated, it's a good idea.
Scot: So myself, as a healthy individual, if I get the vaccination, can you give me a percentage of likely hood that I won't get the flu as had I not been vaccinated?
Dr. Tom Miller: As I have said before, in most people, it's 40 to 60% effective depending on the year that the vaccine is matched.
Scot: Sounds pretty good.
Dr. Tom Miller: It's pretty good. It's better than not and it's not only that you don't want to spread the vaccine, but this is a bad thing to get. You are going to be out of work for a week and you are going to be, if you are infected, you don't mind being out at work, do you, Scot? It sounds like a great deal. Sick time, all right. No, but you don't want to be sick with a 105 fever, that's a bad thing.
Scot: That's not a fun way to be out of work.
Dr. Tom Miller: It's that shaking and shivering and under the covers and sweating and feeling terrible and throwing up, and then maybe even having pneumonia after that. That's not something you want. So, it results in lost work time, it results in personal injury and illness, it's bad. And then the other thing is, if you spread it to somebody who is at risk, you could cause serious harm. That's one of the reasons that hospitals throughout the country are recommending that all of their employees, they are mandating that all of their employees receive the flu shot.
The C.D.C. is very clear about this that those working in the health care arena and working with the patients, need to get the vaccine for the reasons we talked about a minute ago. It's very important.
Scot: What about if I don't happen to get one of the strains that they thought was going to be a strain? Does the flu shot actually boost my immune system?
Dr. Tom Miller: Probably not. The vaccine needs to match the strain that you are infected with [inaudible 00:06:27]. Fortunately, there are anti-virals that will treat influenza and those maybe effective but that's not the best way to look at it. The best way to attack the flu virus is to get the vaccine.
Scot: So get the vaccine. If I get one of those strains that wasn't protected by the vaccine, still go see my doctor because there are some anti-virals that can make it a little less.
Dr. Tom Miller: If you have the flu, if you develop flu, what is flu? Flu is the sudden onset of high fever, body aches, chills, cough. It's very different than a head cold and if you develop that, then you probably should see someone in healthcare rather quickly so you can get the anti-viral. It may be effective.
Scot: Okay. So, as I said on the internet, you mentioned that the C.D.C. is suggesting . . .
Dr. Tom Miller: Well, C.D.C. recommends that all people above the age of six months, babies above age of six months, all the way up through elderly adults, receive the vaccine.
Scot: What about the dangers? We have talked about the benefits. They can improve your ability to avoid the flu by 40% to 60%. Can flu vaccines cause other problems? A lot of people talk about the ingredients like mercury, formaldehyde, aluminum in the shots.
Dr. Tom Miller: The most common side effect from the flu shot is a pain and soreness and a little bit of redness at the injection site for about 24 hours. In some cases, people may feel as if they have a cold and very few will develop a mild fever. In general, a vast majority of people tolerate it well. There has been some concern about the preservatives in the flu shot such as thimerosal and it's very rare that one would have an allergy to that. But if one does have a documented allergy or has a known allergy to one of the preservatives within the flu shot, then you shouldn't receive it. Although, they do make the thimerosal free vaccines at this point
Scot: What about some of these other ingredients, as the internet sites say, are in the flu shot like mercury or formaldehyde?
Dr. Tom Miller: I think that is a bit over blown. Compared to the benefit of not developing flu, I think these are minor problems but again, if one has a known allergy to these ingredients, then you wouldn't want to receive the vaccine.
Scot: How about the notion of creating a super flu by vaccining against it?
Dr. Tom Miller: I have not heard that and I think that's highly unlikely and speculative and not scientific in its basis.
Scot: What's the main reason, in your experience, people don't get their flu shots? It sounds like such a great deal, why aren't we all doing it?
Dr. Tom Miller: I think there is concern among people. Many people don't like the idea of receiving an injection and I can understand that. People are fearful of having something foreign injected into their body. But the reality is, that is an effective treatment. As I've mentioned, it's not 100% effective but it's pretty darn effective and one way to think about it is, you may be preventing the spread of flu to someone who could really suffer if they developed it or even die. And so, as a piece of social conscience, it's a good idea to get the flu shot. If not for yourself, for others in your family or people that you know that you wouldn't want to get the flu.
Scot: What about the flu shot that I could get at, say, a drug store versus at the hospital? Are they all the same?
Dr. Tom Miller: All the same. All the same. Proved by the F.D.A. and from the same companies that make the vaccine. There is nothing different about a vaccine that you'd obtain at a pharmacy or at the doctor's office. Whatever is most convenient and what you can afford, I'd go and do that. I think it's very important.
Scot: Any other concerns or objections you have seen your patients have?
Dr. Tom Miller: Well, there has been a concern about the development of a debilitating [inaudible 00:10:12] degenerative disease called Giambre. But the studies are very conflicting and controversial and the reality is, if one has not had Giambre, the likelihood of developing that is something like one in a million who receive the vaccine. So we don't really think that there is a true relationship between the vaccine and the development of Giambre syndrome. But if one has had Giambre six months after of influenza vaccine, you wouldn't probably want to get the vaccine again. That would be a very rare occurrence and it should not be deterrent for people.
Scot: How about egg allergies?
Dr. Tom Miller: Egg allergies would be a concern. I must mention that there is now a, up to the age of 50, one can use a nasal inhalant vaccine to prevent the flu. It's actually a weakened live version of the vaccine. But it doesn't require an injection and if you are an adult, it's an option that you can exercise.
Scot: Final words on flu shots, Dr. Tom Miller?
Dr. Tom Miller: Get your flu shot. If you are less than 50 and don't want the shot, get the nasal vaccination, the nasal spray vaccination.
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