Flu Vaccine (copy)

The flu shot may not be a perfect match, but it may lessen the length and severity of your symptoms if you are diagnosed. File/David Goldman/AP

How many times have you heard that question since fall began? How many times have you passed your nearest drug store or the pharmacy counter in the grocery store without getting that shot?

Maybe you have had your shot, but you know of a good number of aging amateurs who haven’t. Data from the Centers for Disease Control and Prevention suggest that it isn’t hard to find folks who haven’t had the shot, but are among the most likely to have severe cases of the flu if they catch it (about one in three seniors doesn’t get the shot).

We all talk about the flu, but just to be sure we’re on the same page, the flu develops rapidly over a 24-hour (or less) period with fever, cough and widespread achiness.

Often people say, “I felt fine one hour and the next I felt awful.” This contrasts with a cold or upper respiratory infection where the onset is much more gradual (over days) and nasal congestion is usually the prominent symptom. Tests for the influenza virus are available, but they are often inaccurate, especially early in the disease.

I'm sure you’ve heard or perhaps have even given one of these reasons for avoiding the flu shot: “I’ve never had the flu, so I don’t need it.” (We actually become more likely to get the flu as we get older, so that doesn’t work). Or “I got the flu from the flu shot, so I don’t want it.” (You may get a sore arm in the area where the shot was given, but the virus in the vaccine is altered so that it can’t produce the flu.)

Or, perhaps, “It’s just a bad cold.” As I’m sure you know, the flu is not just a bad cold. It can lead to serious health complications like pneumonia or other bacterial infections which can require hospitalization and even cause death.

In fact 70 to 85 percent of those who die from influenza are over 65 years old.

After you get your flu shot, protection isn’t immediate. It takes about two weeks to develop immunity. To be honest, development of immunity isn’t perfect. The vaccine is based on an educated guess as to the types of flu likely to be in circulation in a given year (based on a review of worldwide data), so some vaccines turn out to be better than others. This year it looks like the match of flu types that are being passed around in the U.S. to those in the vaccine is pretty good, so protection from the flu should be good, too.

As of late November, only six states reported widespread influenza cases, as determined by state health officials. South Carolina was one of the six. Flu activity usually peaks between December and February, so there is plenty of time for you to catch it. (After you’ve had the shot, it takes about two weeks to develop significant protection from the flu.)

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There are multiple forms of the flu vaccine this year. Two are specifically designed for those of us who are 65 or older. The CDC chose not to recommend one vaccine over the other due to limited data, so either of the vaccines for those over 65 is fine — just be sure to ask for an over-65 vaccine. The names of the “over-65 vaccines” are Fluad and Fluzone High-Dose.

As you have probably also heard there is a new treatment for the flu this year called Xofluza (the generic name is a mouthful — baloxavir marboxil.) It is similar to other flu treatments that have been available for several years. All work best if they are given during the first 48 hours of symptoms. And they all decrease the duration of flu symptoms by about 24 hours and may lessen the severity of flu complications in those at higher risk (asthmatics and those with other chronic debilitating diseases, especially of the heart or lungs).

Xofluza is different in that it is given as a single dose, rather than multiple doses over several days. You have probably seen the TV ads suggesting that you can get it for $30. There are a lot of conditions in the material describing the offer, so check with your insurer to see what your price will be if you and your caregiver decide you have the flu and have come in for treatment in the 48-hour window or have one of the higher risk conditions. Xofluza may be hard to find, but Tamiflu (oseltamivir), the most widely use influenza treatment (it is given twice a day for five days and costs around $35 for those without insurance) is widely available.

For the vast majority of us, if we do get the flu despite having had the flu vaccine, expect it to be less severe than it would otherwise have been. What to do for the flu? Rest, drink plenty of fluids, warm saline gargles for sort throat, and acetaminophen, ibuprofen or naproxen for achiness and fever. None of this will change the course of the flu, but will likely help you feel better. See your health care provider if you are not improving after a day or two or getting worse, rather than gradually better.

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.