Who should get the flu shot and why? Our medical analyst explains
Welcome to this year’s flu season.
This year’s flu strain has already begun to spread across the United States, they say new data from the US Centers for Disease Control and Prevention. There have been at least 880,000 flu cases, nearly 7,000 hospitalizations and, tragically, 360 flu deaths this fall, including one pediatric death. It hasn’t been since 2009, during the height of the H1N1 swine flu pandemic. so many flu cases so early in season.
Despite these numbers, many people wonder if the flu is really such a serious illness. What is the benefit of the vaccine, especially if some people can still get the flu despite being vaccinated? Can you get the flu from the vaccine? If you get the Covid vaccine, do you still need the flu shot?
To guide us through these questions and more, I spoke with CNN medical analyst Dr. By Leanne Wen, an emergency physician, public health expert, and professor of health policy and management at the George Washington University Milken Institute School of Public Health. She is also an author “Lifelines: A Doctor’s Journey in the Battle for Public Health.”
CNN: Is the flu a serious illness? What symptoms do people experience?
Dr. AS Leana Wen: It can certainly be serious. The CDC estimates that flu resulted in between 9 million and 41 million illnesses, 140,000 to 710,000 hospitalizations, and 12,000 to 52,000 deaths annually across the US between 2010 and 2020.
Flu symptoms include fever, muscle aches, headache, fatigue, cough and runny nose. Many people recover within a few days, but some may still feel unwell for as long as 10 days to two weeks after the onset of symptoms. Some will develop complications, including sinus and ear infections, pneumonia and encephalitis. The flu can also worsen underlying medical conditions — for example, people with chronic lung and heart conditions may see their conditions worsen because of the flu.
Even generally healthy people can become very ill from the flu. However, those who are particularly vulnerable to severe outcomes include those 65 and older, young children under 2, pregnant women, and people with underlying medical conditions.
CNN: What’s the benefit of the vaccine, especially if some people can get the flu despite being vaccinated?
Wen: The flu vaccine does two things. First and foremost, it reduces the chances of serious illness – that is, hospitalization or death. Second, it can also reduce the likelihood of getting the flu in the first place.
In a sense, this is not too different from the Covid-19 vaccine. The most important reason to get vaccinated against both the flu and the corona virus is to prevent a serious illness. New data published latest CDC Morbidity and Mortality Report shows this year’s flu shot reduces the risk of hospitalization by about 50%. A 2018 study found that people who got the flu shot were 59% less likely to be admitted to intensive care for the flu compared to those who weren’t vaccinated.
The effectiveness of the vaccine can vary depending on how well the vaccine is matched to the circulating strains of influenza. The cites the CDC vaccine effectiveness against “medically controlled disease” from 23% to 61% depending on year and vaccine-strain matching. It is true, then, that you can get the flu shot and still get the flu. But the vaccine reduces your chances of that – and, most importantly, reduces the likelihood that you could end up very sick.
Another thing to consider is that there are many others viruses that can cause flu-like symptoms. The flu vaccine helps protect against viral infections caused by influenza, but there are many other causes of viral syndromes, including adenovirus, rhinovirus, parainfluenza, and others. These other viruses also spread easily, and there are no vaccines against them. I often hear patients say that they got the flu once the same year they got the flu shot, and that’s why they don’t want to get vaccinated again. But when I ask them if they were actually diagnosed with the flu or just had flu-like symptoms, they would say the latter.
CNN: Should children and pregnant women also get the flu shot?
Wen: Absolutely. These are groups that are particularly vulnerable to severe outcomes, so it is very important that they receive the flu vaccine.
Similar results were found in pregnant women. Not only that flu vaccine protects pregnant women, if the vaccine is given during pregnancy, it also helps protect the baby from the flu in the first few months of its life. This is important because the flu vaccine is not available to babies until they are 6 months or older.
CNN: Can you get the flu from the vaccine?
Wen: No. The flu vaccine is inactivated vaccine, which means that it does not contain a live virus and therefore cannot cause the flu. It is also a very well tolerated vaccine, with the most common side effect being discomfort at the injection site which disappears after a day.
CNN: If you have the Covid-19 vaccine, do you still need the flu shot?
Wen: Yes. Different vaccines target different viruses. The Covid vaccine helps protect against Covid, but does not protect against the flu and vice versa. You can get the Covid vaccine (or bivalent enhancer) at the same time you get your flu shot, just at a different injection site.
CNN: Some people wait until later in the flu season to get the flu shot. Is this a good idea?
Wen: Not at this time, as it is now clear that this flu season is starting earlier than usual. Cases are already high and it takes about two weeks to achieve optimal immune protection after vaccination. I would encourage people who have not yet received the flu shot to get it now.
CNN: What should people know about flu treatment?
Wen: Most cases of the flu can be treated symptomatically, which means patients rest, hydrate, and treat symptoms as they occur—such as fever-reducing medications like acetaminophen or ibuprofen. There are also antiviral treatments available. This is really important for people at high risk for severe flu complications and/or who are very sick. The earlier such treatments are started, the better. An oral drug, oseltamivir (Tamiflu), can also be given to non-high-risk patients, too, within 48 hours of the onset of their illness.
I would encourage everyone to have a plan for the flu, the same way you should have a plan for Covid. Ask your doctor in advance if you should receive Tamiflu or another antiviral treatment. Find out how you can get tested and where you can access treatment, including after hours and on weekends.
CNN: How can people prevent getting the flu?
Wen: Influenza spreads primarily through droplets — if an infected person coughs or rains, these droplets can fall on someone else nearby. It is also possible for droplets to fall on a surface, from which someone becomes infected after touching it and then touching their nose, mouth or eyes.
We can help reduce the transmission of the flu by staying away from others while symptoms are present. We should all cough or sneeze into our elbow or a tissue and wash our hands often, including after touching high-contact surfaces. People who are particularly vulnerable to severe outcomes should consider wearing a mask to reduce the chance of contracting viral illnesses such as the flu. And, of course, get vaccinated!
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