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You Don't Say!
(Flu Shot)

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

Article printed in the December 17, 2005 issue of
The Mississauga News under the feature: Health & Wellness, Medical Matters.

There are many fallacies circulating regarding flu shots. Some adults who went through the "large painful needle in the butt stage" as kids are just plain scared of needles. For this group, there is a nasal spray vaccine available in the United States which uses a modified live virus. The flu shot also does not guarantee immunity from colds and diarrhea illnesses. Another common myth is the "I got the flu after the last shot" excuse. This myth originates when late stragglers jam clinics for shots once the flu-bug is circulating. They end up mingling with patients sick with the flu. Since immunity takes at least a week to kick in, they probably contracted influenza while attempting to get the shot. The shot will only protect you against three of the more severe strains. "I am allergic to eggs" is another popular excuse. While it is true that eggs are used in the production, the final product has at best very minuscule amounts of egg protein present. Therefore, only people who suffer full anaphylactic reactions to egg need to be concerned. The same goes for the mercury preservative line. Your system sees more toxins while sitting in the morning rush hour inhaling fumes than you will ever accumulate from flu shots. A flu shot is of no use if you got the flu. When that happens we turn to pills. There are pills to prevent the spread of flu in high-risk populations and other pills which are able to treat infected individuals depending on the strain.

I admit that the flu shot is a bit of a gamble. While it is fairly safe, we can never be certain which strains are going to hit. How long immunity lasts is also controversial. If you measure it in terms of circulating antibodies, it may be months. But immune memory mechanisms may extend it to years. Survivors of the devastating 1918-1919 Spanish Flu pandemic had evidence of immunity decades afterwards. This same Spanish Flu pandemic killed 19 million people, and I still worry about it. Symptoms struck young healthy people hard and fast. You got sick one day and died the next. It overwhelmed all available medical resources within hours of appearing in a community. If you discount the alien invasion theories, it seems that this particular strain was just a chance mutation that held little benefit for the virus or its host. If immunity was truly short lived, then the virus would not need to mutate as often as it does. It is certainly not advantageous for a virus to wipe out its host, since it cannot reproduce on its own. Therefore it is my belief that repeated flu shots year after year may exert an accumulated benefit. Younger children require two flu shots if it is their first immunization year. In some people, the immunizing response just does not occur. One interesting observation from clinical practice is that people who have been vaccinated seem to do better when they do get the flu.

Influenza is a difficult diagnosis to make. In Ontario, doctors' offices are simply not equipped with the rapid influenza tests that our American cousins have been using for the last decade. For this reason, thousands of "just in case it is not the flu" antibiotic scripts are written. No physician wants to miss a treatable illness, and most will proceed with caution while waiting for results to come back. Influenza treatment is available, and most physicians prescribe it only when its certainty level is high. The community laboratory that I deal with had no viral kits available for testing. They were on back order and the lab chief was uninterested in explaining why. It feels a little like landing on the beaches of Normandy and being told the generals are thinking about ordering bullets any day now. I can also use blood samples to help diagnose the illness with a turn around time of weeks. In that time frame, the damage is done. But mostly, we check for Strep throat, cross our fingers and hope our clinical instincts are right - not exactly the preferred method if you are in a setting dealing with complete strangers. One of our community hospitals was equipped to do the bench top swab tests and the more definitive cultures which make it easier to track down strains in hospitalized patients. In our system, there is no mechanism to fund new efficient technology in family practice centers, so we often go without.

I have little patience or sympathy for groups that choose immunization programs as a rallying point for civil rights. It is neither the place nor the topic to take such a stand. Now, hedge your bets and take a shot. Like your own doctor, we are giving flu shots "free" to non-taxpayers and will oblige anyone who walks in requesting one, but only while supplies last.

Related resources:

Seasonal Flu from Flu.gov.
Vaccination & Vaccine Safety from Flu.gov. Everyone 6 months of age and older should get the flu vaccine. Seasonal flu vaccines have a very good safety track record. Where can I get the vaccine? Use the Flu Vaccine Finder to find a flu vaccine location (in United States) near you this flu season.
Find a Vaccine Clinic in Canada.
Find a Flu Shot Clinic in Canada from FightFlu.ca

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