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November 6, 2013

Should getting the popular influenza vaccine be on your fall to-do list?

By Tiffany Esshaki
C & G Staff Writer

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Each year, the Birmingham Area Senior Center offers flu shot clinics. Many doctors agree that adults over the age of 65 are at higher risk of having severe complications from the influenza virus.

To poke or not to poke — that is the question.

Our state already has four confirmed cases of influenza this season, according to the Michigan Department of Community Health, and as another flu season creeps upon us, medical professionals have already begun their annual campaign to promote the flu shot. And like so many years before, many of us will opt out of getting vaccinated against the virus, citing one of dozens of horror stories we’ve heard about the shot.

Medical experts like Dr. T. Jann Caison-Sorey warn that skipping the shot could be dangerous.

“There are clear benefits to having the flu shot,” said Caison-Sorey, the medical director of the Chronic Conditions Program at Blue Cross Blue Shield of Michigan. “There’s great value in the poke, for sure. People have absolutely no idea how devastating the flu is. If we picked one thing from a public health perspective for people to do that would make a huge difference in health care, it would be to have the flu shot.”

According to Caison-Sorey, the most common reason patients fear getting immunized for flu season is getting sick after receiving the flu vaccine itself. She said most patients she comes across are afraid of getting flu-like symptoms, like a mild fever, headache and fatigue. While the chance of getting sick is low, the doctor admits that it is possible when a patient receives a vaccine containing a live virus.

But Angela Minicuci, public information officer with the MDCH, said that the vaccine containing the live virus isn’t commonly distributed to patients anymore. Most people who get flu shots this season will probably receive the one that contains the dead flu virus, which Caison-Sorey said won’t cause flu-like symptoms.

And those symptoms, while undesirable and in some instances contagious, are nothing compared to the full-blown flu virus. Patients need to weigh the risks versus the benefit, she said.

Another common complaint some patients have is that they’re not convinced the flu vaccine is as effective as the medical community claims. While most doctors, like Caison-Sorey, say that the flu shot is essential for individuals in high-risk groups — such as small children, adults 65 and older, and those with chronic conditions — the Centers for Disease Control and Prevention states on its website that the vaccine could be less effective for those patients.

But Caison-Sorey said that’s all the more reason those groups should be vaccinated. Those are the people, she said, who are likely to have severe outcomes if they contract the flu, so any bit of immune system help is a good thing. She insists that the proof is in the pudding: year after year, her patients who receive the vaccine seem to get sick less often, or the severity of their virus is greatly diminished thanks to the vaccine. Any protection is better than none, she said.

“The flu has no respect for your age. It doesn’t care whether you’re 19 or 49 or 70. It’s going to hit you like a tidal wave because that’s what it does,” she said. “Children, for instance, are particularly susceptible because they’re still building their immune systems. That’s why they’re always getting those earaches, sore throats, pinkeye. They don’t have that protection yet, so the bottom line is, until they build up their immune system, they’re at risk and need that shot.”

Minicuci said there’s no way to really gauge the vaccine’s efficacy rate, since the vaccine changes every year, just like the popular strain of flu that’s passed around each season. It’s only after flu season is over that we can look back and get a glimpse of how useful the vaccine was.

“Every year, scientists look at strains of flu that are circulating the entire globe. Then they make their best guess estimate as to what strains should be included in the vaccine, based on trends we’re seeing move across the entire world,” said Minicuci.

Flu shots, in general, protect against three strains of flu, though a new vaccine is now available called the Quadrivalent Influenza vaccine, which protects against four strains. Caison-Sorey said that the scientific community can generally predict which strains will be the most common during a given season and which ones seem to be causing the most severe illnesses. But even educated guesses are still just that, as demonstrated during the 2009 H1N1 outbreak.

“It’s not common that we see that,” said Minicuci, explaining that the H1N1 strain of flu came as something of a surprise to the medical community, and protection for the virus wasn’t included in that season’s vaccine. “That was very rare. We haven’t seen anything like that before or since. What we do know is that the strains of flu detected so far (this season) match up to what’s in the flu shot. So, if you got your flu shot, there’s a very good chance you’ll be protected from those viruses.”

Caison-Sorey said that another reason some people might be wary of getting vaccinated is that they’re concerned that they might have adverse reactions with other health conditions they already have. She said that’s a legitimate concern, and the best line of defense is to consult a doctor with any worries.

“It should not be administered to some persons, including those with asthma, children 2-4 years who have had wheezing in the past 12 months, those with underlying medical conditions who are predisposed to complications from flu, those with asthma,” she said. “It’s so important to have an annual physical exam. There’s nothing like that doctor having recent knowledge of who you are and what your situation is. They can advise if the shot is right for you.”

Minicuci added that some people also have allergy concerns, especially those with egg allergies, which can be aggravated by ingredients in the vaccine. But now, she said, there are specialized vaccines for those with egg allergies.

At the end of the day, you won’t likely find a medical professional who doesn’t endorse the flu vaccine. Like any treatment, there are some risks, but most doctors agree that it’s the best line of defense against the virus that we know is on its way and that could potentially kill.

“Check with your doctor, but don’t poo-poo it and assume you’re going to be OK. Most of us will probably be exposed to the virus, and we’ve had even relatively healthy people in the ICU from the virus,” said Caison-Sorey. “The time to get it is now — N-O-W. Don’t wait until you’re starting to feel crummy. Give your immune system time to ramp up.”

You can reach C & G Staff Writer Tiffany Esshaki at tesshaki@candgnews.com or at (586)498-1095.