The flu vaccine is smart every year

The following is statistics and the medically educated opinion of  Dr. Karl L. Breitenbach, MD regarding annual flu vaccination. 

The Centers for Disease Control and Prevention (CDC) report that the 2017-2018 Influenza (flu) season was the first season to be classified as a high severity season — this was across all age groups. As of Aug. 25, 2018, a total of 180 pediatric deaths due to influenza had been reported. Approximately 80 percent of these deaths occurred in children who had not received a flu vaccination for this season. The mortality (deaths) attributed to pneumonia and influenza exceeded 10 percent for four consecutive weeks, peaking at 10.8 percent during the week ending Jan. 20, 2018. The overall vaccine effectiveness of the 2017-2018 flu vaccine against both influenza A and B viruses is estimated to be 40 percent. This effectiveness rate typically varies from 40 to 80 percent annually.

The remainder of this article is my educated opinion.

The flu vaccine available in the fall and winter of 2017-2018 was not as effective as we would have liked it to be for preventing the strains of the influenza virus that were actually seen. However, there are really only two ways to develop immunity against influenza — which is currently the virus that causes the greatest rates of illness and death in our modern society.

  • Become infected with the virus and if you live through it, your body will develop humoral immunity. (develop antibodies against the strain of the virus you were infected with.)
  • Seek out yearly vaccination with the vaccines developed.

Many people have what I feel is an inappropriate short-term expectation of influenza vaccination. They hope it prevents them from getting “the flu” during the winter after they receive the vaccination, but they don’t think about their long-term immunity.

Unfortunately, as we observed from the 2017-2018 influenza season, not everyone who gets a flu shot will derive good immunity from the vaccination — also, the immunity they derive may not match the strain of the influenza virus that presents in their community that year.

I would like to ask people to take a long-term perspective on influenza vaccination. Everyone understands the concept of giving the same, or similar vaccines, over and over again — each subsequent dose of vaccine is called a booster. This practice occurs with most childhood vaccines and has been highly effective. With each exposure to the antigen (proteins from infectious organisms) in the vaccine, the recipient of the vaccine will develop higher and higher levels of antibodies and immune system memory against the organism.

Immunization against many organisms can be accomplished with one or a short series of vaccinations. Unfortunately, the influenza virus mutates (changes) frequently. It looks slightly different almost every year. This means we must have a lot of immune system memory before we become adequately immune to influenza.

You have two options to achieve this level of immune system memory.

  • Repeated bouts of illness to different strains of influenza virus.
  • Repeated vaccination.

To me, the choice is clear. I feel fortunate to have had the opportunity to have now had 33 years of flu shots. They aren’t always painless — Frequently receiving a flu shot will trigger your immune system to release inflammatory mediators that can cause you to have fever and body aches, as well as pain and swelling at the injection site. My patients tell me that “the flu shot gave me the flu.” This is, of course, impossible for the flu shot to give you the flu as it does not contain any live virus. I also usually tell them that I am happy when my flu shot gives me those symptoms — because then I know it is working. While I don’t enjoy feeling achy and feverish after a flu shot, I am reassured when I get these symptoms, because that tells me that the flu shot has done its job and has caused a response from my immune system.

To conclude:

  • Get a flu shot every year to develop a higher level of immunity against this virus — historically and presently, the most deadly virus that you are likely to be exposed to every year.
  • Have realistic expectations that the flu shot is not always effective, but with enough years of “flu booster,” you will become more and more immune after each shot received.

Dr. Karl L. Breitenbach, MD
Family Practice Physician & TriCounty Health Department Medical Advisor

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