Flu Shots

Nov 4, 2020

By Trevor Shewfelt, Pharmacist at the Dauphin Clinic Pharmacy

Light Saber? Flying car? Replicator to create my hot beverage of choice? (Tea, Earl Grey, hot has a ring to it.) The future is here, and it is not what I expected. For example, I can now have Zoom video conversations with people across Canada very easily. That also means I can't duck things by saying, "I'd love to come to that extremely boring meeting in Winnipeg, but I live in Dauphin, so sorry, I can't make it." And medical science was supposed to be different by now, wasn't it? Whatever happened to reaching inside our cells and fixing our genes? When will that arrive? Actually, it is here already. It is called CRISPR-Cas 9. It works so well that Jennifer Doudna and Emmauelle Charpentier won the 2020 Nobel Prize in chemistry for it.

The future of flu shots are different this year as well. If you are going to go to one of the Flu Clinics put on by Prairie Mountain Health, you will have to call a head and make and appointment. Prairie Mountain Health Flu Clinics will not take walk ups. The Dauphin Clinic Pharmacy Flu Clinic will take walk ups from 9 am to 5 pm Monday to Friday. However, the DCP Flu Clinic is not in the actual Pharmacy this year. It is in the big blue metal building in the parking lot. We have signs all over the building, so you won't miss it. When you come for a flu shot, we'll ask you to wear a mask, take your temperature and ask you a few questions to see if you are feeling well. To maintain social distancing, we will only allow a few people into our flu shot building at a time. If we get lots of people at once, we'll take your name and cell number and get you to wait in your car. The good news is flu shots have been going very well, and hardly anyone has had to wait.

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). Immunocompromised patients, pregnant women, breastfeeding women and post-partum women may receive any licensed, recommended, age-appropriate injectable flu vaccine.

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.

It is extra important to get the flu shot in 2020. In a normal year, a relatively large number of people end up in the hospital, ICU and even die of the flu. This year, our hospitals are already getting full with cases of COVID-19. Let's keep as many cases of flu out of the hospital as possible. On the good side, hand washing, masks and social distancing are really good at preventing the spread of flu as well as it does COVID-19. So, let's keep up with those.

Doudna and Charpentier's Nobel prize is different and remarkable for many reasons. Gene editing with CRISPR Cas9 is already allowing countless advances in medicine and biology. And, it is only 10 years old. CRISPR Cas9's newness is remarkable because many Nobel prizes are awarded decades after the discovery is made. But what surprised me the most about Doudna and Charpentier's Nobel is that this is the first all-female team that has won a Nobel in Chemistry. To all the girls out there trying to learn remotely and learn with masks we know the future is different than you expected. However, if you love science, and study hard, your future just might be unmasked to reveal an award named after Alfred Nobel.

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.

Prairie Mountain Health Flu Clinics - www.prairiemountainhealth.ca/images/Influenza/Flu_Master_sheet_North_2020_5.pdf

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

Health Canada Flu site: www.canada.ca/en/public-health/services/diseases/flu-influenza.html

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


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