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Who's afraid of the flu shot?

Written by: Marilyn Linton, QMI Agency
Nov. 5, 2012

The pinch of a needle is far easier than the pain of getting sick

When it comes to why people don’t get the flu shot, Dr. Don Low has heard all the excuses.

But the one thing that still surprises the microbiologist-in-chief at Toronto’s University Health Network and Mount Sinai Hospital is how complacent we are about this seasonal threat to our health.

“We seem to go through periods of incredible angst about disease and how we want to protect ourselves. We saw that with H1N1 where, initially, people were not convinced it was so important,” Low said. “Then in September of 2009, when a child died of H1N1, there was a public health uproar about there not being enough vaccine available. We go from one end of the spectrum to the other.”

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We are now in what Dr. Low calls the “post-pandemic era” and some people are back to their old ways – making excuses as to why they won’t be getting this year’s flu shot. Surveys indicate that less than 50% of the general population gets a flu shot.

“I hear them say they never get sick and so they don’t need the flu shot. Or they say they once got the flu shot and then got sick,” Low said. “I am wondering if they’re really just afraid of needles!”

Well, that’s no excuse any longer now that Health Canada has approved a nasal spray version of the vaccine.

One of the many myths that keeps people from rolling up their sleeves is the flu shot makes you sick. Other than a sore arm at the injection site and perhaps a few aches, the flu shot (which contains an inactivated virus that cannot induce the flu) should protect you against the virus strains that are included in the vaccine.

This year’s vaccine includes three strains: Influenza A/California – an H1N1-like virus; Influenza A/Victoria – an H3N2-like virus that can be severe in the elderly; and Influenza B/Wisconsin which predominantly is responsible for illness in children. When the circulating strain and the vaccine strain are a match, you can count on about 86% protection against the flu.

But Low admits the strains that are circulating this year may not exactly match the ones in the vaccine; we will know how well matched they are within the next month.

“It’s a bit of a crapshoot and we do the best we can. But even if the vaccine does not completely protect you, you would get a much milder illness than if you didn’t get vaccinated,” he said.

While infectious disease experts are hot on the flu shot campaign trail reminding the general public that the flu shot works and is safe, Ken Flegel, a senior associate editor at the Canadian Medical Association Journal is urging doctors to follow their own advice. Compulsory vaccination for health care workers may be a good idea, he suggests.

In a recent editorial, Flegel wrote no right-thinking physician would ever knowingly harm a patient or fail to do some essential thing that would result in harm. “But when 55 to 65% of physicians fail to take the annual seasonal influenza vaccine, they are exposing their patients to the risk of death from influenza.”

In Canada, the annual rate of infection averages 5 to 10% of the population. That includes about 20,000 hospital admissions and up to 8,000 deaths.

Like death and taxes, seasonal flu is extremely predictable. Each year there will be a number of people who come down with it, miss days of work because of it, pass it on to family, friends and co-workers, and possibly need antibiotics prescribed because of secondary infections. There will be hospitalizations and some deaths.

“The consequences of influenza are quite immense,” Low said. “Yet every year, we still have to go out there and sell it.”

Protect your heart

Having an annual flu shot could help prevent heart attacks, says Heart and Stroke Foundation spokesman Dr. Beth Abramson, a cardiologist. It is especially recommended for people with heart conditions, diabetes, people over 65 years of age, people with a BMI above 40 and children or adults treated with ASA. According to Dr. Jacob Udell, a cardiologist at Toronto’s Women’s College Hospital, the flu vaccine may reduce the risk of a major cardiac event (heart attack or stroke) by 50% and cardiac deaths by 40%. – www.eurekalert.org

Is it safe?

Despite recalls of flu vaccine manufactured by Novartis (the company makes about 20% of Canada’s flu vaccines; safety is not a factor in the recall), flu vaccines are safe. For more, check out www.publichealth.gc.ca and www.phac-aspc.gc.ca.

Full protection

Canadian adults are not up to date on all the vaccines they need to protect themselves. Dr. Don Low says globally 1.6 million people die annually from pneumococcal infections, for instance. In addition to the annual flu shot, three important vaccines adults should talk to their doctors about include the one-time-only shingles vaccine, the one-time-only pneumonia vaccine and the booster vaccine that protects against whooping cough.

Neighbourhood flu shots

Pharmacists in Ontario, B.C., Alberta and New Brunswick are now licensed to give flu shots. Check out your local pharmacy to see when flu shots are available.

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