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Aging for Amateurs: Get that flu shot now, and maybe some other vaccines, too

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Health experts are encouraging patients to get a flu shot now. 

I know you've seen the signs in almost every pharmacy and grocery store for the last two months: “We have flu shots!”

And you have certainly seen articles in this newspaper and other news sources about this flu season and the fact that there have already been six flu-related deaths in South Carolina since the 2018-19 flu season started. Yet, despite the fact that there will almost certainly be hundreds more deaths due to influenza in South Carolina and more than 30,000 deaths due to flu in the U.S., about 30 percent of those over 65 will not get a flu shot.

Why not? People usually give me one of three reasons when they say “No, thanks” to the flu vaccine.

The first: “I’ve never gotten the flu before, so I just don’t think I need it.”

My response: Unfortunately, influenza viruses change frequently, so while your immune system has been able to keep you from being infected thus far, our immune systems become at least somewhat less effective as we age, making us more likely to be infected with each passing year. Because of the ever-changing nature of influenza viruses and because the targets of the vaccine have to be chosen months before the influenza season begins to allow time for vaccine production, sometimes the flu strains in the vaccine don’t exactly match what is being spread in our communities. That makes some vaccines in some years less effective than we would hope, as happened with last year’s vaccine. But, even with a “poor match,” that vaccine prevented almost a third of expected doctor visits and about 40 percent of expected hospitalizations for flu.

The second frequently used excuse given for not getting a flu shot is, “The shot gave me the flu!”

My response: The flu vaccine uses parts of killed influenza virus particles to stimulate your immune system to develop resistance to those viruses. And a killed virus can’t give you a disease. Stimulating the immune system can give you some achiness in your muscles, especially where the shot is given, but it can’t give you the flu. In the past, there were more impurities in vaccines of all sorts and consequently more local reactions, but not so with today’s vaccines. Since it takes at least a couple of weeks for the immune system to build up resistance to the flu after the vaccination, flu that develops during that period is likely due to an infection that was already in you before you got the shot.

The third reason for not getting a flu shot is: “I just don’t feel well enough to get one now.”

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My response: Unless you have a fever of at least 100 degrees or other symptoms severe enough to prevent you from doing most normal activities, it is better to get the vaccine now rather than to put it off and potentially fail to get it at all. A mild illness is not a reason to delay getting your flu shot, and the flu shot won’t make a mild illness worse.

There are other objections to flu shots, but they don’t hold water, except in the case of a severe allergic reaction (symptoms requiring epinephrine treatment) to a past flu shot.

The bottom line: If you haven’t gotten your flu shot this year, please get one soon. Be sure to ask for the “high dose” vaccine. It has four times the immune stimulant of the standard vaccine and is designed to help older immune systems like ours develop better levels of immunity to the flu.

And while we're talking about immunizations, there are four other vaccines that the Centers for Disease Control and Prevention recommend for all of us who are over 65.

  • Shingrix for herpes zoster or shingles (a two-shot series discussed in a column earlier this year)
  • Two vaccines to prevent pneumococcal disease (one of the most common causes of pneumonia): Prevnar 13 and Pneumovax 23
  • Td to prevent tetanus (“lockjaw” due to a contaminated wound) and diphtheria (usually a disease of childhood, now rare, but unless immunity is maintained, it can occur in adults and be transmitted to unvaccinated children)

The CDC also recommends other immunizations for those with specific behaviors or medical conditions. A very helpful tool, “The Adult Vaccine Quiz,” can be found online: www2.cdc.gov/nip/adultimmsched/

The brief quiz includes 11 questions that will help you and your health care provider make a plan to get and keep your immunizations up to date.

Bert Keller and Bill Simpson write the occasional column, “Aging for Amateurs.” Simpson, a retired physician, wrote this installment. Comments, questions and suggestions are welcome at agingforamateurs@gmail.com.

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