Tag: flu myths

I’m Not Anti-Vaccine, I Just Don’t Believe in Flu Shots

Do you know any of these folks?

“I’m not anti-vaccine, I just don’t believe in flu shots.”

They likely get all other available vaccines for themselves and their kids, but for some reason, they skip the flu shot each year.

I’m Not Anti-Vaccine, I Just Don’t Believe in Flu Shots

Are they just anti-flu vaccine? Is that a thing?

Gloria Copeland told her followers that they didn’t need flu vaccinations because Jesus already “redeemed us from the curse of the flu.”
Gloria Copeland told her followers that they didn’t need flu vaccinations because Jesus already “redeemed us from the curse of the flu.”

Why don’t they “believe” in flu shots?

Typical answers you might get, if you ask, include:

  • I never get the flu – since about 5 to 20% of people get the flu each year, it is certainly possible that you never get the flu, especially if you aren’t around many other people that could spread the flu virus to you. But unless you live and work in a bubble, there is a good chance that you will eventually be exposed to someone with the flu, might catch the flu yourself, and will spread it to someone else.
  • I only get sick when I get a flu shot flu shots are inactivated and can’t actually give you the flu. Even the live virus nasal mist flu vaccine won’t cause you to have the flu. While flu vaccines can cause mild flu side effects, if you get sick after after a flu shot, it could be that you have another respiratory virus, your flu vaccine didn’t have time to work, or that it wasn’t effective.
  • I don’t need a flu shotyou do, if you want to reduce  your chances of getting the flu and having serious complications from a flu infection, which can affect anyone.
  • I got a flu shot last year – you need a flu vaccine each year
  • Flu vaccines don’t work – flu vaccines aren’t perfect, but they can reduce your risk of catching the flu and avoiding serious complications, even if you do get sick.
  • Flu shots are too expensive – most insurance plans cover the costs of flu vaccines, but  if you don’t have insurance, it is sometimes possible to find free flu shots at a local health clinic, or you could get a flu shot for $24 at Walmart with a GoodRx coupon.
  • I don’t have time to get a flu shot – do you have time to get sick with the flu? Many doctors now offer regular flu clinics that make it convenient to just come in and get a flu vaccine or if that isn’t possible, you can likely get a flu vaccine at a nearby pharmacy.
  • Someone on the Internet told me to never get a flu shot because they are poison – if you are avoiding a flu vaccine because you are worried about thimerosal, miscarriages, that they contain a vaginal spermicide, or other misinformation, then you likely aren’t just anti-flu vaccine…
  • Gloria Copeland told me I didn’t need one – Jesus didn’t give us a flu shot and doesn’t want you to die with the flu, or measles.

Stop making excuses, none of which hold water.

Get your flu vaccine, preferably before flu season starts and you start seeing flu activity in your area.

More on Being Anti-Flu Vaccine

Is the La Leche League Anti-Vaccine?

Why would anyone think that the La Leche League, an organization who’s mission is to support breastfeeding, might be against vaccines?

“Many parents have questions about the compatibility of vaccines and breastfeeding. Your healthcare provider can address any questions that come up for you.”

la leche league international on Vaccines

They certainly don’t make any strong statements supporting vaccines…

“The LLLI Health Advisory Council suggests families discuss the pros and cons of influenza vaccines with their health care practitioners.”

la leche league international on Influenza

The cons of influenza vaccines?

What are those exactly? That the protection babies get from their mother’s pregnancy flu shot doesn’t last until they go to college?

What’s the greatest evidence that they might not support vaccines? I mean, besides anti-vaccine La Leache League leaders who actively say that they are against vaccines?

Bob Sears is giving two lectures  on vaccines at an upcoming La Leche League breastfeeding conference.
What exactly will Bob Sears be talking about during his two lectures on vaccines at this upcoming La Leche League breastfeeding conference?

Bob Sears is giving two lectures on vaccines at an upcoming La Leche League breastfeeding conference.

Will he really discuss the benefits of vaccines for pregnant and post-partum mothers and their families?

“Dr. Bob Sears, a renowned Dana Point pediatrician who has been sought out by parents who wish to opt out of the state’s mandatory vaccine requirements, has been placed on probation for 35 months by the Medical Board of California.”

Dr. Bob Sears, renowned vaccine skeptic, placed on probation for exempting child from all vaccinations

And considering that he nearly lost his medical license over giving an improper vaccine exemption, what can we really expect from his talk on California’s vaccine law?

“Remember that La Leche League is exclusively focused on breastfeeding support and has no stance on vaccinations.”

La Leche League USA

No stance on vaccinations?

Actually, with bringing Dr. Bob to their conference, it seems like they made a very clear stance…

“Nursing also allows your baby to give germs to you so that your immune system can respond and can synthesize antibodies! This means that if your baby has come in contact with something which you have not, (s)he will pass these germs to you at the next nursing; during that feeding, your body will start to manufacture antibodies for that particular germ. By the time the next feeding arrives, your entire immune system will be working to provide immunities for you and your baby. If you are exposed to any bacteria or viruses, your body will be making antibodies against them and these will be in your milk.”

Can Breastfeeding Prevent Illnesses?

And they have also done a good job of making it sound like breastfeeding infants don’t need vaccines.

They do!

While breastfeeding is great, it is not a substitute for getting vaccinated. In fact, antibodies in breast milk will not protect a baby against most vaccine-preventable diseases.

If the La Leche League truly wants to support what’s best for kids, they should move away from pushing non-evidence based therapies, especially craniosacral therapy and referrals to chiropractors for breastfeeding problems, and they should take a stand supporting vaccines.

The La Leche League is on this list of other organizations that speak out against vaccines.
The La Leche League is on this list of other organizations that speak out against vaccines.

Then maybe they wouldn’t appear on any lists from the NVIC.

More on Vaccines and the La Leche League

Three Reasons to Skip a Flu Shot This Year

We sometimes hear that folks are going to skip their yearly flu vaccine because they don’t believe in flu shots, they never get sick, or they think that flu shots don’t work or are dangerous.

Some nurses and doctors are refusing to get a flu shot and have to wear masks at work.
Some nurses and doctors are refusing to get a flu shot and have to wear masks at work.

Of course, none of those are good reasons.

Three Reasons to Skip a Flu Shot This Year

Flu vaccines are safe and have many benefits, even if they aren’t any where near 100% effective.

So are there any legitimate reasons to skip a flu shot?

Of course.

In fact, three very good reasons to skip a flu shot include:

  1. being younger than 6 months of age
  2. having a severe allergic reaction (e.g., anaphylaxis) after a previous dose of flu vaccine or to any component of the flu vaccine
  3. and, uh…

Actually, although folks might have many of bad excuses, there are only two good reasons to skip a flu shot…

So, infants who aren’t old enough to be vaccinated yet, and anyone who has had a life-threatening reaction to a previous dose.

Additional precautions, but not true contraindications, do including having had Guillain-Barré syndrome <6 weeks after a previous dose of influenza vaccine and having a moderate or severe acute illness with or without fever when you are planning to get vaccinated.

What about egg allergies?

Even if you have had a severe reaction to eggs, you can still get a flu shot. Just get it get it in an inpatient or outpatient medical setting (such as a hospital, clinic, health department, or physician’s office), so that you can be supervised by a health care provider who is able to recognize and manage severe allergic reactions.

Bad Reasons to Skip a Flu Shot

Are you scared of shots? Flumist is back.

Are you skipping the flu shot because you never get sick? How lucky do you feel this year? Don’t continue to gamble that you won’t get the flu. Increase your chances of staying well by getting a flu shot, the best way to avoid the flu.

There aren’t any natural alternatives that work better, no matter how hard you want to believe that going to a chiropractor, using essential oils, or homeopathic remedies might be helpful.

The flu vaccine doesn’t weaken your immune system.

There are no hidden or harmful ingredients in flu vaccines.

The flu vaccine is not going to give you the flu.

And the flu is definitely not a mild disease! There were 176 pediatric flu deaths last flu season, and as in most years, most were unvaccinated.

Don’t wait. Get your flu shot.

More on Flu Vaccine Contraindications

Why Do You Need to Get a Flu Vaccine Each Year?

A yearly flu vaccine is the best way to protect yourself and your family against the flu.

But why do you need to get a flu vaccine each and every year?

Why Do You Need to Get a Flu Vaccine Each Year?

Hopefully we will one day have a universal flu vaccine that covers all flu strains and offers longer lasting protection.

Most folks know we don’t have that flu vaccine yet…

“A flu vaccine is needed every season for two reasons. First, the body’s immune response from vaccination declines over time, so an annual vaccine is needed for optimal protection. Second, because flu viruses are constantly changing, the formulation of the flu vaccine is reviewed each year and updated as needed to keep up with changing flu viruses. For the best protection, everyone 6 months and older should get vaccinated annually.”

CDC on Key Facts About Seasonal Flu Vaccine

So because the protection from the flu vaccine wanes or wears off relatively quickly, even if the flu vaccine strains don’t change from one year to the next, you should get a new flu vaccine.

How long does the protection from the flu vaccine last?

“An analysis from the 2011–12 through 2013–14 seasons noted protection ranging from 54% to 67% during days 0 through 180 postvaccination.”

Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 Influenza Season

The flu vaccines takes about two weeks to become effective and should then last for at least six months – long enough to get  you through the average flu season.

“A number of observational studies and a post hoc analysis from a randomized controlled trial have reported decreases in vaccine effectiveness (VE) within a single influenza season, with increasing time postvaccination. Waning effects have not been observed consistently across age groups, virus subtypes, and seasons; and observed declines in protection could be at least in part attributable to bias, unmeasured confounding, or the late season emergence of antigenic drift variants that are less well-matched to the vaccine strain. Some studies suggest this occurs to a greater degree with A(H3N2) viruses than with A(H1N1) or B viruses . This effect might also vary with recipient age; in some studies waning was more pronounced among older adults and younger children. Rates of decline in VE have also varied.”

Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 Influenza Season

That means it should last past the peak of the average flu season, which is typically between December and March.

And in most young, healthy people, the protection likely lasts even longer.

Make sure you are vaccinated well before flu season starts.
Make sure you are vaccinated well before flu season peaks, which since 1982 has occurred as early as October and as late as March, but is most common in February.

Still, there is some concern that the protection from the flu vaccine can wear off during a flu season, especially if you are very young, very old, or have chronic medical problems, and you get your flu vaccine early and you get exposed late – in April or May.

Of course, that’s not a good reason to delay getting a flu vaccine though, as waiting too long might leave you unprotected if flu peaks early, in October or November.

What to Know About Why You Need the Flu Vaccine Every Year

Since the flu vaccine strains can change and protection doesn’t last from season to season, get a flu vaccine each year. It’s the best way to protect yourself and your family against the flu.

More on Why You Need the Flu Vaccine Every Year

Do They Really Just Guess at Which Strain to Put in the Flu Vaccine?

Every year we hear experts telling us to get vaccinated against the flu.

And more often than not, we hear critics telling us that the flu vaccine isn’t going to work that well because it isn’t a good match.

Is that because they just guess at which flu strains to put into the flu vaccine each year, as some folks say?

Do They Really Just Guess at Which Strain to Put in the Flu Vaccine?

Of course they don’t guess at which vaccine strain to put in the flu vaccine!

“Flu viruses are constantly changing, so the vaccine composition is reviewed each year and updated as needed based on which influenza viruses are making people sick, the extent to which those viruses are spreading, and how well the previous season’s vaccine protects against those viruses.”

CDC on Selecting Viruses for the Seasonal Influenza Vaccine

There are over 100 flu centers in over 100 countries that are involved in testing thousands of flu virus samples each year. Representative samples from these centers then go to the five major World Health Organization (WHO) Collaborating Centers for Reference and Research on Influenza.

The directors of these centers review these samples and other available information and make a recommendation on which vaccine strains to include in the flu vaccine for the next flu season. Each country then considers this recommendation and decides which flu strains to include in their flu vaccine.

“The influenza viruses in the seasonal flu vaccine are selected each year based on surveillance data indicating which viruses are circulating and forecasts about which viruses are the most likely to circulate during the coming season.”

CDC on Selecting Viruses for the Seasonal Influenza Vaccine

Although they don’t have a crystal ball and so can’t know exactly which flu strains will be making us sick each flu season, it is hardly a wild guess.

How often are they right?

“During seasons when most circulating influenza viruses are closely related to the viruses in the influenza vaccine, the vaccine effectiveness estimate has ranged from 50-60% among the overall population.”

WHO on Vaccine effectiveness estimates for seasonal influenza vaccines

Actually, they are right in most years! So if it is a guess, than the folks who choose which strains to include in the flu vaccine are very good guessers!

Except for a few years when their was a poor match, the flu season is typically between 37 to 60% effective.
Except for a few years when their was a poor match, the flu season is typically between 37 to 60% effective.

There have actually only been a few times in recent years when we have had mismatched flu strains. And in one of those years, they picked the right strain, but then the strain changed or drifted before the start of flu season.

“One hundred fifty-six (22%) of the 709 influenza A(H3N2) isolates were characterized as antigenically similar to A/Wyoming/3/2003, which is the A/Fujian/411/2002-like (H3N2) component of the 2004-05 influenza vaccine, and 553 (78%) were characterized as A/California/7/2004-like.”

2004-05 U.S. Influenza Season Summary

Not surprisingly, flu vaccine effectiveness goes way down during a mismatch year. During the 2004-05 flu season, for example, the overall vaccine effectiveness of the flu vaccine was just 10%.

Of course, in most years, flu vaccine is typically much more effective than that.

How effective will flu vaccines be this season?

Will this year’s flu vaccine be a good match?

We won’t know until flu season is well under way, not that you should wait for an answer to get your flu vaccine. The benefits of the flu vaccine extend beyond preventing the flu, so it is a good idea to get vaccinated even in a year when there might not be a good match.

More on Selecting Flu Vaccine Strains

Can You Really Get a Flu Shot If You Are Allergic to Eggs?

Are you still worried about your child’s egg allergy and getting them a flu vaccine?

Everyone needs a flu shot. When will you get yours?
Everyone needs a flu shot. Even kids with egg allergies. Photo by Gabriel Saldana (CC BY-SA 2.0)

That’s not surprising, as we once warned people about residual egg proteins in flu vaccines and the possibility of immediate hypersensitivity reactions in those with severe egg allergies.

Flu Vaccines and Egg Allergies

Of course, that advice has now changed, even though most flu vaccines are still prepared in chicken eggs.

“Recent studies have shown that even individuals with confirmed egg allergy can safely receive the flu vaccine. The Joint Task Force on Practice Parameters of the American Academy of Allergy Asthma and Immunology and the American College of Allergy Asthma and Immunology as well as the American Academy of Pediatrics state that no special precautions are required for the administration of influenza vaccine to egg-allergic patients no matter how severe the egg allergy.”

Egg Allergy and the Flu Vaccine

In fact, it began to change in 2011, when we got the recommendation that it was okay to give flu shots to people with egg allergies, if they only get hives as their reaction. It was still recommended that those with more severe allergic reactions to eggs “be referred to a physician with expertise in the management of allergic conditions for further risk assessment before receipt of vaccine.”

Before that, we would sometimes do skin testing on high risk egg allergic kids, desensitization, or regular chemoprophylaxis.

In 2013, the recommendation changed so that those with severe allergic reactions to eggs should get their flu shot “by a physician with experience in the recognition and management of severe allergic conditions.”

The recommendations were again modified in 2016, removing the recommendation that egg-allergic flu vaccine recipients be observed for 30 minutes and that those with severe egg allergies “should be vaccinated in an inpatient or outpatient medical setting (including but not necessarily limited to hospitals, clinics, health departments, and physician offices), under the supervision of a health care provider who is able to recognize and manage severe allergic conditions.”

Why the changing advice?

It’s because severe allergic reactions to vaccine are rare (in a million doses rare). And even in the flu vaccines that still use eggs, almost all of the egg protein is removed from the final vaccine. So that residual amount of egg protein is unlikely to trigger an allergic reaction. And that’s what we saw as the recommendations were slowly changed year after year.

Getting a Flu Shot When You Are Allergic to Eggs

And that’s why we have our current recommendations:

  • Those with a history of egg allergy who only get hives can get any age-appropriate flu vaccine.
  • Those with a history of egg allergy who have severe reactions, including angioedema, respiratory distress, lightheadedness, recurrent emesis, or who required epinephrine or another emergency medical interventions, can still get any age-appropriate flu vaccine, but they should get it in an inpatient or outpatient medical setting (such as a hospital, clinic, health department, or physician’s office). And the vaccine administration should be supervised by a health care provider who is able to recognize and manage severe allergic reactions.
  • Those who can eat eggs without reaction can get any age-appropriate flu vaccine.

Do you still have to be observed after getting your flu vaccine if you have an egg allergy?

No postvaccination observation period is recommended specifically for egg-allergic persons.

Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 Influenza Season

Nope. But that’s likely because although they are rare, reactions might not occur right away.

So yes, you can and you should get a flu vaccine if you are allergic to eggs.

More on Flu Vaccines and Egg Allergies

 

Which Flu Vaccine Should You Get?

After decades with a single type of flu vaccine – the flu shot – there are now many different kinds of flu vaccines that many of us can choose from. And your choices are not just between the nasal spray flu vaccine vs a flu shot. There are also a lot of different kinds of flu shots available now.

Everyone needs a flu shot. When will you get yours?
Everyone needs a flu shot. When will you get yours? Photo by Gabriel Saldana (CC BY-SA 2.0)

Having choices is nice.

It would be also be nice to have a little more guidance on what to do with these choices.

Are any of the flu vaccines better than others?

Which Flu Vaccine Should You Get?

This year, we will have:

  • quadrivalent flu shots – Afluria, Fluarix, FluLaval, Fluzone, Fluzone Pediatric Dose
  • quadrivalent flu shots that are cell-culture based – Flucelvax
  • quadrivalent flu shots that can be given intradermally – Fluzone Intradermal
  • trivalent flu shots – Afluria
  • trivalent flu shots that are adjuvanted – Fluad
  • high dose trivalent flu shots – Fluzone High-Dose
  • quadrivalent flu shots that are made with recombinant technology – Flublok
  • nasal spray flu vaccine – Flumist

Which one should you get?

It is actually easy to start by asking which one you should get for your kids, as many of these flu vaccine options are only available for adults and seniors.

Flu Vaccine Options

Before you start thinking too long and hard about potential options, keep in mind that you might not have as many options as you think.

“Not all products are likely to be uniformly available in any practice setting or locality. Vaccination should not be delayed in order to obtain a specific product when an appropriate one is already available.”

Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 Influenza Season

Doctors and clinics might not stock multiple brands or types of flu vaccines, so you might have to get whatever flu vaccine that they have available.

“Within these guidelines and approved indications, where more than one type of vaccine is appropriate and available, no preferential recommendation is made for use of any influenza vaccine product over another.”

Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 Influenza Season

And that’s okay. In most cases, there haven’t been head to head studies showing that one flu vaccine is better than another.

Flu Vaccine Options for Kids

Still, since these options might be available to you, it is good to know about them.

This year, younger kids, between the ages of 6 months and 3 years, can either get:

  • FluLaval Quadrilvalent
  • Fluarix Quadrivalent
  • Fluzone Quadrivalent Pediatric

While you are unlikely to notice a difference, both FluLaval and Fluarix are given at a 0.5ml dose containing 15 µg of HA per vaccine virus, while Fluzone is given at a 0.25ml dose containing 7.5 µg of HA per vaccine virus. Why the difference? “Safety and reactogenicity were similar between the two vaccines,” even at the different doses.

Basically, these are just different brands of the same type of flu shot.

There are even more options as your kids get older though, including  Fluzone Quadrivalent (age three and above), Afluria Quadrivalent or Trivalent (age five and above), Flucelvax Quadrivalent (age four and above), FluLaval and Fluarix.

Of these, some folks wonder if Flucelvax, since it isn’t made in chicken eggs, might be more effective than the others. Remember, one of the things that are thought to make the flu vaccine less effective than most other vaccines is that they are made in eggs, leading to mutations. And there is actually some evidence that those flu vaccines that are not made in eggs might be more effective.

“And the University of Pittsburgh Medical Center is taking that a step further, saying it will only be buying the two egg-free vaccines on the market: Flucelvax and FluBlok. That’s because there is some evidence these two formulations may work better than the older vaccines grown in eggs, said Dr. Richard Zimmerman, who advises the UPMC Influenza Committee.”

Guidance on which flu vaccine to get: Shots for kids, maybe go egg-free

Again, remember that the CDC has made “no preferential recommendation” for one flu vaccine over another. Why not? We don’t have enough information to make that kind of recommendation.

Should parents only ask for Flucelvax? That would only work if they made enough doses for every kid to get vaccinated, which they didn’t. Should you hold out until you can find FluceIvax for your kids? No, since doing that might leave them unvaccinated once flu season hits.

What else should you know about your flu vaccine options? While over 80% of flu vaccines are now thimerosal free, most of these flu vaccines are still available in multi-dose vials with thimerosal.

Also thimerosal free, this year, Flumist is back as an option. It is available for healthy kids who are at least two years old. Although the AAP has issued a preference for flu shots this year, the ACIP says that kids can get either Flumist or a flu shot.

What about if your kids are allergic to eggs?

“Persons who report having had reactions to egg involving symptoms other than urticaria (hives), such as angioedema, respiratory distress, lightheadedness, or recurrent emesis; or who required epinephrine or another emergency medical intervention, may similarly receive any licensed, recommended, and age-appropriate influenza vaccine (i.e., any IIV, RIV4, or LAIV4) that is otherwise appropriate for their health status.”

Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 Influenza Season

Unless they had a severe allergic reaction to a previous flu vaccine, they can get any available flu vaccine, especially if the previous reaction was only hives or they are able to eat eggs.

What if you want a flu vaccine without aluminum? Take your pick. While it would be safe it was, aluminum is not an ingredient in flu vaccines.

Flu Vaccine Options for Adults

In addition to all of the flu vaccines available for older kids, adults have a few more options:

  • Afluria Quadrivalent or Trivalent can be given by jet injector  to those between the ages of 18 and 64 years
  • Flublok Quadrivalent – a recombinant flu shot that can be given to those who are at least 18 years old
  • Fluzone High-Dose – a trivalent flu shot with a higher dose of flu virus antigens (4 times the amount of antigen as a regular flu shot) that is available for seniors who are at least 65 years old
  • Fluad – a trivalent flu shot with an adjuvant that is available for seniors who are at least 65 years old

Why get a flu vaccine with a jet injector instead of a standard needle? High-pressure jet injectors don’t use needles!

Like FluceIvax, Flublok is not made in chicken eggs. The recombinant hemagglutinin(HA) proteins are made in insect cell lines. Does Flublok work better than egg based flu vaccines? That’s the theory, but again, there is no preference for one of these vaccines over another.

Seniors have even more choices.

Should they get Fluzone High-Dose, Fluad, or one of the other flu vaccines? Both have been shown to be more effective than standard flu vaccines in seniors, but they have not been compared against each other.

“In a Canadian observational study of 282 people aged 65 years and older conducted during the 2011-12 season, Fluad was 63% more effective than regular-dose unadjuvanted flu shots.”

CDC on People 65 Years and Older & Influenza

But neither Fluzone High-Dose nor Fluad are quadrivalent, so only protect against three flu virus strains.

Is there a quadrivalent flu shot for older adults that might work better than standard flu shots?

Yes. FluceIvax and Flublok are non-egg based quadrivalent flu shots that might be more effective than standard flu vaccines.

So are you more confused now that you know you have so many options? Just remember that for most people, the mistake isn’t about choosing the right flu vaccine, it is about not getting vaccinated.

What to Know About Your Flu Vaccine Options

While it might seem like you have a lot more options in a flu vaccine this year and that some might be more effective than others, keep in mind that availability will likely greatly limit these “options.”

And the best flu vaccine is the one that you actually get, as it will be the one that reduces your risk of getting the flu. Missing your chance to get vaccinated and protected because you are waiting for a specific brand or type of flu vaccine isn’t going to help keep the flu away.

More on Your Flu Vaccine Options