You probably already know that the “flu season” can be quite variable from year to year. Some years, relatively few people die, for instance in 1986–1987 only 3,349 died. But some years the flu can be very dangerous, in 2003–2004 for instance, 48,614 deaths were attributed to flu.
In 2014, San Diego, Washington state, North Carolina and Alberta, (Edmonton, Canada) each saw their deadliest flu seasons ever or within the past 5 years. In 1918 a flu (H1N1) pandemic killed an estimated 25 million people, infecting 500 million globally. This flu killed healthy young people with robust immune systems, not the weak or elderly. The 2009 H1N1 “swine flu” pandemic was similar to the 1918 strain, and part of the reason the 2014 season was so deadly is because H1N1 dominated yet again.
The reason for this wide variation is simple; deaths peak when strains of “Influenza A” dominate, and are quite a bit lower in years when “Influenza B” dominates. No one really knows what will happen on a given year. Flu mutates notoriously quickly. During the 2014–2015 flu season, the virus mutated in people, and the mutated strain spread rapidly, making the vaccines that people had been given less effective- at about only 19% immunity.
In the last few weeks of the 2015–2016 flu season, Influenza A (H1N1) viruses have begun to predominate. Overall, the viruses that have been circulating appear to have been well matched with the strains included in this season’s trivalent and quadrivalent influenza vaccines. The Centers for Disease Control and Prevention (CDC) has reported preliminary overall influenza vaccine effectiveness of 59% percent this season. That is great and compares well with data from previous years!! We have seen less pediatric mortality in this last flu season overall then the previous few years.
Planning for the 2016–2017 season is already underway. The recommended composition of the 2016–2017 influenza strains were recently announced, differing slightly from the 2015–2016 vaccine. The World Health Organization (WHO) recommended that the trivalent vaccine contain:
- A/California/7/2009 (H1N1) pdm09-like virus
- A/Hong Kong/4801/2014 (H3N2)-like virus NEW, and
- B/Brisbane/60/2008-like virus
The quadrivalent vaccine recommendation includes an additional B virus (B/Phuket/3073/2013-like virus). Last year, the B/Phuket/3073/2013-like virus was included in the trivalent vaccine, with the B/Brisbane/60/2008-like virus only appearing in the quadrivalent vaccine.
Every year I get the same questions about the flu shot. I have compiled my answers along with some general information on how the vaccine works. I hope this helps you to decide if the flu vaccine is right for you and your family.
Question: How do viruses and vaccines work anyway?
Answer: Viruses HIJACK our cells, they cannot replicate on their own. Viruses are basically a ribonucleic acid syringe. They are paragons of Darwinian evolution, having shed every single functional organelle (for example, they do not have mitochondria, ribosomes, Golgi apparatus, endoplasmic reticulum, or nuclei). They inject their DNA or RNA right into our own cells where it gets incorporated into our own DNA, where it is then translated and transcribed, so that our cell’s protein production machines are put to work, making new viral particles. The immune system protects the body from viruses. Specialized cells (Macrophage and T cells) roam around and when they encounter a viral particle they capture it, engulf it, break it apart, and present a small piece of it to the immune system. The immune system then goes to war, and becomes an antibody factory, making antibody-soldier cells against the small piece of virus that has been shown to it. Virtually hundreds of antibodies are released all day everyday by our immune systems. Vaccines work by mimicking a virus and stimulating the immune system to build up defensive antibodies against the pathogen if it is ever encountered again. You want your immune system to detect the most deadliest and destructive viruses before they can insert their DNA (or RNA) into yours.
You get symptoms after a viral infection because your body tries to kill the cells (YOUR CELLS) that are infected. Symptoms come from instructions provided to your cells by the virus itself, fro example, it will make you cough and sneeze (etc). The virus uses your body to spread itself to other people. It doesn’t have legs or arms or independent “locomotion”, it needs you to spread it around.
Question: Can’t I STILL get the flu, even if I get a flu shot?
Answer: Yes. The flu shot is only as good as your own immune system’s response to it!!! The effectiveness does not come from the vaccine, it comes from you. If your body creates a strong response to the vaccine then your immunity to flu will be high. If you have a weak response then your immunity will be low, and you may still get the flu. That is why the effectiveness of the vaccine can vary between people. Usually, the flu vaccine is “quadrivalent”, meaning you will be vaccinated against only the 4 most common strains of flu. That being said, the shot does ALSO give you protection in general from the flu (not just to strains in the vaccine). Getting the shot “primes” your body to recognize and fight all strains of the flu. So, if you are infected with a strain not covered by the vaccine your symptoms will be less severe, and even the most severe consequences of infection, like death, can be prevented.
Question: Why bother getting the shot then, if I can still get the flu?
Answer: Even just a ‘simple’ hospitalization from the flu will cost on average up to $4,000, and that number doesn’t include your lost wages! Flu makes you miserable! And don’t forget, it is a DEADLY disease. On average 40,000 people die every year from the flu.
Most people do things every day that are only somewhat effective at preventing severe consequences, but they do them anyway on the off chance that it might prevent some freak occurrence from happening. For example: some people “always” buy organic because they think that it prevents cancer or is healthier (neither of these claims have evidence to back them up). Brushing your teeth everyday is kind of effective at preventing cavities, but it needs to be coupled with flossing, which a lot of people don’t do. Wearing your seat belt probably can’t prevent every death from *catastrophic* car accidents, yet most people never question these activities, despite the fact that they can not prevent all cavities or all car deaths or all cases of cancer. YET these same people will turn around and say that they wont get the flu vaccine because it is not effective against every strain of flu. It doesn’t really make any sense, at all.
Also, it’s not just whether you get sick or not. The most vulnerable members of our society need to be protected by us. It is a concept called “herd immunity”. You can spread germs to others who can’t get the shot even if you don’t get sick yourself. Examples of people who cannot get the flu shot are people who are immune-compromised, very sick people, babies under 6 months, the elderly, people undergoing cancer therapy, and people who legitimately can’t get vaccines because of allergies.
Question: If I get a vaccine won’t that weaken my own immune system because I won’t be challenging it enough? What doesn’t kill you makes you stronger?
Answer: No. Most people don’t know that getting the shot actually does “work” your immune system. Just as hard as actually getting the flu from natural infection. It puts your immune system to work making antibodies against the virus, the EXACT same way as if you were infected, but without the miserable, costly or even deadly side effects.
Our immune systems are MIRACULOUS things. They fight off thousands of encounters with bacteria and viruses and parasites every day. When you allow your self to get sick, you open yourself up to getting massive secondary bacterial infections (like pneumonia, bronchitis or rhinovirus). Because coughing rips up the throat, making you vulnerable to the common bacteria that live in our throat and around our nose and that we are exposed to all the time. A lot of people that die during the flu season actually die form these secondary infections that they never recover from. And god forbid you actually pick up a strain of bacteria that is antibiotic resistant, which many are now (!!) due to the over use of antibiotics.
Question: I don’t want to get flu symptoms from the shot, and I’ve heard that if I get the vaccine I will feel sick.
Answer: You can’t get the flu from getting the shot.
That is a common misconception because vaccines used to be made with whole viruses that had been “weakened” (attenuated), they were still strong enough to make us feel sick. Today’s vaccines are made with just the smallest piece of virus possible, not the whole virus, therefore it is impossible to get sick from them. There is one exception: If you opt to get the nasal mist vaccine, that is made with “live attenuated” virus, so you can get some symptoms if you chose that delivery method over the shot.
Question: When should I get vaccinated?
Answer: CDC recommends that people get vaccinated against flu soon after vaccine becomes available, if possible by October.
It takes about two weeks after vaccination for antibodies to develop in the body and provide protection against the flu.
Doctors and nurses are encouraged to begin vaccinating their patients soon after vaccine becomes available, preferably by October so as not to miss opportunities to vaccinate. Those children aged 6 months through 8 years who need two doses of vaccine should receive the first dose as soon as possible to allow time to get the second dose before the start of flu season. The two doses should be given at least four weeks apart.