Dr. Kevin Most: Flu Shots
Dr. Kevin Most joins the Steve Cochran Show live at the Blackhawks Store on Michigan Ave to give us our flu shots.
Many of you are now seeing the signs in front of what appears to be everywhere touting flu shot availability, pharmacies, medical offices, I think even some bakeries or banks have jumped on the flu shot wagon. So what do you need to know about flu shots for this year, when should you get your flu shot, which shot should you get and what is not available this year.
First just some basics, a flu shot is needed each year, for a couple of reasons, One is your body does not remember the vaccine from last year with great recall. Two the flu strains change from year to year due to mutations and spread. The vaccine is a simple shot you get in your arm. It does not give you the flu, the vaccine is made up of dead virus so you cannot get the flu from the shot. The vaccine is not like an antibiotic that can be given after the onset of an infection, it is not a treatment. Vaccines are given to actually prevent the illness not treat it, and the body needs 10-14 days to develop the antibodies needed to fight off the virus.
Influenza is more than just a bad cold, especially in seniors and young children. Deaths from influenza occur each year, we often will see between 10,000- 40,000 deaths a year attributed to influenza. It also places close to 250,000 people in the hospital and millions seeking care in doctors’ offices and Emergency rooms. What are your odds of getting the flu? Some place the odds as high as 1 in 4. The classic patient will have headache, muscle aches and high fevers, some of the symptoms will last up to 10 days. The bad thing about influenza is that you are contagious for a few days before you even have symptoms to 5-10 after the symptoms start. Although we have medication for influenza, it is really not very effective. It may shave a few days off the illness but it must be started very early in the disease.
So what is new this year, first the bad news. For those of you who are needle phobic, the needleless nasal spray is again not approved by the CDC due to its lack of effectiveness in previous flu seasons. Studies showed during the 13-14 , 15-16 and 16-17 seasons Flu Mist having very low rates of response or protection and for those reasons the CDC is again recommending that it not be used. The makers of Flu Mist are hoping to reformulate and get it approved before this flu season is over.
Last year we talked about a study that was underway using the band aid like micro needle patch. This technology is essentially a fancy band aid that has very tiny microneedles imbedded in it, so by placing the band aid you are getting the vaccine. The patch has 100 microneedles and you can barely see them. It was used in an early study this past year with surprisingly good results. The way it works is the individual places the band aid on their wrist for a few minutes, the micro needles gently abrade the skin and deliver the vaccine. The results were good, 96% said they felt no pain or discomfort from the patch. The bodies response to the patch was equal to the traditional flu shot. This study also allowed some of the individuals to place and remove the patch themselves and found the same encouraging results. More studies will be run this year, however none in Chicago that I know of. The great thing about this technology is that the patches do not need to be refrigerated and thus the technology could allow for vaccination for many illnesses in areas of the world where it is not possible to vaccinate large numbers of people. It is felt that this will reduce the cost (think no needle, no vials) and the administrative cost ( no need for a nurse, doctor or pharmacist ). Hopefully this technology advances over the next 2 seasons and is ready for widespread use soon.
So what are we recommending this flu season? First lets discuss timing. The vaccine takes 2 weeks to reach its full strength. That being said we rarely have a very early flu season, so getting a vaccine this month is a good idea. I am a fan of mid October for receiving the vaccine. The reason is it protects you well before Thanksgiving, the busy travel season where outbreaks can be moved quickly across the country by travelers. It also assures protection well into the winter /early spring when historically we have seen peaks of influenza.
Do you realize there is more than one vaccine, and understanding which vaccine you need is important. First remember that all individuals over the age of 6 months should be vaccinated, and if you are going to be around anyone under the age of 6 months please get the vaccine to protect the infant, even if you don’t believe in the vaccine. Influenza in an infant under 6 months can be deadly. It is also important and safe that women who are pregnant or attempting to become pregnant get vaccinated to protect the fetus as well as themselves.
This year we have a vaccine that protects you from 3 strains and one that protects from 4 strains. The additional strain is a B strain that may play into this season. Remember the vaccine is based on previous flu seasons, trends noted and predictive analysis of the vaccine. So they take a lot of data and decide on the vaccine, historically we have had 3 strains noted and contained in the vaccine. Over the past few years a newer vaccine has added a 4thstrain for increased protection. My opinion is, if you are getting a vaccine why not make sure you have the maximum protection so I recommend the quadrivalent vaccine.
Older adults, over age 65 should make sure they are vaccinated. Ideally they should consider receiving the High Dose vaccine. The reasoning behind this is that as we age our immune response is not as strong, so getting a vaccine with a higher dose increases the chances of a good response. That being said if the high dose is not available and you are present to get the vaccine, go ahead and get the standard dose. The CDC is recommending any standard dose but prefers that individuals over age 65 get the high dose if available. The high dose has only been used for a few seasons now and data is still being collected to show its impact.
For children receiving the influenza vaccine for the first time a 2 shot regimen is recommended. The child is recommended to have a single vaccine followed up at least 4 weeks later with a booster vaccine. This is only for the initial year of vaccination, the following
Individuals who are allergic to eggs should talk to their provider to make sure they receive a vaccine that is not egg based. Fortunately this year we have 6 companies manufacturing flu vaccine. Some companies are making vaccine not using eggs so the opportunity for a flu shot to an egg allergic patient is present this year. Also for those concerned about Mercury being used as a preservative, many of the vaccines have no mercury at all. The only vaccines that have mercury are the multidose vials. Those that are in prefilled syringes direct from the manufacturer do not.