Many Americans shun the seasonal flu vaccine, according to federal health data. Here is why doctors say that is a bad idea.
Four months pregnant with her youngest child, Michelle Heil got a flu shot. She never had one before, but her doctor strongly recommended it, so she followed his advice.
Within a week, she was in hospitalized for two days. Doctors diagnosed her with the flu.
A coincidence? Maybe, she said. But the Bensalem, Pennsylvania, woman says she isn’t taking any chances.
“I swore I got sick from that shot,” she said. “I will never get a flu shot again.”
Doctors believed Cheryl Campbell had the flu when she was hospitalized for a week nearly 30 years ago, she said. Turned out she had the measles, a condition she was vaccinated against as a child.
The 55-year-old Bristol Township, Pennsylvania, resident has never had a flu shot or the flu, she said. Campbell has no plans to get one either, despite urging from her doctor, pharmacist and husband, who gets his flu shot every year.
“The flu can’t be any worse than getting the measles,” she added.
These Bucks County, Pennsylvania, residents are far from alone in their skepticism of something many people consider a routine part of preventative health care. Only 43 percent of U.S. adults were vaccinated for seasonal flu during the 2016-17 season, up from 42 percent the previous year, according to the Centers for Disease Control. Among children 17 and younger, the vaccination rate was 59 percent last year, the same as the previous three years.
Scientists predict a severe flu season for the Northern Hemisphere based on flu activity in the Southern Hemisphere, where winter recently ended, according to Dr. Henry Fraimow, an epidemiologist and infectious disease specialist at Cooper University Health Care in Camden, New Jersey.
Already, hospitals in the Bucks County areas are experiencing “sporadic” flu cases which is typically an early signal that a bad flu season is approaching, added Dr. Ronald Goren, an infectious disease specialist at St. Mary Medical Center in Middletown, Pennsylvania.
While scientists are getting closer to developing a universal one-time only flu vaccine, until then, area doctors like Goren and Fraimow say they will continue attempts to bust myths surrounding the flu shot — including some of the most pervasive and popular ones.
‘I got a shot, then I got the flu’
The most common flu vaccine is the injectable variety and it contains dead virus. The human body recognizes the inactive virus as a foreign invader and makes antibodies to fight it, Goren said. So while dead virus can help protect the body, it cannot transmit the flu.
The more likely scenario is someone who gets sick after a flu shot was already exposed to the flu or a respiratory virus that imitates the flu, said Dr. John Peterson, an infectious disease specialist at Lourdes Health System with a practice in Mount Laurel, New Jersey. Only a lab test can confirm someone has the flu.
Infectious flu is highly contagious during the 24 hours before symptoms appear, according to the CDC. It can take one to four days after exposure for symptoms to appear. Also, it takes two weeks after a vaccination for the body to develop antibodies to protect against the flu virus, according to the CDC.
Until a vaccine is fully effective in the body, there is still a risk of contracting the flu.
Another possibility is the vaccinated person did get the flu. But not as a result of the vaccine.
The conventional mass-produced flu vaccine is created based on one or two “Type A” and two “Type B” viruses that scientists predict will be prevalent strains during a given season. (It’s also why doctors say you need a new flu vaccine annually.) But there are all sorts of flu virus circulating, including a “Type C” strain the seasonal vaccine doesn’t protect against.
Even when the seasonal vaccine is a good match to the most prevalent viruses, the effectiveness varies depending on age, gender, and underlying medical conditions, doctors said. Recent CDC studies found the annual flu vaccine reduces the risk of developing the flu by 40 to 60 percent.
And the way the vaccine is created can affect its effectiveness. The flu virus can easily and quickly mutate. New research from the University of Pennsylvania in Philadelphia found the use of chicken eggs in vaccine manufacturing can introduce mutations rendering the vaccine less effective against a particular strain.
That’s what happened last flu season, according to Penn researchers. The mutation meant most people who received the seasonal flu vaccine didn’t have immunity against what turned out to be the most prevalent of the four strains the vaccine contained. As a result, the vaccine was only about 30 percent effective. In the 2015-16 flu season only 19 percent of Americans vaccinated were protected, according to CDC data.
While a flu vaccine may not stop someone from getting the flu, there are still health benefits, doctors point out. It will create some immunity protection meaning the illness won’t last as long and the symptoms won’t be as severe as someone who is not vaccinated.
‘I don’t need it; I’m healthy’
No one is too healthy to get the flu, doctors say.
Remember the 2009 Swine Flu pandemic? Younger healthy people were at a higher risk of contracting it than those over age 60, a group typically among the most susceptible to flu. During the outbreak, the CDC received reports of 282 U.S. children deaths where lab-confirmed H1N1 virus was present, according to the agency.
As a comparison, 358 U.S. children died of flu-related complications between 2010 and 2014, and at least three quarters were not vaccinated against the virus, according to a CDC report released earlier this year.
Last year, an estimated 24.5 million Americans got sick with the flu, resulting in 308,000 hospital stays and 12,000 deaths, often from flu-related complications like pneumonia, according to the CDC. But it could have been worse. The federal health agency estimates that the flu vaccine prevented about 5.1 million illnesses, 71,000 hospitalizations and 3,999 flu-related deaths.
“Flu is not just a bad cold. The flu is fundamentally and profoundly different than other respiratory viruses,” said Peterson, the Mount Laurel doctor.
Healthy people can have compromised immune systems as a result of certain medicine and behaviors like smoking. Pregnancy also weakens the immune system, Goren said.
CDC studies show pregnant women who were vaccinated against the seasonal flu cut the risk of infection in half for themselves and their newborns. Since pregnant women pass antibodies to developing fetus, the protective benefit of the flu shot was observed for several months after birth, according to the CDC.
Such reasons are why doctors strongly recommend the flu shot as early as the first trimester, St. Mary’s Goren said.
“They are extremely susceptible to the flu,” he added. “It’s absolutely important.”
‘I’m allergic to eggs’
An egg-free flu vaccine is now available for people who are highly allergic to egg products, which are used in the development of the mass-produced flu vaccine. While the egg-free substitute is more expensive, health insurance should cover the cost, according to Fraimow and other doctors.
But some people with egg allergies might not need the egg-free version. People who can eat foods containing eggs without developing a severe allergic reaction likely can tolerate the regular flu vaccine, which contains “very little” egg product, according to Fraimow.
‘It’s too late to get the shot’
No, it’s not.
While the typical preseason vaccine push starts in September, the flu activity typically peaks in January or February and the flu can linger into the late spring.
Goren said that he has seen flu cases as late as April.
And it’s only early November. There’s still time to roll up your sleeves.
— Contact Jo Ciavaglia at email@example.com and @JoCiavaglia.