Tag: flu shot myths

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

How Does a Mother’s Flu Shot Protect a Newborn Baby?

We know that pregnant women are supposed to get a flu vaccine.

Although recommendations on exactly when to get it have changed over the years, it has been a universal recommendation since at least the 1994-95 flu season.

But why?

How Does a Mother’s Flu Shot Protect a Newborn Baby?

One obvious way that a flu shot provides protection during pregnancy is that it reduces your risk of getting the flu while you are pregnant.

A flu shot during your pregnancy protects both you and your baby.
A flu shot during your pregnancy protects both you and your baby.

That’s good, as having the flu while you are pregnant can lead to preterm labor, a premature birth, birth defects, or a miscarriage. And of course, the flu can be life-threatening for pregnant women.

Getting a flu shot while you are pregnant can also help to make sure that you don’t get the flu after your baby is born, which not only keeps you healthy, but decreases the chance that your baby will be exposed to the flu. After all, if you get the flu, no matter how much you try to cover your cough and wash your hands, there is a good chance that you will give it to your baby.

And since babies can’t get flu shots of their own until they are at least six months old, a flu shot during pregnancy helps to make sure that your baby gets some of antibodies to protect them from the flu.

“When you get a flu shot, your body makes antibodies that also pass to your fetus. This means your baby has protection against the flu after birth. This is important because infants less than 6 months of age are too young to get the flu shot.”

Frequently Asked Questions for Patients Concerning Influenza (Flu) Vaccination During Pregnancy

Do you have to wait until late in your pregnancy to make sure that the most antibodies get passed to your baby?

While that might seem like a good idea, especially since that’s what we do for the Tdap vaccine and protection against pertussis, there are several reasons that we don’t do that with the flu vaccine, including that:

  1. pregnant mothers need the protection before flu season hits, so waiting would not be safe and could mean that you get sick with the flu before getting your shot
  2. protection from the flu vaccine shouldn’t wane or wear off so quickly that you need to get it later, after all, the earliest that you can get vaccinated is when flu vaccines first become available in August or September and that should provide good protection past the peak of flu season

When you get your flu shot while pregnant is going to have more to do with when you got pregnant in relation to the start of flu season more than anything else.

“The flu shot can be safely given during any trimester. Pregnant women can get the flu shot at any point during the flu season (typically October through May). Pregnant women should get the shot as soon as possible when it becomes available. If you are pregnant, talk with your obstetrician–gynecologist (ob-gyn) or other health care provider about getting the flu shot.”

Frequently Asked Questions for Patients Concerning Influenza (Flu) Vaccination During Pregnancy

Most importantly, remember that flu shots are considered an “essential component of prenatal care.”

While everyone should get a flu vaccine each year, since pregnant women are in a high risk group for flu complications, you should especially make sure that you get vaccinated and protected if you are pregnant. Everyone around you should get vaccinated too!

More on Flu Shot Protection During Pregnancy

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

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

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

Can Flu Shots Cause the Flu?

Most folks get a flu shot each year.

Most, but not all.

Some people still think that getting a flu shot will cause them to have the flu.
Some people still think that getting a flu shot will cause them to have the flu.

Why do some people skip it?

Can Flu Shots Cause the Flu?

Yes, some people think that getting a flu shot will actually cause them to get the flu.

It’s not hard to see why though.

The flu vaccine is not the most effective vaccine we have, so it is certainly possible that you can still get sick with the flu even though you have had your flu vaccine. Of course, that’s not a good reason to skip getting a flu vaccine, as they have lots of benefits.

Some other reasons you might still think that the flu vaccine can cause the flu include that:

  • side effects after a flu shot can include a soreness, low-grade fever, headache and muscle aches, which some people might confuse with a mild case of the flu
  • many other respiratory viruses can make you sick during cold and flu season, none of which the flu vaccine protects you against
  • since the flu vaccine takes about two weeks to work, if you got sick shortly after being vaccinated, you may have already been exposed and developed the flu before the vaccine became effective

But why can’t the flu shot cause the flu?

That’s easy.

It’s because the flu shot is an inactivated vaccine. The influenza virus is killed or inactivated, the viral particles are purified and split up, with only the HA and NA surface glycoproteins remaining. Those glycoproteins can not cause a natural flu infection.

What about Flumist, the nasal spray flu vaccine?

While Flumist is a live virus vaccine, it is made with attenuated or weakened strains of the flu that are cold-adapted, unable to replicate at the warmer temperatures that are found in the lungs and other areas of our bodies.

So Flumist doesn’t cause the flu either.

Hopefully this is one vaccine myth that folks will stop spreading. Remember, flu vaccines don’t cause you to get sick with the flu. Get vaccinated. Flu vaccines are your best protection against the flu.

What about those folks who say that they are going to skip the flu shot because they never get sick with the flu?

They are gambling.

It is estimated that about 5 to 20% of people get the flu each year. Unless you are rarely around other people during flu season, the chances are that you will eventually get the flu, especially if you are unvaccinated and unprotected.

More on the Myth that Flu Shots Cause the Flu

When Should I Get My Flu Shot?

For most the folks, the real question isn’t if they should get a flu shot, but when.

When Should I Get My Flu Shot?

The original flu shot recommendations  were based on the fact that flu vaccine became available for distribution in September, but was not completed until December or January. And that high-risk folks should get vaccinated “to avoid missed opportunities for vaccination” if flu vaccine was available in September and they were already at a doctor’s appointment or in the hospital.

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)

But for most people, the original recommendation was really that “the optimal time for vaccination efforts is usually during October–November.”

“Persons and institutions planning substantial organized vaccination campaigns (e.g., health departments, occupational health clinics, and community vaccinators) should consider scheduling these events after at least mid-October because the availability of vaccine in any location cannot be ensured consistently in early fall. Scheduling campaigns after mid- October will minimize the need for cancellations because vaccine is unavailable.”

Prevention and Control of Influenza Recommendations of the Advisory Committee on Immunization Practices (2006)

What was the problem with this strategy?

Early flu seasons.

And trying to vaccinate over 100 million people in such a short time.

While it might work fine if flu season doesn’t hit until January or February, waiting until mid-October could leave a lot of folks unvaccinated if you had an early flu season that was peaking in November or December.

Fortunately, we don’t have to rush to get people vaccinated so quickly anymore. For one thing, manufacturers have gotten much better at distributing flu vaccine and are able to get a lot of the doses out at the very beginning of flu season. And with more manufacturers, we are seeing fewer delays and shortages of flu vaccine than we used to.

That’s why the recommendation on the timing of flu vaccination has changed over the years.

“In general, health-care providers should begin offering vaccination soon after vaccine becomes available and if possible by October. To avoid missed opportunities for vaccination, providers should offer vaccination during routine health-care visits or during hospitalizations whenever vaccine is available.”

Prevention and Control of Influenza Recommendations of the Advisory Committee on Immunization Practices (2010)

That nice, simple message has changed yet again though.

To balance the concerns that getting a flu shot too early might leave you unprotected at the end of a late flu season, but getting a flu shot too late might leave you unprotected at the beginning of an early flu season, the latest recommendations from the CDC on the timing of flu vaccination aren’t so clear cut:

  • Balancing considerations regarding the unpredictability of timing of onset of the influenza season and concerns that vaccine-induced immunity might wane over the course of a season, it is recommended that vaccination should be offered by the end of October.
  • Community vaccination programs should balance maximizing likelihood of persistence of vaccine-induced protection through the season with avoiding missed opportunities to vaccinate or vaccinating after onset of influenza circulation occurs.
  • Revaccination later in the season of persons who have already been fully vaccinated is not recommended.
  • Vaccination should continue to be offered as long as influenza viruses are circulating and unexpired vaccine is available.
  • To avoid missed opportunities for vaccination, providers should offer vaccination during routine health care visits and hospitalizations.
  • Optimally, vaccination should occur before onset of influenza activity in the community.
  • Although vaccination by the end of October is recommended, vaccine administered in December or later, even if influenza activity has already begun, is likely to be beneficial in the majority of influenza seasons.

What’s the problem with these recommendations?

If everyone waits until the end of October to get vaccinated, then you might have a hard time getting a flu vaccine. And you might get stuck if you try and time your flu shot with the onset of flu activity. Unless you have a crystal ball, you don’t know when flu season is going to start.

Still, it is important to note that the CDC doesn’t actually say to wait until the end of October. They say to get vaccinated by the end of October. Getting your kids vaccinated as soon as you can is the best way to make sure that happens.

Could getting a flu shot early leave your kids unprotected at the very end of flu season?

Maybe, but that’s typically when flu activity is low. And we have that same type of low flu activity in early October, well before flu season peaks.

So just remember that your child could end up unvaccinated and unprotected if you mistime their flu vaccine.

What to Know About the Best Time to Get a Flu Vaccine

Experts say to get vaccinated by the end of October. Getting your kids vaccinated as soon as you can is the best way to make sure that happens.

More on the Best Time To Get a Flu Vaccine