Did you get the Flu Shot?

Oct 29, 2019

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

We all have someone like Aunt Peggy. Aunt Peggy lives in Winnipeg and has strong opinions about everything. Aunt Peggy was right that Winnipeg has the record for the longest skating rink in the world, beating out Ottawa. But Aunt Peggy was wrong about which city was the coldest. The coldest temperature ever recorded in Winnipeg was -47.8°C in December 1879. That did make Winnipeg the coldest city in the world with a population of 600,000 or more. But now Batar in Mongolia has now moved into first place. Aunt Peggy was right that Winnipeg is home to Olympic speed skaters Clara Hughes and Cindy Klassen. But Aunt Peggy is wrong that all Winnipeg produces is skaters and hockey players. Aunt Peggy didn't know that James Peebles was born and raised in Winnipeg. James Peebles won the 2019 Nobel Prize in Physics for "for [his] theoretical discoveries in physical cosmology."

Aunt Peggy says flu shots are a bad idea. Let's see how that assertion stacks up. The flu (or influenza) is a highly contagious viral illness. It can spread easily from one person to another through coughing, sneezing or sharing food and drinks. You can also get the flu by touching objects contaminated with flu virus and then touching your mouth, eyes or nose. That is why hand washing is so important to prevent the spread of the flu. It is also recommended that you cough or sneeze into your elbow, sleeve or into a tissue. Influenza symptoms include fever, headache, cough, muscle aches, runny nose, sore throat and exhaustion. The symptoms of the flu are usually more severe than that of a cold. The onset of the flu is usually quite sudden. Flu symptoms usually last from 7 to 10 days, but the cough and weakness can continue for 6 weeks. Influenza arrives in Manitoba every year in late fall or early winter.

The best way to avoid getting the flu is to get the flu shot. As safe and effective as the flu shot is, people do still have questions. Questions such as "Can I get the flu from the flu shot?" No. The flu vaccine is made from dead virus parts. It cannot give you the flu. Unfortunately, some people can get sick, or can even get the flu immediately after the flu shot. That is because the flu shot doesn't start working until 2 weeks after the shot. That means you can catch the flu and get symptoms during that two week period. Also, people who seem to have gotten the flu within a day or two of the shot probably had the flu virus in them already at the time of the shot, and would have gotten sick anyway. Finally, the flu shot only protects against some very specific influenza viruses. It doesn't protect against the common cold virus or bacterial illnesses.

"Can the flu shot give me a bad reaction?" Rarely. But it is almost always safer to get the flu shot than to get the flu. The flu shot is made in chicken eggs. That means people with serious egg allergies should not get the flu shot in the pharmacy. By serious egg allergy, we mean more than hives. We mean swelling of your face, lips, trouble breathing and needing epinephrine to fix the problem. But if you have a serious egg allergy, you are not off the hook. Patients with a history of severe egg allergy can usually tolerate any flu vaccine. But they should talk to their doctor. Their doctor may arrange to give the vaccine in a medical setting under the supervision of a healthcare professional who can identify and treat severe allergic reactions such as the emergency room.

Children under 7 years old can't get a flu shot at the pharmacy, but they should still get a flu shot. To provide optimal protection, children between the ages of 6 months and eight years should receive two doses of influenza vaccine (separated by at least four weeks) if they have not received at least two doses of influenza vaccine (separated by at least four weeks) prior to July 1, 2019. Immunocompromised patients, pregnant women, breastfeeding women and post-partum women may receive any licensed, recommended, age-appropriate injectable flu vaccine. If you are mildly ill, like a slight fever or mild cough, still come get your flu shot. If you are moderately or severely ill, delay your flu shot until you feel better.

You can get a local reaction at the injection site that turns red and sore for up to two days. You may also get fever, headache, or muscle pain. Your pharmacist can get you acetaminophen products to help with these mild symptoms. If these symptoms get very bad or last for a long time, seek medical attention. If you get hives, difficulty breathing, or swelling of the throat, tongue or lips after you leave the flu clinic, call 911 or go to the nearest emergency department for immediate treatment.

"How well does the flu shot work?" That is difficult to say. The influenza virus mutates every year or so. Scientists look at what the flu virus was like last year and try to predict what it will be like this year when they make up a new batch of vaccine. If the virus only changed a little, the flu shot works well. If the virus changed a lot, the flu shot doesn't work as well. The on average, the flu vaccine is effective in about 40-60% of healthy adults and children. In nursing homes, the flu vaccine stops 50%-60% of flu related hospitalizations, and 85% of flu related deaths. As said before immunity to the flu usually starts about 2 weeks after the shot and lasts less than 1 year. The elderly, unfortunately, can have their immunity fall off in as little as 4 months.

There are lots of smart people from Manitoba. And Aunt Peggy might not be one of them. We officially have a Nobel Prize winning theoretical physicist in James Peebles. We also have a bunch of really bright scientists at the National Microbiology Lab in Winnipeg. They work on infectious diseases from around the world. They have been involved in developing a vaccine for Ebola. If you had a virologist from the National Microbiology Lab in the room with you right now, what do you think she'd say about getting your flu shot? And who should you believe, the virologist or Aunt Peggy?

As always if you have any questions or concerns about these or other products, ask your pharmacist.

The information in this article is intended as a helpful guide only. It is not intended to be used as a substitute for professional advice. If you have any questions about your medications and what is right for you see your doctor, pharmacist or other health care professional.

Manitoba Health Flu info site: www.gov.mb.ca/health/flu

Health Canada Flu site: www.fightflu.ca

CDC How Flu Shots Work - https://www.cdc.gov/flu/vaccines-work/index.html

Canadian Immunization Guide Chapter on Influenza and Statement on Seasonal Influenza Vaccine for 2019-2020 - https://www.canada.ca/en/public-health/services/publications/vaccines-immunization/canadian-immunization-guide-statement-seasonal-influenza-vaccine-2019-2020.html


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