Tag: flu shot myths

Can I Get a Second Flu Shot for Extra Protection?

If one flu shot is good, wouldn’t two be better?

Can I Get a Second Flu Shot for Extra Protection?

Some people do get a second flu shot.

In fact, all kids eight years and younger, if it is their first time getting a flu vaccine, get two doses of flu vaccine.

How many doses of flu vaccine will your kids need this year?
How many doses of flu vaccine will your kids need this year?

The first dose is a priming dose and the second, at least 28 days later, is a booster dose.

Why do we do it that way?

Because studies have shown that is the best way to do it.

We don’t need to use this same priming/booster strategy in older children and adults though.

But with recent talk that protection against the flu after a flu vaccine might wane before the end of a flu season, some folks are likely wondering if they should just get another flu shot later in the season.

“Revaccination later in the season of persons who have already been fully vaccinated is not recommended.”

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

And the official answer is no, except for younger children getting vaccinated for the first time, you should just get one dose per season.

Why not?

Mostly because a lot of studies haven’t been done to see what effect that second dose will have. And since some studies have even suggested that regular annual flu vaccines could actually lower vaccine effectiveness, you would want to know if getting an extra flu vaccine was safe and effective before we started to do it.

Not surprisingly, someone has looked into this already. One small study, Influenza revaccination of elderly travelers: antibody response to single influenza vaccination and revaccination at 12 weeks, actually showed that a second dose in the same season “did not enhance the immune response.”

So just one flu vaccine per season.

“Prior-season vaccination history was not associated with reduced vaccine effectiveness in children, supporting current recommendations for annual influenza vaccination of children.”

McLean et al on Association of Prior Vaccination With Influenza Vaccine Effectiveness in Children Receiving Live Attenuated or Inactivated Vaccine

But do get a flu vaccine every season.

Again, while there were some reports that an annual flu vaccine could lower vaccine effectiveness, other studies have disproven this.

More on Getting a Second Flu Shot

Did Dr. Bob Uncover a CDC Plot to Give Adult Flu Shots to Babies?

Have you heard the news?

Uh, the ACIP can't request a license for a vaccine...
Uh, the ACIP can’t request a license for a vaccine…

Dr. Bob and his new podcasting side kick think that the “CDC wants the FDA to approve adult doses of the flu vaccine for babies, because the normal half-doses approved for babies don’t work well enough.”

Did Dr. Bob Uncover a CDC Plot to Give Adult Flu Shots to Babies?

This is likely going to surprise Dr. Bob, but many infants already get the same dose of flu vaccine as adults.

Both FluLaval and Fluarix are given at the same 0.5ml dose, containing 15 µg of HA per vaccine virus, to infants, older children, and adults.

Fluzone, on the other hand, is still given at a 0.25ml dose, containing 7.5 µg of HA per vaccine virus, to children between the ages of 6 months to three years, and a larger 0.5ml dose to older kids and adults.

Why the differences?

“In a randomized trial comparing immunogenicity and safety of 0.5 mL FluLaval Quadrivalent with 0.25 mL Fluzone Quadrivalent, safety and reactogenicity were similar between the two vaccines.”

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

Because they are just as safe at the lower doses and might actually work better.

Then why did we ever use a lower dose for infants?

That recommendation was based on the older, whole-virus version of the flu shot, which did cause more side effects for infants when given at a full dose. We now use split-virus flu shots that don’t have this problem.

And now, the manufacturer of Fluzone has done a study, and not surprisingly, they have also found that “safety profile of a 0.5 ml (full-dose) is similar to 0.25 ml (half-dose) and may be more immunogenic.”

So they are submitting a BLA to the FDA for the use of the 0.5ml dose of their flu vaccine for infants.

What about the idea of an “adult dose of mercury” for infants?

Over 80% of flu vaccines were thimerosal free this year. You almost have to go out of your way to get your kids a flu vaccine with thimerosal, so no, this won’t mean an “adult dose of mercury” for your infant.

Most importantly though, if you understand how vaccines work, you know that the dose of vaccines for kids and adults is not calibrated by weight or age, so none of this really matters. The immune reaction that helps antibodies travel all through your body starts locally, near where the vaccine was given, so a 20-pound infant and a 200-pound adult can get the same dose of flu shot and both can be protected.

More on Dr. Bob’s CDC Plot to Give Adult Flu Shots to Babies

Does Getting a Flu Vaccine Increase Your Risk of Spreading the Flu or Getting Others Sick?

Have you heard the latest flu vaccine bombshell from anti-vaccine folks?

Like all other anti-vaccine bombshells, this one is a dud.
Like all other anti-vaccine bombshells, this one is a dud.

They think that they have evidence that flu vaccines spread the flu.

Does Getting a Flu Vaccine Increase Your Risk of Spreading the Flu or Getting Others Sick?

The latest anti-vaccine bombshell comes from Mike Adams, the Health Ranger, and is posted among a bunch of other articles that will have you scratching your head.

Did you know that Amazon’s Alexa is a ‘demon device,’ Apple is banning Christian apps in a war on Christianity, and that CHAOS is coming in the new year?

Not surprisingly, the “latest” anti-vaccine bombshell was a dud, even though it continues to be shared on the majority of anti-vaccine websites and Facebook groups.

What’s the problem?

Anti-vaccine folks are simply misinterpreting a small study, Infectious virus in exhaled breath of symptomatic seasonal influenza cases from a college community, from the Proceedings of the National Academy of Sciences.

Of course, that the study wasn’t a great anti-vaccine bombshell is easy to see if you actually read it.

Although the study did find an association between vaccination and greater fine-aerosol shedding for influenza A infections, if the flu vaccine really increases your risk for spreading the flu, then:

  • why wasn’t getting a flu vaccine associated with coarse-aerosol or nasopharyngeal shedding?
  • why wasn’t the association of vaccination and shedding significant for influenza B infections?

The answer is that because it was a small study, the finding about vaccination and shedding likely wasn’t really significant.

It wasn’t even what they were looking at in the study, which was instead trying to prove that you don’t have to cough and sneeze to spread the flu – simply breathing can spread infectious flu particles.

“Unvaccinated people are more likely to get the flu and transmit it to other people because they shed lots of virus into the nasal secretions into the air.”

Donald K. Milton

And as the authors of the study clarified, folks who aren’t sick because they got vaccinated and didn’t get the flu won’t shed and won’t get anyone else sick.

If anything, the study confirms just how hard it is to avoid folks sick with the flu and why everyone should get a flu vaccine each year.

And how hard it is to avoid anti-vaccine misinformation

After all, anti-vaccine folks could have done a little digging and found that a previous study about influenza virus aerosols, Exposure to Influenza Virus Aerosols During Routine Patient Care, didn’t find a statistically significant difference among folks who got a flu vaccine and how much flu virus they shed (emitters vs non-emitters). In fact, they found that a small percentage of these patients were superemitters, who “exceeded average influenza virus aerosol concentrations by multiple times.”

What’s that mean?

It’s just another reason to get vaccinated and protected. While you don’t want to be exposed to a superemitter and get the flu, you also don’t want to get the flu and become a superemitter, getting lots of other people sick.

More on Does Getting a Flu Vaccine Increase Your Risk of Spreading the Flu or Getting Others Sick?

Flu Season Predictions

No, I can’t see into the future…

I predict that I will continue to get a flu shot each year, at least until they come out with a universal flu vaccine.
I predict that I will continue to get a flu shot each year, at least until they come out with a universal flu vaccine.

But some things are very easy to predict.

Flu Season Predictions

Here are some predictions for this year’s flu season.

  1. We will have a flu season epidemic in the United States this year. Surprised by that prediction? Don’t be. Flu activity reaches epidemic levels each and every year. What we don’t always have are flu pandemics, during which flu activity is very high in multiple parts of the world. By definition, flu season is an epidemic.
  2. Almost all states will eventually report having widespread influenza activity as flu season peaks. Again, this is not a bold prediction. It happens every year. How severe is flu season going to be? No one can really predict that, but we can look at the proportion of people seeing their health care provider for influenza-like illness (ILI) and laboratory-confirmed influenza-associated hospitalization rates as flu season moves along to get some idea. Remember, measures of the geographic spread of the flu don’t really tell you anything about the severity of flu activity.
  3. Dozens of kids will die with the flu – most of them unvaccinated. Remember, 37 kids died in the mildest flu season we had.
  4. A little under half of adults will get a flu vaccine, even though the current recommendation is that everyone who is at least six months old without a true contraindication get vaccinated each year.
  5. A little over half of parents will get their kids a flu vaccine.
  6. Some people who get a flu vaccine will still get the flu. You know the flu vaccine isn’t the most effective, but it still has plenty of other benefits, so even if you did still get the flu, hopefully you got a milder case, weren’t hospitalized, and didn’t die.
  7. Some people who get a flu vaccine and get the flu will blame their flu shot, even though it is well known that the flu shot can’t give you the flu.
  8. Many people who aren’t high risk will be prescribed Tamiflu. Or Xofluza, because it is new.
  9. Tens of thousands of adults will die with the flu. Even in a mild flu season, the flu is very deadly.
  10. Some folks will continue to push the idea that there is a vaginal spermicide in flu shots, even though that anti-vaccine talking point has been refuted a thousand times already.

What else can you predict about flu season?

Some folks will think it is too late to get a flu shot.

It isn’t.

Get your flu shot if you haven’t and get protected for the rest of flu season.

Another bold prediction? Elderberry syrup and Oscillococcinum are not going to help prevent or treat your flu symptoms.

More Flu Season Predictions

Were More Than Half of the Kids with Severe or Fatal Influenza in California Last Year Vaccinated?

We know that the flu is deadly and that most kids who die with the flu aren’t vaccinated.

Would it be news to anyone if Bob Sears was pushing misinformation about pediatric flu deaths in California?
Would it be news to anyone if Bob Sears was pushing misinformation about pediatric flu deaths in California?

That’s likely why some folks might have been surprised when Dr. Bob Sears said that “half of the patients admitted to ICUs for severe or (eventually) fatal cases of influenza last year were vaccinated.”

He seemed to be citing a news report from the California Department of Public Health.

Were More Than Half of the Kids with Severe or Fatal Influenza in California Last Year Vaccinated?

So what did the report from CDPH actually say?

“Influenza vaccination information was available for 455 (47.8%) of the 952 adult cases reported with severe or fatal influenza; 211 (46.4%) received the 2017–2018 influenza vaccine. One hundred twenty (64.2%) of the 187 reported pediatric cases >6 months of age had influenza vaccination information available; 61 (50.8%) received the 2017–2018 influenza vaccine.”

Influenza Surveillance Report 2017–2018 Season

When you do the math, you quickly see that only 61 of 187 kids, or 33% of the pediatric patients were known to be vaccinated.

The numbers are even lower for adults with severe or fatal flu – only 211 of 952 adults, or 22% were known to be vaccinated.

Melissa Floyd does not seem to understand basic epidemiology.
Melissa Floyd does not seem to understand basic epidemiology.

So the majority of kids and adults were either unvaccinated or their vaccination status was unknown. While an unknown vaccinated status doesn’t mean that they weren’t actually vaccinated, it certainly doesn’t mean that they were.

What about the idea that these vaccinated patients would “eventually” turn into fatal cases, as Dr. Bob posted?

Although there were 18 fatal pediatric flu cases in California during the 2017-18 flu season, and that is more than any of us want to see, it should be clear, with 194 non-fatal ICU cases, that most severe cases weren’t eventually fatal.

Hopefully it isn’t a newsflash to anyone that most kids who die with the flu aren’t vaccinated.

More on Flu Deaths in California

Are Flu Deaths Exaggerated?

A lot of people die with the flu each year.

How many? Exactly? That’s hard to know for sure.

We know how many kids die with the flu, because pediatric flu deaths are a nationally reportable condition.

At least we think we know. There were 185 reported pediatric flu deaths during the 2017-18 flu season.

“However, influenza-associated pediatric deaths are likely under-reported as not all children whose death was related to an influenza virus infection may have been tested for influenza. Therefore, we used a mathematical model to estimate the total number of pediatric deaths based on hospitalization rates and the frequency of death in and out of the hospital from death certificates, estimating that there were more than 600 deaths associated with influenza in children.”

Estimated Influenza Illnesses, Medical visits, Hospitalizations, and Deaths in the United States — 2017–2018 influenza season

The true number of pediatric flu deaths was probably far higher than the number that has been reported.

Estimating Flu Deaths

Whether or not flu deaths are a nationally reportable condition, how do we know how many people actually die with the flu each year?

“CDC does not know exactly how many people die from seasonal flu each year.”

Estimating Seasonal Influenza-Associated Deaths in the United States

Instead of counting each and every death, statistical models are used by the CDC and other public health agencies to estimate the number of seasonal flu-related deaths each year.

“For these and other reasons, statistical modeling strategies have been used to estimate seasonal flu-related deaths for many decades. Only counting deaths where influenza was included on a death certificate would be a gross underestimation of seasonal influenza’s true impact.”

Frequently Asked Questions about Estimated Flu Burden

And these statistical models that have been improved and updated over the years. That’s why instead of the general “36,000 flu deaths a year” that we used to see, we get more specific estimates of flu deaths each and every year.

CDC estimates that influenza has resulted in between 9.3 million – 49.0 million illnesses, between 140,000 – 960,000 hospitalizations and between 12,000 – 79,000 deaths annually since 2010.”

Disease Burden of Influenza

Why such a big range in the estimates?

Some flu seasons are worse than others.

The 2017-18 flu season, for example, was especially bad, “with an estimated 48.8 million people getting sick with influenza, 22.7 million people going to a health care provider, 959,000 hospitalizations, and 79,400 deaths from influenza.”

Were there definitely 79,400 deaths?

No, again, that’s an estimate. There were likely somewhere between 69,000 (low range of the estimate) and 99,000 (high range of the estimate) flu deaths.

It’s hardly a guess though, as anti-vaccine folks seem to imply.

The estimates come from analyzing data from the Influenza Hospitalization Surveillance Network (FluSurv-NET), which is made up of 267 acute care hospitals and laboratories in 13 states and has comprises over 27 million people.

Are Flu Deaths Exaggerated?

Not surprisingly, anti-vaccine folks don’t like to hear about deaths from vaccine-preventable diseases. They would much rather exaggerate the risks of vaccine injuries!

Minimizing the risks of vaccine-preventable disease comes straight from the anti-vaccine propaganda playbook.
Minimizing the risks of vaccine-preventable disease comes straight from the anti-vaccine propaganda playbook.

And guess what? None of the folks challenging the CDC’s “influenza math” seem to be epidemiologists or statisticians. They are just folks who want to scare you away from getting a flu shot.

“It takes little subtlety to recognize that the principal reason for flu hyperbole is to sell more vaccines. However, more and more people—even infectious disease specialists—are realizing that flu shots are fraught with problems. Roughly four-fifths of the vaccine injury and death cases settled through the National Vaccine Injury Compensation Program are flu-vaccine-related.”

Robert F. Kennedy, Jr on The CDC’s Influenza Math Doesn’t Add Up: Exaggerating the Death Toll to Sell Flu Shots

Speaking of flu hyperbole, Kennedy doesn’t mention that there have only been about 2,500 flu-vaccine related compensated cases through the National Vaccine Injury Compensation Program since 2006, even though at least 1,372,400,000 doses (yes, that billions!) of flu vaccine have been distributed since that time!

And although Kennedy calls those all “vaccine injury and death cases,” folks should be aware that since 1988, the number of “death cases” is far fewer than 2,500. In fact, there have been 157 filed death cases in the NVICP for the flu vaccine among billions of doses of flu vaccine given. Even then, we don’t actually know how many of those 157 cases were compensated, settled, or dismissed. It’s still a relatively small number though.

Vaccines are safe. The flu, like other vaccine-preventable diseases, is deadly. If you don’t believe the estimates, go visit an ICU during flu season and verify just how deadly the flu can be.

Get a flu vaccine each year and get protected against the flu.

More on Flu Deaths

What Are the Side Effects of the Flu Vaccine?

Like other vaccines, flu vaccines can have side effects.

Fortunately, most of those side effects are mild.

What Are the Side Effects of the Flu Vaccine?

Not surprisingly, a lot of things that get blamed as being caused by flu vaccines are not actually side effects.

Did you actually get the flu in the days or weeks after your flu vaccine?

That’s not a side effect of your flu vaccine. Neither the inactivated flu shot, nor the attenuated FluMist can actually cause a flu infection.

Did you get a little sore at the site where you got your flu shot?

That’s a common side effect to getting a flu shot.

So is having some redness and swelling at the site, all of which begin soon after getting the shot and go away in a few days. You can also get a headache, fever, nausea, and muscle aches or signs and symptoms of an allergic reaction.

Do you have a runny nose or a cough? Side effects of the nasal spray flu vaccine can include a few days of runny nose, wheezing, headache, vomiting, muscle aches, fever, sore throat and cough.

Again, a bad cough and cold after a flu shot isn’t a side effect of the vaccine though.

Remember, correlation does not imply causation.

If you found out you were pregnant shortly after getting a flu shot, you wouldn’t think they were associated, would you?

What about narcolepsy?

“An increased risk of narcolepsy was found following vaccination with Pandemrix, a monovalent 2009 H1N1 influenza vaccine that was used in several European countries during the H1N1 influenza pandemic.”

Narcolepsy Following Pandemrix Influenza Vaccination in Europe

Although the focus has been on the Pandemrix flu vaccine as a trigger for narcolepsy in some countries (the vaccine wasn’t used in the United States), interestingly, several countries that weren’t using the vaccine also saw a spike in narcolepsy cases as the 2009 H1N1 pandemic hit.

Doctors and pharmacies rarely give away flu shots for free. They might not charge a copay sometimes because they are getting paid by your insurance company!
Doctors and pharmacies rarely give away flu shots for free. They might not charge a copay sometimes because they are getting paid by your insurance company!

What about all of the reports of severe reactions and deaths after getting a flu shot that you might hear about? In addition to vaccine injury stories, those reports are to VAERS and typically are not causally related to getting a vaccine.

Why are there so many reports to VAERS and the NVICP about flu vaccines? Since 2006, over 1.6 trillion doses of flu vaccine have been distributed in the United States, which equals about the total of all other vaccines we use.

What Are the Side Effects of This Year’s Flu Shot

Even when folks understand that flu vaccines don’t typically cause serious side effects, the question always comes up whether or not this year’s flu shot is causing more side effects than usual.

That’s actually not unreasonable, even when you consider that the biggest change in most flu vaccines from year to year is the strain of flu viruses they include, and not any of the other ingredients.

In addition to the Pandemrix flu vaccine, in 2010, the use of one brand of flu vaccines in Australia was suspended because they were causing more side effects (fever and febrile seizures) in young children than expected.

“The studies flesh out preliminary findings from CSL in June 2012, which said that the manufacturing process retained more virus component than that of other manufacturers and that the 2010 virus components triggered an excessive immune response in some young kids.”

CSL studies shed light on 2010 flu vaccine seizures

So are there any more side effects this year?

No, there is no evidence of increased side effects from this year’s flu vaccines

More on Flu Vaccine Side Effects