Tag Archives: Influenza

Should I Get A Flu Shot?

It is Influenza Season in the Northern Hemisphere. So, this is a good time to talk about the flu. Three years ago we had an unusual flu season, with a nasty variant about that seemed to be threatening a pandemic, and that’s the year Huxley was born (in November) so we faced the problem of getting an off season flu shot and not being a member of a Fortune 500 company. We also faced the problem of varying levels of understanding of the flu, and varying odd beliefs about it, among people to whom newborn Huxley might be exposed. This year, my S-I-L is expecting to produce an offspring some time over the next two weeks, so she’s dealing with the same concerns. Also, this year is a non-typical season (as, of course, many seasons are). The rate of Influenza infection seems to be rising early. This could mean one of two things (or something in between). It could mean that we are having a flu season that will look normal once it is all over, but shifted early, or it could mean that we are having a very bad flu season, which will have a high peak rate of infection, and what we are seeing now is just the beginning.

I’m not an epidemiologist, so I don’t monitor and report on disease. But I am a science blogger and an anthropologist so I do monitor what people are saying about the flu with the idea of addressing potential misconceptions. This post is, essentially, a reaction to what I’m seeing on facebook and in other social networking worlds.

What is the flu shot for?

The flu shot is for Influenza. If you have a flu shot this year, it will signal your immune system to prepare itself for the invasion of three different strains of flu. If you are an average adult person with no notable medical issues, this will likely make you more unlikely to get the flu than you were before the shot. If you are older, or very young (under 2?) or have any immune issues or are just on the wrong end of the curve, you will gain only moderate protection against the flu, but that’s better than nothing.

Will I get sick after getting the flu shot?

First, let’s be clear: You can’t get the flu from the flu shot. The flu they shoot into you is dead. You’re not that special that you can bring dead things back to life. There can be side effects but they are typically mild. If you got really sick after getting the flu shot some time in the past, chances are something else has happened.

Here in Minnesota, there is a stomach virus going around and a bad cold going around. Julia and I got our flu shots many weeks ago, Huxley and Amanda got theirs much more recently. All four of us got sick after Huxley and Amanda go their shots. Clearly, we have the local crud, and not the flu.

The “mist” vaccine is not dead, it is merely very beat up. The side effects from the mist are a bit more likely and a bit more severe when they happen. The upside of the mist, other than that you don’t get stuck with a needle, is that it is thought to last longer or be more effective.

How long after I get the shot will it start to protect me from the flu?

If you are an average adult, not too old, not too young, etc., your immune system will build the antibodies to the flu strains covered by the shot in about six or seven days. The CDC will tell you “two weeks” before the shot is effective. This is to cover the fact that for some people it can take up to about two weeks. But for many people it is closer to one week.

Can I still get the flu if I get the flu shot?

This year’s seasonal influenza shot is typical in that it covers the three flu strains that influenza experts think are the most likely to affect people in the US. It is hard to say what level of effectiveness will pertain in a given year. Various studies suggest that if you are exposed to the flu for which you have been vaccinated there is about a 30% to 50% chance of getting the flu compare to someone who would get it, and if you do get it, you’ll have a reduced degree of illness.

Can the flu shot protect me from anything other than what it is designed for?

Yes and no. If you are exposed to a flu that is not one of those in the shot, you still might have a reduced chance of getting that flu, or reduced severity if you do get it. It all depends on the complex interaction between the flu and your immune system, and how your immune system was altered by the vaccine.

I’ve noticed people saying that the flu shot protects you from a variety of other respiratory diseases that are not the flu. As far as I know, that is highly unlikely. It would be kind of amazing if true. Don’t count on it.

Do I really have the flu?

There’s a good chance you don’t. This is tricky. People who feel really sick and think they have the flu might go to the clinic. Some of them might get tested to see if they have the flu. Of those who are tested, only about a third or a bit more test positive. I don’t know enough about the test to evaluate that. Perhaps they have a flu the test does not cover, or perhaps they have some other illness.

A health professional told me something that seems rather unbelievable about the flu. What should I do?

I have all the respect in the world for nurses, having been nursed by them a number of times and all, but … I’ve seen both wise and accurate advice and some of the dumbest wrongest things I’ve heard said by them regarding the flu. Having said that, the really wrong stuff is almost always someone on the internet, so how do we really know they are nurses? They probably aren’t. The nurses I know personally are smart about the flu. (Clarification: The fact that the person who claims to be a “nurse” who says the most wrong stuff is on the internet does not mean or imply that other people who claim to be nurses on the internet are automatically wrong. Further clarification: Being a nurse and misleading people about health advice is way bad. Claiming to be a nurse when you are not so that you can push your anti-Vax strategy or do some other unethical thing is bad in a different way. The particular case I’m thinking of is in a recent “ask me anything” web site page where a person claiming to be a nurse went on and on about the dangers of vaccines imploring everyone not to get any vaccines. A different person who also claimed to be a nurse dressed that person down and provided factual accurate information.)

But, if you hear something funny from anyone you can check it out. The CDC has a pretty good bunch of information about the flu. Their main flu page is here, and you can find links to all sorts of information thereon.

What about people having babies during flu season. What do they do?

This is an issue we dealt with three years ago when Huxley was born during a major epidemic of a nasty flu. As I mentioned, my S-I-L is dealing with it now. Here’s a few things you should know:

The part of the immune system that protects a person from the flu does not exist in new born humans. They won’t have that ability for many months (I see “six” as a commonly used number). This means that if your new born is exposed the flu, and gets it, you’ve got a serious problem. The best way to avoid this is to avoid contact with anyone who is sick, or for that matter, anyone who has not had a flu shot. You can be sure that everyone in our family was tied down and stuck with a needle three years ago!

Some people harbor the belief that a mother’s immunity to the flu is passed on to the baby. This can not be true because that part of the baby’s immune system does not exist yet. Some people believe that the mother will pass on to the baby immune products via her milk to protect the baby from things like the flu. This is not really true. The total amount of immune stuff that is passed on to the baby is much smaller than one might hope. If the mother is immune to a particular strain of flu (having had a flu shot, perhaps) that immunity will not protect the infant from that flu, and even if it did, there will be no protection from other forms of the flu.

The best strategy is for all people in the child’s household to get a flu shot, avoid lots of interaction with other people, and keep a bottle of hand sanitizer around and make everyone use it.

This, by the way, is where nurses can be especially helpful. If you are having the baby in the hospital or some other place where there are nurses, ask their advice. Pediatrics nurses are well versed in flu related issues vis-a-vis babies. Also, they are IRL nurses, not fake Internet nurses.

So, should I get a flu shot?

Yes. But if you are still not sure, do this. Go to your local clinic. Go to the waiting room. Hang out with the people in the waiting room, the ones who look half dead with illness and are wearing masks, waiting for a doctor to see them and send them home with little more than advice to take something for the fever and headache and drink lots of fluids. They’re the people who didn’t get flu shots. Spend a little time with them, and maybe you can get the flu too!

Or alternatively, you can hold your breath on your way past the waiting room to the place they give out cheap or free flu shots and just get one.

But, but, I heard about this person who got the flu and died from it and they had the flu shot and this other guy who….

OK, OK, hold on a second. In Minnesota, that happened. A child sadly died form the flu, but had had the flu shot. Here’s the thing. Every day in Minnesota there are thousands of people at the clinics who are sick and think they have the flu. Of them, many do. For every one of them, there are many, probably something like 20, that did not got to the clinic. So, we have many thousands of people at any moment in time who have the flu. For some, the shot was not effective, and for some, the flu is deadly. The juncture of those two unfortunate circumstances is unlikely, but given enough chances, unlikely things happen. That is why that child died.

But lots and lots of other people got the shot, were protected, did not get sick, and of them, a small number would have died, but their lives were saved.

Also, there is herd immunity. Last year we almost didn’t have a flu season, and I think that may be because so many people got flu shots that year. A couple of years ago we seem to have put off an epidemic, because so many people got immunized against the coming plague, as it were. Everyone who gets the flu can thank a number of individuals who did not get the flu shot for that gift. When you get the shot you give the more difficult to detect gift of not giving the flu to some other person. Not every time, not every year, but over time, that’s a give you give again and again. If you get the shot.

Finally, of you don’t get the shot you can’t see the baby until it’s in college!

How effective is the flu shot?

There are several answers to this question. One was overheard the other day among a bunch of well educated people oriented towards science who were taking a break from their job.

Person 1: “So, how effective is the seasonal flu shot?”

Person 2: “I heard about 1%. If you get the flu shot, you’ll have a 1% difference in if you get the flu.”

Person 3: “That’s crazy. I don’t know where you are getting your data from. It can’t be 1%, but I admit I don’t know what the actual answer is, but it can’t be that.”

Persons 4 through 6: “Well, if YOU don’t know, and HE says 1%, I’m going with the 1%. Too much trouble to get a flu shot anyway.”

Person 3: “Wait, wait! That’s crazy! That makes no sense!” as persons 1, 2, 4, 5 and 6 are filing out of the break room to go back to work. “You can’t leave thinking that 1% is correct! It can’t be correct!!!”

Person 5: [Over her shoulder on the way out the door.] “Hey, why don’t you go ask your husband. He’s a Scienceblogger, right?”
Continue reading How effective is the flu shot?

Innate Immune Response Defines Pathology and death in Those Infected by Highly Pathogenic Influenza

ResearchBlogging.orgFor the last couple of decades, perhaps beginning around the time of the publication of Laurie Garret’s excellent thesis (The Coming Plague: Newly Emerging Diseases in a World Out of Balance) on disease and politics and continuting through Gina Kolata’s “Flu: The Story Of The Great Influenza Pandemic” there has been increased attention on the 1918 flu virus and pandemic, as well as subsequent outbreaks. This interest has probably been fueled by increased knowledge of (or incidence of?) tragic and highly newsworthy outbreaks of Ebola, SARS, and so on. More recently, the perception has grown that the Bird Flu is a’comin’ any time now to ultimately replace the Great Pandemic of 1918 as well as the mud shark in our mythology.

If you read the better done public-oriented literature of this period, you will learn that the nature, cause or origin, and pattern of the 1918 epidemic has been very mysterious. The same level of mystery (but with only a few victims) arose in connection with the Swine Flu threat of the 1970s (see expecially Garret’s book for how this event links to current attitudes as well as public policy regarding vaccines).

This brings us to some time last year or so, when key papers were published (and I presume presented at conferences) regarding what may ultimately be seen as the most important single step in the history of understanding the way the flu vaccine works, and thus, how to combat it. (See this to explore one of those key moments in research history.)

The new knowledge is essentially an improved evolutionarily and developmental understanding of how influenza virus strains change over time. To put it very simply, these viruses are made of chunks that come apart in the host and then recombine. If there are multiple ‘strains’ (think species, more or less) of influenza in an individual, these genetic chinks, each representing a huge percentage of the influenza genome, can and do re-combine to form entirely new strains.

That is in a sense macro-evolution of a pathogen in situ, in the host. What is an immune system to do!?!!?!?? Not much, really. This can be very fatal.

It is now understood that these epidemic or pandemic influenza outbreaks arise from these recombination events. If you now look back at the quirky data, the odd logic influenza seemed to be patterned by, the epidemiological dead ends that seemed to confound everyone through the lens of knowledge of these genetic chunks, called “reassortants,” things suddenly become much much clearer.

A paper has just come out in PNAS reporting research using a primate model to explore immune response and associated pathology under the influence of a recombinant influenza virus, and this research is a direct outcome of this new way of looking at the flu. I offer it here without comment largely because you can get the article yourself, since this one is an OpenAccess piece from the normally not OpenAccess PNAS. Here.

Continue reading Innate Immune Response Defines Pathology and death in Those Infected by Highly Pathogenic Influenza