Common Objections to the Flu

Flu season is approaching and it’s the perfect time to get your flu shot. Not only can it protect your health, it can also protect family, friends and co-workers.

Dr. Gennady Gelman, family physician, discusses the benefits of getting a flu shot.
Common Objections to the Flu
Featuring:
Gennady Gelman, MD
Gennady Gelman, MD, is a board-certified Family Medicine Physician and the Director of Medical Informatics for Harrington Physician Services. His practice is located at 128 Main Street, Suite 4 in Sturbridge, MA.
Transcription:

Prakash Chandran (Host): I don’t need a flu shot. Sound familiar? You may have been telling yourself this for years. But you actually might want to reconsider. I’m Prakash Chandran and in this episode of Healthy Takeout, we’ll talk about why you should get the flu shot and some common objections that people have with it. I’m pleased to welcome Dr. Gennady Gelman, a family physician at Harrington HealthCare. Dr. Gelman, pleasure to have you here. So, let’s get started with why is it so important to get a flu shot.

Gennady Gelman, MD (Guest): So, the flu affects a lot of people. I am glad we are doing it now because the numbers just came out recently for last year. There were – we think the flu affected about 20% of Americans so if you look at 350 million people; that’s a huge number. There were 900,000 hospitalizations last year, 80,000 deaths more than that. I think that’s enough argument that kind of covers a lot of your preventable deaths, things you can prevent. Flu is on top of that list, actually smoking is on top of that list and if I could just plug it you should quit smoking as well. So, flu affects a lot of people and it causes death, so you got to protect yourself and protect those around you.

Prakash: Yes, you definitely do. So, let’s talk a little bit about how the flu shot actually works. Because there does seem to be some fear from people about getting it.

Dr. Gelman: So, the flu shot – so essentially what they do is they grow the flu virus and flu virus is and by viruses, they are not a living creature. Things they are just old pieces of RNA or DNA and they use cells whether human cells, whether an eggs or chicken eggs or other methods or other cells to grow the virus. And then what they do is sometimes using heat, sometimes some chemicals like formaldehyde they inactivate the virus and the virus is dead as far as we consider it dead. It’s inactivated. It can’t cause the flu. That’s what goes into the flu shot. They give you the injection with it. Your body recognizes it and says you know what this is something foreign. This is something that I should prepare for because this is something coming into my body. And it creates immunity for it. So, the next time that you actually get the live virus; your body is ready and just suppresses it right away.

Prakash: So, I think the question that a lot of people probably have is because you are injecting them with that virus, even though it may be dead; is it something that is still safe?

Dr. Gelman: Definitely. Flu shots are safe. The way it works is you may get sick and this is a lot of times people – I hear this a lot, oh last time I got a flu shot I got sick. So, there is a lot of kind of – the question becomes this. When you get a flu shot, we are giving you a piece of a virus. You may feel fatigue, you will kind of get a headache, you may even get a low-grade temperature for a day or two. It’s not going to knock you out. It’s not going to make you actually sick. When we are talking about the flu, we are talking about the airways that it goes to your lungs, it goes to your nasal passages, it goes to your throat. You get fevers up to 104, 102. You are actually – you are out – you are missing work, you are missing school, you are not – and if you have other illnesses, if you have like diabetes, COPD, you have heart failure; that can endanger your life at that point. So, when we are talking about yes you are getting something that is going to stress your body, so maybe don’t plan any big activities the next day or two, make sure to stay hydrated and you’ll be fine.

Prakash: Yeah so if the flu shot is so safe, I hear what you are saying regarding that, you know some people think that you actually get the flu from the flu shot, but what you are saying is that while you may feel a little sick; you are not actually getting the flu itself. So, can you maybe dispel some of the myths that you hear about getting the flu shot?

Dr. Gelman: Sure. So, a common one is kind of what you mentioned but you will get sick from it and that’s just not true. And as I said, the other thing about it is that it takes about two to three weeks to get immunity for the flu once you are vaccinated. So, if you are thinking about it a lot of people are waiting and I still see this now I am telling patients – we started giving patients the flu shot already and I tell patients, they say you know I usually get it in November. And I’m like you got to get it now because it takes two to three weeks to get protection. If you get it in the middle of flu season; the reason you might be feeling sick is because you actually have the flu and you got it in flu season.

The other one is as I said already, that it may make you a little bit sick, it’s still a lot better to be protected. Other things I see people will sometimes talk about is they are afraid of needles and they don’t want to get that shot. We use a really small needle. It’s really, I get it, I take a picture every year when I’m getting my flu shot and make sure to smile. It’s fine. If you want other measures we can take we can have you laying down, we can hold your hand, we have staff, we have people to do all those things about it. Sometimes I tell patients just think about how many needles you might need if you do get sick and you get hospitalized.

And then the other one we talk about is – I have really found that patients are still talking about flu shots causing autism or immunizations causing autism in general. That’s unfortunate. It goes back to a study done in the UK by Andrew Wakefield. He did two studies. They both have been redacted and discredited. But that notion is kind of like I don’t know sensational is the word, but it causes a little bit of a rise in people and they still remember that as much as we have been saying that it’s not the case. And those studies included small numbers of people. Studies including hundreds of thousands of kids have proven that it doesn’t cause it. So, it really is safe. We can’t stress that enough and it’s the best thing you can do.

One of the other things that I get feedback from patients is well I’m healthy. You know we talk about those populations that are at risk. We talk about the kids. We talk about the older adults or people with certain illnesses and a lot of people say well I’m healthy. I got the flu last year, okay yeah, I spent a day in bed, but I’m fine. But we have to think about the community immunity. We live in society. We go out in the public and you can be carrying the flu virus. You can be carrying it out to the supermarket, you are carrying it to the movies and there is somebody else who is in those populations who are at risk, who does have that illness and maybe that person has not gotten their flu shot yet this year. And it would be a shame to think that you are causing other people to be hospitalized or possibly even dying because you are spreading that illness.

Prakash: I think it’s really important what you said about not being selfish about it because even if you are healthy, you have to think about the people around you. So, one of the things that you were talking about was the autism study. I was actually going to bring that up with you. And I guess it’s so crazy how long that myth stays around even though the study has been redacted. Right like a lot of people, I have heard some people say that oh you know there’s a risk of the autism coming up, that’s quite common. So, it’s good that you are dispelling that here.

Dr. Gelman: We still hear it. It’s been years and we are still hearing it. Which is why it’s so important that the research that does come out is accurate because once it’s – even if it’s dispelled, that stays with society.

Prakash: Absolutely. So, you were talking about the flu season and even though we talk about it; I don’t think that many of us know when that actually is. So, can you talk a little bit about the time of year when it’s considered flu season and the optimal time to be getting your flu shots?

Dr. Gelman: Sure. So, flu season is when the temperatures are around 45 degrees or below on a regular basis. And that’s when the flu virus becomes more stable. So, most – in most areas, so we are in New England, it’s starting late October early November and it goes all the way through March and April. And obviously, in the – this is always a fun fact to mention is in the southern hemisphere, flu season is reversed because their winter is when our summer is. So, there is no one world flu season. This is based on where you are, where your seasons are, what your temperatures are. As I mentioned before, it takes about two to three weeks to get immunity. You really want to start two to three weeks before that. We have started our flu campaign here at Harrington already. We started October 1st essentially. We have been recommending since September. So, you want to get it now so when flu does come in, when that cold comes in; you are protected. So, get your shots now, flu season starts in about a month is the short of that.

Prakash: And let’s talk about its effectiveness because I imagine year after year technology and innovation is only improving within the flu shot space. Can you talk a little bit about how the shot has improved over time?

Dr. Gelman: So, the shot has actually – one of the ways we do the shot is the way we get it through chicken eggs has really not changed in 70 years. We do have new ways – we are using like - one of the brands through Flu Cell Vac uses cells and that started around 2011- 2012. So, the way we make vaccines hasn’t changed that much. But it is what we put in them. And as I mentioned, that the southern hemisphere has their flu when it’s our summer so there are world health organization centers all over the world watching the strains of flu that are happening either in – wherever they are, they are locating them, they are testing them and saying this is what’s going on. Because there are so many different variations and strains of flu. The trick is predicting the right one for the season that we are coming up. So, what they do, or the CDC does, and the World Health Organization does is they look at what’s going on in the world right until pretty much until August and then they say this is what the strains of the flu are. This is what we need to make for the vaccine. That’s why they don’t have the vaccine in July because we don’t know what needs to be- what we are protecting against. So, if we get the strains correctly, we have pretty good protection. The problem is, a lot of the years; the flu keeps on mutating, it changes. We are a very global society right now. People are brining in the flu – different strains from all over the world. We can’t predict it. So, we can give you the vaccine and then you will have epidemics and the case may be pandemic; but vaccines do work and if we think about this is the 2018 in 100 years since the 1918 pandemic of the Spanish flu. At that time, we think we estimated 500 million people were infected, 50 million people died, and we have to also put that into perspective that the world was 1.5 billion people total, so a third of the world was infected. Today, even though when we were talking about the number earlier and I said 900,000 people were hospitalized in the US last year, 80,000 deaths, that number is significantly as far as you looking for proportions and percentages, that number is significantly reduced. And we even see when there was a pandemic in the 1960s at that point, about two million people died worldwide. So, vaccines started – we started covering for flu – we are seeing the numbers go down from 50 million to one million to two million to one million and now we are in the thousands. It’s still – we still want those numbers to be down so much more, 80,000 is not an acceptable number, but it is so much better than 50 million.

Prakash: Yeah, it’s very clear that something is working because we see those numbers go down year after year. So, I just wanted to ask is there anyone that should not get the flu shot? Like for example does age restriction come into play, pregnancy come into play. Talk a little bit about that.

Dr. Gelman: So, the flu shot is recommended for pretty much everybody over six months. So, if you want to talk about age, it’s six months and older, you should get the flu shot. Some people who shouldn’t get it are if you have an egg allergy, although there are vaccines that are egg free, so you can’t get every shot, but you can get some. Some people who can’t get it are if they have previous reactions to previous immunizations for the flu. Those people should not be getting it. Everybody else should be. Pregnancy is even more important to get it because we think some of the antibodies will pass on to the baby so because the baby as we said can’t get it in the first six months. If you are going to be delivering during flu season, this is one way of protecting your baby. The other thing is that you have a newborn and you are protected as well so you are not like we were talking about the community immunity; we are talking about a small community the two of you and the mom doesn’t pass it on to the baby as well. So definitely in pregnancy. We have different types of vaccines that we give by ages to adults to those 65 and over to pregnant women, but as long as - your doctor will give you the right one. You don’t need to worry about that. You just say I want the flu shot and we will figure it out.

Prakash: So, Dr. Gelman just to wrap up here, where can people actually get their flu shots and how much does it cost?

Dr. Gelman: So, if you have health insurance and you are coming to any of the Harrington sites, it’s free. It’s covered at 100%. You can go to most retail pharmacies and you can get it there as well and depending on your insurance, it’s either covered 100%, sometimes there’s a small copay but a lot of the pharmacies are doing things where they give you a coupon to kind of compensate for that. So, in the end it costs you nothing. We are hosting two flu clinics one on October 13th from 8 a.m. to 12 p.m. on 100th South Street at suite 108 and then we are also hosting one October 20th at 10 North Main Street in Charlton also from 8 a.m. to 12 p.m. Those are only open to current Harrington Physician Services patients, but they are walk-ins, they are Saturdays and you can just walk in and get it done.

Prakash: Okay everyone, so there is really no excuse. Go out and get your flu shots not only for yourself but for your community. And it sounds like even the small amount of sickness that you experience is going to be much better than if you actually got the flu. So, I think it’s really important and very valuable information that you shared with us today Dr. Gelman. I really appreciate your time. For more information please visit www.harringtonhospital.org, that’s www.harringtonhospital.org. Out guest today has been Dr. Gennady Gelman, and this is Healthy Take Out from Harrington HealthCare. I’m Prakash Chandran. Thank you so much for your time.