To flu shot or not
October 28, 2018
STEAMBOAT SPRINGS — There is significant division on the decision of whether or not to get a flu shot.
Some people religiously get one every year.
Some people get one when they are presented with it, and the shot is cheap, easy and convenient.
For some, it is dependent on where they work.
For others, they are adamant about not getting them.
If you go
Northwest Colorado Health Flu Clinics
Nov. 6: 3:30 to 4:30 p.m., South Routt Elementary School, Yampa
Nov. 8: 11 a.m. to 1 p.m.,Yampa Valley Bank, Steamboat
Bring insurance card. Low-cost options are available to individuals who do not have insurance. Flu shots also are available by appointment. Call 970-879-1632.
In an informal, unscientific survey of 70 people, of all ages from different parts of Routt County, 31 had gotten a flu shot or were planning on getting one soon. Thirty-five had not and were not going to, and four were undecided, with no strong feelings either way.
Reasons for not getting them vary, from feeling healthy and strong to that it was unnecessary and ascribing negative effects to the shot.
A number of people said they don't get them because of a bad experience. They either had an allergic reaction (like lymph nodes swelling under the arms), or said, “The one time I got one, I got sick."
A few others said they got sick the one time they didn't get a shot.
Lauren Bryan, infection preventionist at UCHealth Yampa Valley Medical Center, said the shots do not contain a live virus.
"The flu shot cannot give you the flu," she said.
The nasal sprays can contain a live virus. And, when the body is building up antibodies after getting the shot, the process can make people feel achy and tired, Bryan said.
But, this can be unconvincing to personal experience. Different bodies have different reactions to the foreign proteins as well as the other ingredients in any vaccine.
And, there are allergic reactions, Bryan acknowledged — there were about five in the 70-person survey. People who are allergic to eggs may experience a reaction because most vaccines are egg-based.
While "exceptionally rare," people have gotten Guillain-Barre Syndrome as a result of the vaccine, which happens in one to two cases per million, Bryan said.
And of course, a quick search on the internet can bring up many other arguments of risk, often hotly debated as with all vaccines. Then there’s always the money trail, with the global annual flu vaccine profit estimated at $4 billion.
People can get the flu even if they've had the shot, Bryan said, though, again, not the direct cause. They can be exposed to the flu before the two weeks it takes for the protective antibodies to develop, which is why the Center for Disease Control recommends shots early in the season (by the end of October).
Or they can get a strain that is not included in that year's vaccination. And, they can get a strain even if it is included in the vaccination.
However, a vaccination can reduce the severity of the illness and reduce the chance of hospitalization.
"People underestimate the complications," she said. They also underestimate how the rates can increase for things like cardiovascular events.
There are also people who cannot get the shot, like babies younger than six months, those who do get severe reactions and others who are too ill.
For some people who are adamant about getting one every year, it is the protection of those who are more vulnerable (elderly, immunocompromised, infants and children, pregnant women) that is the motivating drive.
Nationwide, last year was a bad year. About 80,000 people died from influenza and influenza-related illnesses, Bryan said. During a typical season, there are between 12,000 and 56,000 deaths.
There were about 171 pediatric deaths, she said, and about 80 percent of those kids were unvaccinated.
In Colorado, last year's flu outbreak was worse in the Denver metro area, she said. Rates "skyrocketed" in early December.
"It's pretty frightening how bad it got and how quickly."
According to the Colorado Department of Public Health and Environment, "the 2017-2018 influenza season was an extremely high severity season," with 4,650 reported hospitalizations. “This was the highest number of influenza-associated hospitalizations reported in a season to date."
People older than 65 and younger than 6 months had the highest rate of hospitalization.
In Routt County, for the October through March flu season, there were nine cases reported of people testing positive for influenza who were hospitalized (inpatient, not Emergency Department). There haven't been any hospitalizations thus far for this flu season in Routt County, but five have been reported in Colorado.
However, with a transient population, we are just "a car or a plane ride away from a major outbreak," Bryan said.
Bryan is the first to acknowledge the "flu vaccine is not a perfect tool — but it's the best we've got."
The influenza bug is particularly "tricky," she said. It's smart, very adaptable and is always changing its genes.
Ineffectiveness of the vaccine is a valid concern, Bryan acknowledged. But, ranging between 40 to 60 percent effective against that particular year's strains, Bryan argues the odds still favor getting a shot over not getting one.
Last year, according to the CDC, the vaccine was deemed 40 percent effective. In 2004-2005, it was just 10 percent effective, the lowest percent in the past 14 years. In the same time period, the peak effectiveness was at 60 percent in 2010-2011, and the most recent low was at 19 percent in 2014-2015, followed by 48 percent in 2015-2016.
Each year, the CDC looks at what strains are circulating worldwide, where flu seasons cover all months of the year.
Then they pick which strains to include in the shot. It's still unpredictable and a guessing game, hence the wide variance in effectiveness.
This year's is either a trivalent (three strains) or a quadrivalent (four).
The quadrivalent two includes (non-activated) "A" lineages — H1N1 and H3N2 — and two "B" lineages — Colorado Victoria lineage and Phuket.
For the 2017-2018 season in Colorado, there was a shift from the A lineages to the B lineages in mid-February, with H3N2 as the predominate subtype throughout.
So, what can you do to keep from getting the flu — regardless of whether you get vaccinated?
For one, said Bryan, know that people are contagious 24 hours before they exhibit symptoms, so "treat everyone like they are contagious."
Be aware that big social gatherings promote the most germ sharing and risk. Wash your hands frequently, and sneeze or cough into your elbow.
At the end of the day, it is up to the individual to determine how they will approach risk reduction to themselves and others.