Joey Wahler (Host): It prevents millions of influenza cases each year in the United States and reduces hospitalizations from related complications. So, we're discussing the importance of a flu vaccination. Our guest, Dr. James Snow. He's an Urgent Care Physician at St. Simon's Immediate Care Center and Medical Director of Team Health for Southeast Georgia Health System.

 This is Health Matters from Southeast Georgia Health System. Thanks for joining us. I'm Joey Wahler. And hi there, Dr. Snow. Thanks for being with us.

James Snow, DO: Hi to you, and thanks for having me.

Host: Oh, great to have you aboard. So first, just curious about a little quick background as we get started. What initially piqued your interest in a medical career and particularly the kind of medicine that you're involved in?

James Snow, DO: I came from a background of medical people. My mother was a nurse, and I had other relatives and friends that were physicians. I had an interest in medicine through high school and in college. After I went to medical school, I developed an interest in emergency medicine and family practice, and did both for many years, and for the last 26 years I've been in urgent care medicine.

Host: So it sounds like you knew very early on, largely because of your family, that this was what you wanted to do. Yeah?

James Snow, DO: Oh yes, definitely.

Host: You had family involved in the medical profession which motivated you to follow suit. Any advice you were given back then as a young person that you think still stays with you today in terms of being a doctor?

James Snow, DO: Yes, my family always was interested in helping others, and that was, that's a cliche, but, it really is pertinent. I always was interested in some trauma, in exploring new treatments for illnesses, and my curiosity led me into medicine, I believe. I'm very happy with my decision. For years I was in family practice as well as emergency medicine and got a good background in both. I spent two years as a Navy physician back in the late 60s and early 70s, and that was a good experience as well.

Host: What was that like? What were you, what would you say your main takeaway from being a military physician was?

James Snow, DO: Those who have served in the military would understand, but it's a special world. I was stationed at Paris Island. I was a Navy physician attached to the Marine Corps and was there from 1969 to 1971 just about the height of the Vietnam war. We had a lot of recruits coming through with a lot of illnesses. And it was, uh, an experience that helped me grow up since I was in my mid to late twenties at the time.

Host: But I would imagine you look back and you feel fortunate that you were able to go through something like that, yes?

James Snow, DO: Yes, it was a good experience. And I was young enough to be able to take it good exposure.

Joey Wahler (Host): So, what exactly constitutes the flu and what are its common symptoms?

James Snow, DO: The flu is a viral illness caused by two types of virus, A and B, which give essentially the same symptoms. It's a disease that starts about mainly nasal passages. And the throat, you get a sore throat, progresses to maybe cough, sinus, headache, some nausea. It's, it is contagious about a day before the symptoms start until about five or seven days afterwards. And the two types of flu, A and B, give essentially the same symptoms. The two viruses are different only because of the types of virus they are. Type A has several substrains, whereas type B does not, but the effects are similar.

Host: So who should get a flu vaccine and what's the best time of year to do so?

James Snow, DO: Everyone aged six months on up through a hundred should get a flu vaccine. There are some that shouldn't, but we could get into that later, but basically, almost everyone can be covered with the flu vaccine, except those that might be sick or allergic to the vaccine. Now, the nasal spray has some limitations. It can only be given age 2 to 49 and can't be given to pregnant women and certain other people with conditions such as asthma, Guillain Barre syndrome, certain other conditions, but the flu vaccine can be given to just about anyone.

Host: And when's the best time to get it?

James Snow, DO: Usually in the early fall, September through February, which is the flu season, they're the earliest time that it's best. Some places have it as early as August. The latest strain has four variants and the vaccine has the four variants covered, so we should start getting it very soon.

Host: Let's say, Doc, you want to be on the safe side and get it early as possible in August, as you mentioned. Will it still be as effective as fall turns to winter in the height of flu season?

James Snow, DO: Yes, it'll be the same vaccine through this season and does last. The immunization from the vaccine will wane over time, but it should last the full flu season.

Host: Gotcha. So what groups are at higher risk for flu complications where things can spiral into other issues?

James Snow, DO: Those that have chronic illnesses, those over 65, those with diabetes, kidney disease, asthma, heart disease, chronic pulmonary disease. Young children under the age of 12 seem to get it worse. Those that are most susceptible are, of course, people that work with other patients in the hospital, like hospital workers. Those in military barracks in the military. Also, nursing home workers. They're at high risk. Anybody in health care, and anyone that's involved with a large number of crowds, they're at high risk also.

Host: Now, you touched on this briefly a moment or two ago, but tell us a little bit more about anyone that should not receive a flu shot.

James Snow, DO: The flu shot is okay, even for those that are pregnant or have allergies to eggs. It used to be thought that they could not; but those that shouldn't take it are very limited. And it mainly involves those taking the nasal spray, and that shouldn't be given to pregnant people or breastfeeding people, people that have chronic illnesses, and anyone under the age of two. But, basically the flu shot can be given to anyone except those that are allergic to the shot or are sick at the time that the shot would be given.

Host: Now, you mentioned the nasal spray. When is that used as opposed to an injection?

James Snow, DO: Some people prefer it, and it might be easier to use in children, that some people are definitely afraid of needles. But, personally, I, don't like to use the nasal spray. I think that the shot is the best way to go.

Host: Absolutely. So what are the flu vaccine side effects?

James Snow, DO: The side effects of the vaccine, mostly the soreness around the injection site. There may be some swelling, some redness around the shot, soreness around the area that the shot is given. You might get a little headache, sometimes a little muscle cramping, basically, like a small degree of a cold, but not actually the flu itself. Usually, the soreness can be treated with ice packs and ibuprofen or Tylenol.

Host: And speaking of which, you led me perfectly into my next question, because there are vaccine myths out there, as you well know, including some thinking that the flu vaccine will actually give them the flu, but you say no, correct?

James Snow, DO: That's not possible. People think that because they get a little reaction to it, people tell me that, oh, I got the shot, then I got the flu. First of all, the shot takes about two weeks to become effective. You need to have two weeks before you are immune, but if they have symptoms, after that time, or right after the shot, it's usually just a mild sensitivity reaction to the shot, not the flu itself.

Host: Any other misconceptions out there about the flu that you need to correct people on, on a regular basis from your experience?

James Snow, DO: The main thing is, it will not give you the flu, and you need to wait two weeks before you're fully immunized. The best thing to do is, to tell them that expect to get good immunization. And, if you do get the flu, your symptoms will be very minimal compared to not having the flu shot.

But the concern is, if you don't get it, you could develop complications, especially in those that are elderly or more susceptible. We have a high dose vaccine for those over 65, and it's much more effective.

Host: Interesting. So if you're an older patient, you can actually get a stronger version of the vaccine?

James Snow, DO: Yes, they have the flu HD shot, which we recommend for those over 65.

Host: Gotcha. Now, one thing you mentioned there that I just want to confirm, people I'm sure wonder oftentimes, does the vaccine provide 100 percent protection? And you say, maybe not exactly, but of course it's still the way to go, right?

James Snow, DO: Yes, nothing is 100%. The COVID vaccine, the flu vaccine, any vaccine, is not 100%. But it's close enough.

Host: Right, it's as close as, as close as we can get at this point in time, right? How about something you touched on earlier, Doctor, was that it's also fine to get the flu vaccine if you're pregnant. What about mothers that are breastfeeding?

James Snow, DO: Yes, they can take the flu shot. In fact, it's recommended.

Host: It's recommended, okay. So, why do people need to get the flu vaccine on a yearly basis?

James Snow, DO: The vaccine is developed according to the strains that are out there. And they change every year. So they formulate the vaccine according to what develops. The flu A especially has variants that change every year. And the strains are formulated into the shot to cover what's going around each year. So it changes and it only lasts for about a year anyway. So it's necessary to get it each year.

Host: Speaking of strains and changes in the vaccine on a yearly basis, how about with all we've all been through concerning COVID, have these flu vaccines changed in any way that you can point to since we've gone through the pandemic?

James Snow, DO: Not that I'm aware of. They're entirely different viruses. I'm not aware of any changes that the flu vaccine has undergone because of COVID. There may be some information on that, but I'm not aware of it.

Host: Gotcha. Is getting the flu vaccine a mandatory requirement at the health system?

James Snow, DO: Definitely. We mandate it here. I'm Director of Team Health, and we require all employees and people that are associated with the health system to have the vaccine, unless they are allergic or other circumstances.

Host: Do you find that enough people take advantage of the flu vaccine?

James Snow, DO: I think now more people do. There was a time when it first was introduced that people were resistant, but I think people realize now the advantage to taking it so they don't miss work, so they don't spread it to other people, and it's necessary to do so, and there's less resistance. now.

Host: Less resistance. So do you think, getting back to my prior question about impact from the pandemic, do you think maybe that helped to make people aware of the importance of getting vaccines in general like the flu vaccination?

James Snow, DO: That's a very good question, and that's true. They definitely are more aware, and more people are getting vaccinated with COVID as well as the Flu vaccine, and it's okay to take both together.

Host: It's okay to take both together, which a lot of people don't realize probably, right?

James Snow, DO: Right, yeah, if you go to get the flu shot, get your COVID vaccine too.

Host: Kill two vaccines with one visit, right?

James Snow, DO: You can, and you can get your RSV for those that are qualified also, respiratory syncytial virus vaccine. It's available for certain persons.

Host: And that can be taken at the same time as well?

James Snow, DO: I'm not sure that you should take all three at the same time, but you, can take the RSV and flu shot together. I personally, have done that.

Host: people So, people get to see you at least on two occasions then to take care of their shots.

James Snow, DO: Yes.

Host: And what you mentioned a moment ago, Doctor, about your interest in helping people. Do you think sometimes nowadays that with some of the red tape involved in being a patient with insurance and appointments and things of that nature, that sometimes it gets lost in the shuffle how many people that do what you do really do still love to help people first and foremost?

James Snow, DO: Certainly, that's one of the reasons why I like urgent care. Every day I have people come in and see me. I can't get into my doctor. Next appointment is two months away. I'm sick and urgent care has really taken off in the last few years and filled a niche that is necessary to cover people that have acute illnesses that no longer can see their local family doctor.

Host: Finally, Doctor, in summary here, how rewarding is it for you and yours to serve the community as you do?

James Snow, DO: I think every day that I go to work, I see something different and new, and it keeps me stimulated and interested. It's not a mundane situation. I have challenges. I meet people, some are friendly, some are not, and I understand that when they're sick. Other practices may be a little different. But it's a challenge, and it's stimulating and very rewarding, I believe, at least for me personally.

Host: Well, it certainly sounds like it. Folks, we trust you're now more familiar with flu vaccines. Dr. James Snow, valuable information indeed, and certainly an interesting background to say the least. A pleasure. Thanks so much again.

James Snow, DO: Thank you very much, and thank you for having me.

Host: Absolutely. And flu vaccines are available at all Southeast Georgia Physician Associates primary care locations. You can schedule your appointment online at sghs.org/schedule. If you found this podcast helpful, please share it on your social media. I'm Joey Wahler and thanks again for being part of Health Matters from Southeast Georgia Health System.