5 Flu Vaccine Myths Debunked

Me ( White Coat Me That Is)Every August I go through a bit of an emotional roller coaster. I am sad to see summer ending, elated to have un-bored kids again, and anxious. It is time to center myself, consider yoga, or become a Buddhist.

It is time for…..the flu vaccine.

For about the next six months, my job will take on an added layer of stress. I will spend hours upon hours educating, explaining, answering, and sometimes down right pleading with patients to get their flu vaccine. Over the coming months, countless patients will listen to my earnest plea and say a polite “No, thank you.” So, this year, instead of banging my head against a brick wall or whimpering in the fetal position, I decided to try to address the five most common reasons my patients decline the flu vaccine.

First, why do I care so much if people get the flu vaccine or not? Put simply, the flu freakin’ terrifies me. No, not in an irrational, phobic–escalator kind of way. More in the oh-man-this-could-be-bad-kind of way.

Who Cares?

The current census estimate for the US is just over 310 million.

In 1918 the flu killed an estimated 100 million people worldwide. Most were young and healthy. That is 1/3 of our current population. If that’s not staggering enough, consider this. In 1918, our population was somewhere around 110 million. So, the flu, in one horrific pandemic, wiped out as many people world wide as we had living in our entire country. Please take a moment to digest that.

While there have been other pandemics since, thankfully, none have approached that of 1918. If another flu pandemic happened, our MODERN health care system would be overwhelmed within weeks. Forget no room in the ERs–we already have that. I am talking, not enough Ambu-bags to resuscitate people in respiratory distress, not enough IV fluids or medications to administer even if we had the medical staff–which we wouldn’t. Believe me, usually I am not a doom and destruction kind of girl. But, in the above scenario, the word “apocalyptic” would not be a hyperbole.

Since the early 20th century, scientists, doctors and geneticists have been working feverishly to understand the influenza virus and develop effective vaccines against it. Astonishingly the entire genetic composition of that horrific bug of 1918 is now well documented.

The Flu Virus Picture courtesy of Science Media Centre

The Flu Virus
Picture courtesy of Science Media Centre


The WHO (World Health Organization)

Imagine thousands of the smartest, highest educated, most selfless scientists, medical engineers, and mathematicians working around the clock to come up with ways to prevent such a pandemic from ever happening again. Imagine them presenting, on a gilded platter, the final life saving potion. Now, imagine me: smart, educated, yet a relative neanderthal* when it comes to brain power, turning my nose up and walking away.

*No, I am not saying that if you don’t get a flu vaccine you are a neanderthal.


Why are people declining the flu vaccine?

Let me point out that, while I consider myself well-respected and trusted by my patients, most years, I am lucky if 30-40% of my practice population gets the flu vaccine.

Here are the top five reasons MY patients report and my counter arguments.

One Sneeze: Millions of Viruses Picture Courtesy of Loc.gov

One Sneeze: Millions of Viruses
Picture Courtesy of Loc.gov

1. “I never get sick.”

Well, lucky you. Unfortunately, you interact with people every single day that do not have your “mental will” against sickness. Not getting the flu vaccine because you don’t get sick is, in the words of one of my fave South Philly girls, a “bitch move.” People do get the flu and get over the flu. But, in the meantime, they could be coughing on a new mom whose baby could die from the flu. Take the “I” out of your answer. Influenza vaccine protects the youngest, oldest, and most vulnerable folks in our community, our society, our country, and the world.

2. “Every time I get the flu vaccine I get sick.”

Ah. Here comes my hate mail. First, if you don’t believe in the power of evidence based medicine please stop reading–nothing I say from this point forward will matter.

For those of you still with me, countless studies have compared the incidence of an acute flu like illness following the administration of the KILLED vaccine with the incidence of a similar illness following a placebo. There is absolutely no statistical difference. Because the LIVE vaccine (indicated for the young and healthy) needs to replicate in the cool environment of the nasal passage, it can cause a relatively minor cold-like syndrome.

Disclaimer: I am not a military expert nor do I pretend to understand the way our service men and women are trained. The following is for illustration only

Training Weapon vs Actual Weapon picture courtesy of Modern-Military.com

Training Weapon vs Actual Weapon
picture courtesy of Modern-Military.com

“So,” you ask. “Why do I get sick EVERY time I get the vaccine–even the killed one?” The answer is that your immune system is doing PRECISELY what we want it to do. It is reacting to that tiny bit of inactivated virus. Some people can have pretty significant reactions like fever, muscle aches etc. Most professionals agree that those patients that get “sick” from the flu vaccine are not actually getting a case of the flu. Rather, they are experiencing an enhanced immune reaction to the antigen (the protein responsible for stimulating the production of antibodies) within the vaccine. These immune reactions can be miserable. We STILL recommend receiving the vaccine. Some would go as far as to argue that if the KILLED vaccine antigen caused such havoc on the immune system, imagine what an actual case of the flu would feel like? It is advisable to choose the timing of your vaccine wisely in these cases (i.e….avoid getting it say the day before your wedding or dream job interview) and perhaps premeditate with ibuprofen or tylenol. Of course, it is important to consult with your physician about such reactions before receiving the vaccine.

Imagine a military training site. Every soldier is given an AK47. It is the same size, weight, and configuration of an actual weapon. However, the deadly bullets have been replaced by paint balls. After weeks using this dummy weapon, a soldier has learned to do battle with a fully loaded one.
The killed flu vaccine has all the components of the live one, minus the most dangerous bits that can cause illness. That model weapon may cause our soldier to have a sore arm and shoulders, but it is not capable of killing. Our killed vaccine will train our immune system to battle the real flu virus should we be exposed to it. You may even see signs of that. But, like that training weapon, about the most dangerous thing it can do is give us a sore arm.

3. “The vaccine doesn’t even work.”

Flu vaccine efficacy is one of the most frustrating and nail biting things in medicine today. Development of the vaccine starts in the midst of the season the year before. Folks way smarter than you and I are analyzing, pooling, predicting, and agonizing. In the end, the strains chosen for the coming year are based on a well thought out guess. Most scenarios place the efficacy of flu vaccine at 70-80%. Last year was a bad year; our vaccine was only about 59% effective. One of the most dangerous things about the flu virus is its mutability. Imagine playing catch with a water balloon. Now imagine coating that balloon in grease. Now imagine dipping your hands in that same grease. That’s about how easy it is to pin down the influenza strains.
One frequently misunderstood point is that even when you get a case of the flu after being vaccinated, your illness is almost always milder than if you were not vaccinated.

4. “Flu vaccine is just a money making scheme for pharmaceutical companies and doctors.”

If you really believe that, shame on you. I am getting ready to pay a $12,000 flu vaccine bill. When you factor in nurse time, supplies, storage, my time to explain, crummy insurance reimbursement etc, we are lucky to make a few dollars on every flu vaccine we administer. I would be better off with a lemonade stand in the parking lot.

5. “The flu vaccine causes Gullian-Barre Syndrome (GBS.)”

GBS is a scary neurologic condition caused by an autoimmune attack of the nerve cells. Most cases resolve completely but it can lead to paralysis or death. Multiple studies have concluded that the incidence of GBS after the flu vaccine is 1:1,000,000. One in one million. Guess what the incidence of getting GBS is after a case of the flu? At least 1:1,000,000 and some studies estimate it to be a lot higher. A French study looked at four hundred cases of GBS occurring over an 8 year period. After all the dust settled, ten out of seventy three cases of otherwise unexplained GBS were associated with a recent influenza infection—not vaccine

I sincerely hope that this year will be a “quiet” flu year. But we just don’t know. By the time the flu season is upon us, we have missed the opportunity to protect our most vulnerable citizens.

My family is always dragged down to my office on flu vaccine delivery day. We line up our kids, tell them to stop whining and give them each their vaccine. Then, I stick my husband and he sticks me. Clearly, I am not uneducated or under the influence of a big bowl of WHO Kool-aid. I simply dread the thought of my kids getting the flu or worse: passing it on to someone who could die from it.

Comments

  1. Stephanie says:

    Your husband is my daughters pediatrician and I trust and respect him enough to know that when he recommends something, it isn’t to make more money! I love this post and agree with every one of your counter arguments! When it comes to my daughter, I’d rather be safe than sorry!!

  2. mark says:

    I guess there’s no use to me saying no this year. lol Christine when are u going to start dishing out the arm pain? ITS A JOKE people (the pain part) Trust me . She put two needles in my knees a few weeks ago and I never knew she did it. so I guess this will be the 1st year I get a flu shot. Christine quit smiling, lol lol
    mark

  3. Jeanie says:

    I know how you feel. It’s frustrating that I cannot get my husband to get a flu shot. I think it’s just plain stupid. I’ll be in soon for my flu shot. Many people are hard headed.

  4. Joanne says:

    My husband finally agreed to get the flu shot last year. And my two daughters (20 and 22) had the shot last year as well. None of us felt a thing. Well worth it!

  5. lisa says:

    thank you for the great post. I am 100% all in for flu shots every year and am in healthcare as well, so I do get it. But, can you share any opinion on live vs. killed? I give my kids the mist mostly because shots are a nightmare, but want to make the best choice… thanks!

    • Thanks for your comment and for spreading this important message. In adults, there seems to be little difference between the killed and live vaccine. In children however, studies suggest it is MORE effective than the killed. The only reasons for children NOT to get the live vaccine is if they have asthma, diabetes, or suppressed immune systems. As an aside, pregnant women also should NOT get the live vaccine. Hope that helps.

  6. I have never taken the shot, but your arguments made me rethink my decision, thank you for sharing them!

  7. Patti says:

    Christine,
    I love your post, and look forward to your insight and wit.

    I have worked in the medical field for 15 years, and what hurts me most is how pushy physicians, nurses and administrators are about vaccines. I believe wholeheartedly in educating people, but let’s not bully them. They have a right to decline, and they should not be made to feel as if they need to defend their choice.

    I had the flu vaccine once, years ago, in nursing school, “because I had to”. I didn’t understand at the time I had rights. I have never had it again, nor has anyone in my family. My family is healthy, and I taught my children early, that frequent, good hand hygiene is essential to good health.

    Several flu seasons ago. You will remember there was a severe flu vaccine shortage. Only healthcare workers, and those meeting certain criteria would get the vaccine. My mother, with diabetes, a fib, kidney disease-and ended up on dialysis during that winter, was hospitalized several times that flu season, was told she was not a critical enough patient to receive the vaccine. I, however, was still being “encouraged” to get the vaccine. But, my sick mother, in the same hospital I worked in, could not receive “my” vaccine I was declining. My mother died that February of kidney failure and a heart attack. She had only held my newborn daughter, 3 times.

    I will continue to decline the vaccine, as is my right, so someone, who is really in need of it can have it. I will cough and sneeze into tissues, use Clorox wipes to disinfect, and wash my hands a million times. The pharmaceutical industry is famous for medication shortages, including vaccinations. And, for the record. Yes, my family has been vaccinated with all required vaccines, so I am not anti-vaccine. (Although my 16 year old daughter will not receive the gardinella vaccine, a choice we made collectively.)

    This is just one of my “selfish” reasons to decline.

  8. Corinne says:

    Unfortunately, the situation in the United States is getting even worse in this area. Many state governments are mandating these vaccines — and failure to comply results in prison time. The intrusion of the government into our personal freedom is unconscionable.

    Meanwhile, ALL vaccines are immune suppressing, which means they depress your natural immune functions, leaving you vulnerable to any number of diseases.

    And this is not even taking into account the vaccine additives, such as the mercury preservative thimerosal, which has been linked to autism and other neurological and developmental disorders in children.

    Many of the vaccines that are now “required” for children are not even medically necessary. At the top of my list of vaccinations that are highly questionable are the:

    Hepatitis B vaccine
    Human papillomavirus (HPV) vaccine, Gardasil—–REALLY AGE 11, crazy and it only touches a few of the 100 strains of hpv
    Chicken pox vaccine
    Flu vaccine

    Thats why i am refusing vaccines. If i knew more i would have cut back on my children’s infant and toddler vaccines. Just saying cause i read your post. Cms

  9. Michael Ross says:

    CM:

    I got the shot last year. I still got the Flu. My buddy got it too, no Flu shot. He was down for 10 days, I was down for 4. Your right, it was not as bad.

    Although it was not 100% I’ll take those 6 days anytime. And thank the lord for Tamiflu!

    Michael

  10. jodiparsons says:

    Oh, God. I can’t stand the straw man argument of “herd immunity.” So, basically what you’re telling me is that I should inject myself and my children with thimerasol (a mercury derivative), fomaldehyde, multiple antibiotics, MSG, polysorbate 80, Triton-X-100 and a host of other ingredients (known toxins and poisons to the human body) for the sake of SOMEONE ELSE???? Ha! That is the most ridiculous reason ever. So, because my family takes measures already to keep ourselves healthy and our immune systems in top working order, we should sacrifice that by taking immune-suppressing drugs just so that someone else who treats their bodies like crap all year long can have a 60% (at best) chance of not getting the flu? I don’t think so.
    Rather than wasting all your time from August to March trying to convince them to get the flu shot, how about you spend January to December teaching them how to strengthen their immune systems? You know, eating more live foods than dead, processed foods, getting off their butts and exercising, taking supplement known to have immune-enhancing properties such as Vitamin D, Vitamin C and probiotics, and living a cleaner, more vibrant life. Oh, I know why. You don’t make money off of healthy people. :(

    • So much misinformation and stupidity in this argument. Sadly, you are the voice of many. Yes. Herd immunity saves lives. No. Thimeresol does not cause whatever nonsensical things folks like you think it does.

      In fact, this year there are several Thimeresol/preservative free options.
      Does that help you? I bet not.

      To your unbelievable “get off your but argument- let me point out that in the late 1880s our life expectancy in this country was HALF what it is now. That’s when folks toiled for 14 hours per day “off their butts” as you so ingeniously said. Clearly their fresh air and exercise wasn’t enough to keep them alive after 40. Any idea what changed that? It wasn’t vitamin C or D or whatever other BS you claim promotes health. It was TWO things– THE ADVENT OF VACCINES AND ANTIBIOTICS.

      Lastly, do I make money off of healthy people?? I think you answered your own thoughtless question. I would be better off with a community of flu patients if my motivation was money wouldn’t I? Come on folks please skip your vaccines, get sick so I can make money off of you!

      What an idiotic and shameful statement. While I do feel sorry for your kids because they don ‘t yet have a choice, I pray they are far away from mine and my thousands of compromised patients for whom exercise and vitamins have not prevented their cancers and disease.

      • jodiparsons says:

        I truly hope for the sake of your practice and your patients that you do not speak to them the way you just spoke to me. Name calling, belittling, shaming and bullying. Unbelievable actions from a “professional” such as your self. Listen, I know without a shadow of a doubt that I am not going to change your mind about vaccinations, nor you mine. Let’s get that straight right now and remove it from the table. However, I would like to ask for further clarifications from you on some of the statements that you made in your rebuttal to me.

        First, “Thimeresol does not cause whatever nonsensical things folks like you think it does.” What “nonsensical” things do “folks like me” think thimerasol causes? Who are “folks like me?” Do you even know me or know enough about me to make such a blanket and judgmental statement? I don’t think so. But, even if I’m of the camp that believes that thimerasol is a neurotoxin, which, according to the EPA it is, I’m not alone. Here’s some research for you, http://www.ncbi.nlm.nih.gov/pubmed/16766480.

        Second, are you really comparing 1880 to 2013? Really? Has our hygiene, sanitation, waste/garbage removal, water treatment systems, workplace safety, etc not changed dramatically since then? Think maybe that may have had something to do with the life-expectancy differences?

        Thirdly, am I to understand that you believe that Vitamin D and Vitamin C have nothing to do with immune strength? Do I even need to list the myriad of studies to prove that you’re mistaken?

        Fourth, antibiotics do not promote health. They treat disease, sort of. Big difference. The World Health Organization (the “thousands of the smartest, highest educated, most selfless scientists, medical engineers, and mathematicians working around the clock) defines health as a “state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” While an argument could be made that antibiotics encourage the absence of disease or infirmity, they most certainly do not encourage a state of physical, mental, and social well-being. If that were the case, then everyone should be taking them daily.

        Many of the diseases that people hold vaccines up as the “saving grace” were already in a drastic decline before the vaccines were even widely distributed. If you’re interested, I’ll supply you with all that research, too.

        And finally, the “keep your unvaxxed kids away from mine” statement. This one just baffles my mind. If your kids are vaccinated, and you believe that the vaccinations work, then what are you worried about? My kids should be of no concern to you.

        At the end of the day, you raise your family the way that you and your husband feel is best-making educated and informed decisions all along the way. If that means 40-44 vaccinations before the age of 6, then so be it. My husband and I will raise our children the way we feel best, making educated and informed decisions as well. How about we compare the overall health of our kids to yours in 5-10 years and see where we stand?

  11. Judi says:

    Perhaps you can answer a question for me. About 14 years ago, I had a PPD test;the subdermal kind. I had a reaction and still have a small scar where it was administered. I do not know what in the tiny shot I am allergic to that made my arm blow up, or maybe it was the IV antibiotics that I had been getting for two weeks just prior (that’s a different long story). My concern is being allergic to anything in the shot whether it is added or whatever. I am not crazy against vaccines and my 4 children have had them all with the exception of the flu vaccine. It is not so much that I am against it, but that I am unsure of it. My children all had the chicken pox vaccine (with boosters) and three of them got chicken pox anyway (although milder). So, in essence, I am asking if there is anything I need to be concerned about when it comes to the vaccine and where the best place to get 4 of them for free since we do not have insurance right now.

    • Judi
      The PPD is a funny thing. It is administered intradermally. That means the needle is placed in the skin not in the tissue beneath. It is not an easy technique. If the nurse inadvertently went just a bit too deep, you could have a reaction. Further the PPD is not a vaccine so does not have the same components. Regarding free flu vaccines, I would go to the local health department. They all have them and offer them free of charge. Also I’m not sure about your doctor but in my practice, we offer free or discounted flu vaccines for any of our patients that are struggling financially during flu season. You might want to check with your doctor.

      • Sorry I also just realized I didn’t answer your question about efficacy. As I said in the post, the flu vaccine is not perfect. It takes a lot of research and many many months to try to find the proper strains. However remember even if it is not perfect, having the flu vaccine will at least keep you from getting the most severe case of the flu.

  12. Judi says:

    Thanks for your answers. I appreciate them.

  13. Audrey says:

    I wonder if doctors underestimate needle phobia. I know many that won’t get it because of the needle factor, but they won’t admit that to their doctor. Silly, yes, but phobias are powerful. My flu shot last year was surprisingly painful. Perhaps more access to the nasal mist would be helpful?

    • Great point Audrey! Thanks for pointing that out. In fact, this year a new vaccine was introduced called the intradermal shot. The needle is so tiny it doesn’t penetrate past the first layer of skin. I was told by many patients that it was much less uncomfortable however there was a reaction the next day similar to a mosquito bite. The FluMist would be great for more people however it’s only FDA approved up to the age of 49.

  14. Your post just came up on one of the pro-vax Facebook pages I follow. Thanks for this post.

    Personally, being in the Black Hole (old enough that my immune response to the disease is not as robust and immunity wanes more quickly; younger than 65, so not eligible for the Super Duper vaccine) I delay my immunization until mid-November. This is relatively safe, as in my area, historically influenza activity is low-to-none until then.

  15. Thanks so much for your comment Liz. Would you share with me the pro-vaccine page you followed to get here? I would love to like it and share it myself!

  16. Sharon O'Shaughnessy says:

    All I know is that I got chicken pox when I was seven years old. A few pox on the face, a few on the chest. No big deal.

    My friend Kevin, having somehow missed chicken pox as a kid, got them when we were in college. The first thing that happened was that professors lined up to bring their kids into his apartment and intentionally infect them. My youthful self was categorically appalled. Why would you intentionally expose your kids to something as aggravating as chicken pox? I asked one of the parents in the room, and he said, “We have all seen chicken pox in an adult. You do Not want chicken pox as an adult.”

    The next thing that happened is that Kevin got sick. Really Sick. More than just the pox I had that I could reach…he had oozing, disgusting pox inside his eyelids, inside his nose, and down his trachea. Then he got an infection. And then he got sepsis, so he had to go home in the middle of his first semester senior year. I had never seen anyone so sick in my life.

    Having seen this in action, and having also lost an aunt to diphtheria, I am firmly in the vaccinate camp. I think it’s easy to think you’re making an intelligent choice for your family when you have never seen any of these horrifying illnesses in people you love(d). For the people who choose not to vaccinate their children – keep your vector-selves out of my schools, churches, and stores – wherever people congregate…because infants and older people and cancer strugglers are depending on your choices to keep us all safer without these diseases floating around ready to infect the vulnerable, regardless of how your body may be able to overcome them when you get sick.

  17. Lynn Duncan-Cone says:

    I have always been a little confused about my RA and the flu shot. I was told only to get the dead ones so I have been afraid. The flu this year knocked me for a loop and I was quite sick. I don’t want that to happen again. Can you explain flu shots and auto immune diseases where patients have compromised immune systems and medications to lower their immune systems. Thank you.

%d bloggers like this: