Saturday, June 4, 2016

A Flu Shot Primer: Basic Answers To Common Questions

Influenza is the seventh leading cause of death in children under the age of 14 in the United States.  Illness can be life-threatening and needs to be taken seriously.  A flu vaccine is developed each year to keep up with the ever changing strains that are circulating.  This year 2015-2016, the strains circulating match the vaccine accurately.  Last year 2014-2015, the vaccine was less than 50% preventative. Obviously, this subject is near and dear to my heart in light of recent events.  Education is the foundation of what I do and who I am. I hope you find this information helpful.

Each year, two Influenza A (H1N1), A (H3N2), and one or two influenza B viruses are included in the vaccination. Flu vaccine can protect against slightly different strains that are related to the viruses in the vaccine, which the reason receiving it annually makes sense over the long term. The seasonal flu vaccine does not provide protection against influenza C. There are many other non-flu viruses that can result in influenza-like illness (ILI) that spread during flu season to make things more confusing.  Flu vaccine will NOT protect against any of those illnesses either.  Many viruses out there look like the duck, walk like the duck, but yet are not the “influenza” duck. 

After many years in practice, I will confess patients do seem to get sick following influenza vaccination, but none have died.  I have experienced that myself.  My best theory is that while your immune system is distracted by the vaccination, another cold or virus sees its chance and infects you before you know what happened.  I will probably experience some backlash from the medical community on this one, but I do think it is possible.  Be reassured, however, you are not getting Influenza A (H1N1) from the flu vaccination. 

The typical symptoms of influenza are fever (100-104 degrees), cough, runny nose, headache, muscle pain, and fatigue. Complications include viral or bacterial pneumonia, dehydration, ear infections and sinusitis, especially in children. Severe complications are muscle inflammation and destruction (rhabdomyolysis), central nervous system inflammation (encephalitis), and heart problems such as a heart attack or inflammation of the heart (myocarditis) or the sac around it (pericarditis).  I have seen some cases already this year with both Influenza A and B. 

Even if those additional complications are diagnosed, sometimes influenza is like a runaway train and death ensues regardless of proper and timely care due respiratory or cardiac arrest, kidney failure, or hemorrhage due to a coagulation (clotting) problems. This is what makes influenza infection so serious.   

I am not a fan of antiviral flu medications and have never used them.  Most studies show while they are safe, it only shortens symptoms of influenza by 24 hours.  It does not prevent complications or death.  As to the years where the flu vaccination is not a match, basically your child may still get the flu despite vaccination.  Here is where it becomes interesting:  studies have shown your child is far less likely to die from that influenza infection regardless, meaning there is some cross protection. 

My ultimate goal is that your child does not die.  If mine or yours get sick from the flu vaccination or even get influenza despite vaccination, I have never seen them die.   My recommendation is that you consider the influenza vaccine for yourself and your children; or think about your reasons for not doing the vaccination, so you are at peace with your decision.  I am always going to encourage my patients to receive influenza vaccination, I vaccinate my own children against influenza every year, but that choice for your own children is and should be ultimately, up to you. 



  1. It's encouraging to see a licensed pediatrician talking about the need for the flu vaccine. Many people seem to be paranoid about giving their children inoculations of any kind, and yet, as you were kind enough to point out, influenza continues to kill many children every year. My wife, kids and I all get vaccinated every year and have seen a reduction in how often we get sick.

    1. Thank you for your comments. I lost a young patient this year to Influenza A and absolutely will keep recommending vaccination. It is effective at preventing death, (maybe not perfect at preventing disease), but nevertheless has much value. Thank you for vaccinating your family.

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