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Here in the Coachella Valley we are starting to see the first few cases of influenza coming through our clinics and hospitals.  Usually we see a handful of infections until after the holidays, when all the parties and get-togethers make it easy to spread germs and we see an explosion of influenza and other respiratory illnesses.  That is why now is a great time to get your flu shot if you haven’t already. They are available at most pharmacies and are often free with most insurances. 

 

And without further ado, I wade into the bane of the primary care doctors existence, the morass of the vaccine convo, where there are more eye-rolls than a lecture on vaping at a high school assembly.  In my 20 years of doctoring, the current level of vaccine avoidance and fear is probably the highest it’s ever been. So I’d like to address many of the things people say to me in the clinic and around town.

 

I’d rather get the flu.  It’s better to build up immunity naturally.

 

Funny, no one says that about ebola.  But that underscores what I think is the underlying assumption here, that flu is not that bad so it’s better to suffer through a few days and tough it out than risk any negative effect from the vaccine.  And it is true that after you recover from the flu you do have nice immunity to that strain for many years.

 

But flu isn’t always that mild.  Last year in the US the CDC reported 42.9 million cases of the flu with 647,000 hospitalizations and 61,200 people dying.  Which was actually better than the year before where 79,400 people died. That’s about 1 ½ people per 1000 with the flu who die.  But 10X more people than that end up in the hospital, and pretty much everyone who gets it misses work and/or school.

 

Last time I got the flu shot I got the flu.  I never got it after that and I’ve been fine.

 

There’s a few ideas involved in that statement.  First is “Does the flu shot actually work?” My answer is “Not as well as I’d like it to.”  In fact, it’s one of our least effective vaccines. So why do we recommend it? Because even if it only works about 50% of the time, that’s still thousands upon thousands of lives saved each year.  Millions of people who didn’t miss a week (or two) of work or school; which translates to around 8.4 billion dollars of lost productivity in the US each year.

 

Even for our patients who still get the flu after being vaccinated, they are less likely to end up hospitalized, but if they are hospitalized they go home faster and are less likely to need ICU care.  Links to the studies on this are below.

 

https://www.cdc.gov/flu/vaccines-work/vaccineeffect.htm

 

Another assumption in our statement is that somehow getting the flu shot got you sick.  Since the flu shot is not a live virus, it can’t actually give you the flu (Yes I know the nasal spray version is live but that’s not what most people get).  People can get an immune response to the shot that feels flu like that lasts for around 24 hours, usually aches, a low grade fever or a headache. I’m a little happy when that happens to me because that means my immune system really went to town making antibodies that year.

 

An actual illness lasting more than a week with runny nose, cough, and sore throat is a real infection, not a vaccine reaction, and didn’t come from the vaccine.  It could however have come from some of the bazillions of germs we come into contact with each day. Sometimes these are bad colds, and sometimes influenza. A lot of times it is hard for patients and doctors to tell them apart.  Flu shots only protect against the virus influenza. But colds are caused by different viruses such as adenovirus, rhinovirus, RSV, and just to confuse everyone, parainfluenza. None of these are influenza, but can cause similar symptoms, so people often blame the flu shot for not protecting them against the wrong infection.

 

There’s scary stuff in vaccines and I’m worried they could make me sick.

 

Maybe one of the saddest things I’ve seen in my career (wow I sound old) is the erosion of trust in doctors.  And yeah, some of us have brought shame on us all. And honestly, I don’t blame people who have lost trust in the healthcare system, I’m right there with you.  So when people read things online, or who meet a person who is JUST SO DARN SURE that vaccines are going to hurt you, it sows a seed of doubt that maybe that’s true.  And the more that you look, the more there are people claiming facts that are exact opposites, telling stories that scare you to death (I’ve got my own collection) and it’s enough to just avoid the topic altogether.

 

That’s why I never get mad if people don’t want a shot.  And I will talk with you about your concerns, and I will respect your right to refuse any medical treatment.  And I’ll never say “I told you so” if you choose not to get a shot and come in with the flu. And I will try to earn your trust and keep recommending what I feel is the best, evidence based preventive care for you, year after year, no matter what.

 

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