Do I Need A Flu Shot?

By Christian Sandrock, MD, MPH, Yolo County Health Officer
October 13, 2011

I was having coffee at the hospital a few weeks ago and overheard colleagues at the next table talking about the influenza vaccination that is mandatory for all healthcare workers. “I have never been sick a day in my life,” one said. “I don’t see why I need it.” His friend chimed in, “the last one made me sick.” A third said “even if I get the flu, I would recover quickly and am not at risk for any problems.” If this is the way healthcare professionals feel, encouraging influenza vaccinations is going to be an uphill battle.

My colleagues’ concerns are unfortunately common. Many healthcare systems, under the guidance of the Yolo County Health Department, require healthcare workers to be vaccinated or wear masks in patient care areas during flu season to protect patients. One common reason for declining the flu shot is fear of getting sick. This belief is pervasive in the medical community, is found throughout the greater community, and is one of the main reasons vaccination rates remain low.

So what is the likelihood of getting sick from the flu shot? For the general public, there are largely two types of vaccinations offered. The most common is an inactivated vaccine which contains portions of the virus. This is administered by injection. Since it contains small portions of the virus, we cannot get the flu from the shot. The most common reaction is local pain and swelling. In children, fever can occur. We recommend this vaccination for all over age 6 months.

The second vaccine is an activated virus. It is administered as a mist into each nostril and the virus is specially designed to be replicated at lower temperatures so it stays only in the nose rather than moving deeper into your body. As a result, your body develops resistance to these influenza components based on the natural infection process. This type of vaccination has been best studied among children and confers much better immunity in the 2-5 year old age group, but we can administer the vaccine for ages 6 months to 49 years. Since this is a live virus, we can see some flu-like illness, wheezing, and in some cases, coughing as part of the immune response. So, yes, with this vaccination you can see a mild illness that then confers protection to seasonal influenza.

The CDC recommends vaccination for all age groups, but particularly the younger (6 months to 18 years), the older (over 65) and those with medical conditions (heart disease, lung disease, transplantation). Influenza kills approximately 30,000 individuals yearly and hospitalizes over 100,000, mostly in these age groups. The community burden then is in our otherwise healthy individuals, ages 10-30. By vaccinating them, we provide a “herd” immunity that reduces the rates of influenza among all. As with many vaccinations, the administration not only benefits the individual, but the community as well.

One of the most common questions I get from parents and friends is, “should I give my child the flu shot; they are so healthy.” Each time I say, “yes, without question.” Ask your nurse or doctor if they got their flu shot this year. It might be an educational opportunity.