It’s that time again. The flu season starts in October. You will be protected about two weeks after you get the flu shot. Flu vaccination is recommended every year for everyone over 6 months of age. This year there is a quadrivalent option in addition to the usual trivalent option (covering four circulating strains of virus vs. three). The live attenuated nasal spray vaccine is no longer recommended due to concerns about its effectiveness. High-dose vaccines are available for the elderly, who may not mount a satisfactory antibody response with the standard dose. Egg allergy is not a contraindication. It is now considered safe for people with egg allergy to get any standard vaccine; but if the allergy involves any symptoms other than hives, the vaccine should be given in a medical setting and supervised by a professional trained to handle emergencies. And if you’re still worried, there are egg-free vaccine options.

The CDC has a useful information page.

Flu shot myths

Every year people refuse to get their flu shots because they believe false information they have encountered. Every year we have to repeat our efforts to debunk that false information and provide accurate information. We feel like Sisyphus: we roll that rock up the hill every year, and every year it rolls right back down.

Science journalist Tara Haelle has compiled the most comprehensive list of flu shot myths I’ve come across. On her website, she provides answers to the myths and links to her sources. I encourage you to go there. As a preview, here is her list:

  • Myth #1: The flu vaccine gives you the flu or makes you sick.
  • Myth #2: Flu vaccines contains dangerous ingredients, such as mercury, formaldehyde and antifreeze.
  • Myth #3: Pregnant women should not get the flu shot. / The flu shot can cause miscarriages. / Pregnant women should only get the preservative-free flu shot.
  • Myth #4: Flu vaccines can cause Alzheimer’s disease.
  • Myth #5: Flu vaccines provide billions of dollars in profits for pharmaceutical companies.
  • Myth #6: Flu vaccines don’t work.
  • Myth #7: Flu vaccines don’t work for children.
  • Myth #8: Flu vaccines make it easier for people to catch pneumonia or other infectious diseases.
  • Myth #9: Flu vaccines cause vascular or cardiovascular disorders.
  • Myth #10: Flu vaccines can break the “blood brain barrier” of young children and hurt their development.
  • Myth #11: Flu vaccines cause narcolepsy.
  • Myth #12: The flu vaccine weakens your body’s immune response.
  • Myth #13: The flu vaccine causes nerve disorders such as Guillain-Barré syndrome.
  • Myth #14: The flu vaccine can cause neurological disorders.
  • Myth #15: Influenza isn’t that bad. Or, people recover quickly from it.
  • Myth #16: People don’t die from the flu unless they have another underlying condition already.
  • Myth #17: People with egg allergies cannot get the flu shot. It will kill them!
  • Myth #18: If I get the flu, antibiotics will take care of me.
  • Myth #19: The flu shot doesn’t work for me, personally, because last time I got it, I got the flu anyway.
  • Myth #20: I never get the flu, so I don’t need the shot.
  • Myth #21: I can protect myself from the flu by eating right and washing my hands regularly.
  • Myth #22: It’s okay if I get the flu because it will make my immune system stronger.
  • Myth #23: Making a new vaccine each year only makes influenza strains stronger.
  • Myth #24: The side effects of the flu shot are worse than the flu.
  • Myth #25: The flu vaccine causes Bell’s palsy.

Some further points

She covered it pretty well. I can only think of a few things to add. Some of the people who think they got influenza after the shot did get influenza, but from another strain of the virus that was not covered by the vaccine. Others had a “flu-like” illness from another virus that was not influenza. You can hardly expect the flu shot to protect against strains it was not formulated to work on! Although actually it might provide partial protection against related strains.

The protection from the vaccine is not perfect, but if you are infected with one of the strains of virus that were covered by the vaccine, you will likely have a milder illness.

Cost should not be a concern. It may cost more than some people think they can afford, but catching the disease would be much more expensive (count not just treatment costs but time off work, pain and inconvenience, and the risk of transmitting it to others). If you don’t have health insurance, there are ways to get a free flu shot, or to get one for a reduced cost (as low as $14.99 at Costco). There is a convenient website that tells you where to look.

Some people have objected that the yearly-changing new flu vaccines have not been properly tested. They don’t need to be, because they are the same vaccine as in previous years, just with slightly different strains of the virus. And if we were to do controlled studies on each year’s vaccine, by the time the studies were completed it would be too late to use that vaccine, because it would be another year with a new group of strains circulating.

Babies under the age of 6 months can’t get the flu shot; they are unprotected. The elderly, the chronically ill, and the immunocompromised are more vulnerable than the average healthy adult. The more people in a community who get the flu shot, the smaller the chance that flu will spread through the community and reach these vulnerable groups. One way to put this is “If you won’t get the flu shot for yourself, get it for Grandma!”

Flu shots make sense

No immunization is 100% effective, and flu shots are less effective than immunizations for many other diseases, like measles. By one estimate, 33 to 100 healthy adults have to be vaccinated to prevent one case of influenza symptoms. But that one case might be you. It’s like insurance. How many houses have to be insured against fire for one house to burn and get a payout? Does anyone say, “I don’t need insurance because I’ve never had a fire”?

Flu shots have been given to millions of people; they are remarkably safe, and far safer than catching the disease. The disease can kill; the shots are not known to have ever killed anyone (deaths after vaccination have been reported, but no causal link to the vaccine has been found).

So, we have a safe, low-cost (or even free) insurance that will reduce your risk of having to suffer through a bad case of influenza and might even save your life, and that might help save the lives of vulnerable people in your community. It’s a no-brainer.

Get your flu shot!

Posted by Harriet Hall

Harriet Hall, MD also known as The SkepDoc, is a retired family physician who writes about pseudoscience and questionable medical practices. She received her BA and MD from the University of Washington, did her internship in the Air Force (the second female ever to do so),  and was the first female graduate of the Air Force family practice residency at Eglin Air Force Base. During a long career as an Air Force physician, she held various positions from flight surgeon to DBMS (Director of Base Medical Services) and did everything from delivering babies to taking the controls of a B-52. She retired with the rank of Colonel.  In 2008 she published her memoirs, Women Aren't Supposed to Fly.