The flu demystified

Local health experts discuss both sides of flu vaccine controversy

Flu shot versus flu mist:
The vaccine that’s injected differs from the vaccine that’s inhaled nasally. The flu shot consists of dead virus; flu mist has live virus that’s been weakened. The shot and mist are not wholly interchangeable: The shot is recommended for people over 6 months old, the mist for people ages 2 to 49—and certain health conditions (such as autoimmune diseases) may preclude one or the other, if not both.

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It’s hardly breaking news that the flu is going around, but its virulence may be a surprise. The California Department of Public Health reported that as of Feb. 7, more than 200 Californians under age 65 have died from influenza this flu season, compared to 106 for the entire 2012-13 flu season. That figure likely will increase with new diagnoses as well as CDPH investigations into 44 other deaths that may be flu-related.

“It’s been a bad year,” said Dr. Mark Lundberg of Butte County Public Health, “with more than the expected number of deaths—and those deaths, and complications, have occurred disproportionately more severely in young people. Most times younger people can tolerate it, but there have been complications and death [among] people you wouldn’t have expected.”

Like many public-health officials, Lundberg encourages vaccination against influenza, such as the flu shot or flu mist. “There are still at least two months left in the flu season, and if you haven’t had the flu yet, it still could be a good idea,” he said. Both Lundberg and Susie Benson, a nurse and infection preventionist at Enloe Medical Center, recommend flu shots for anyone older than 6 months old.

But not everyone agrees.

“I do not get vaccines myself or recommend them,” wrote Deborah Penner, chiropractor and nutritional consultant at Chico Creek Wellness Center, in an email. “Evidence shows that there are more incidences of sickness and death in the vaccinated population than the unvaccinated population where the flu shot is concerned. Even a nonmicrobiologist can easily deduce the idiocy of creating a vaccine that takes many months to develop for a virus that is mutating at lightning speed.

“It is dumbfounding to learn the history of vaccines, and sickening to realize the financial forces involved,” she continued. “There is a large and growing body of evidence that vaccines are at the very least contributory to neurological development disorders (ADD, autism, bipolar) as well as autoimmune disease, asthma, allergies, cancer, diabetes and gastrointestinal disease, which are occurring at a frighteningly increasing rate, especially in the [U.S.].”

Penner referred to the work of fellow Northern California chiropractor Tim O’Shea, specifically his book Vaccination is not Immunization, which she said “should be in every household, in my opinion. As he says, the decision to vaccinate, or not, is quite possibly the most important decision you will ever make for your child.”

Lundberg understands “reasonable people having reasonable fears”—he hears concerns from patients and parents—but remains steadfast in his recommendation.

“Vaccines are probably one of the greatest medical advancements,” he said. “It’s certainly not to say that there is not a complication with any therapy; with any medical treatment that’s of benefit, there can be a complication rate. … So I think public-health officials and medical professionals all have to be diligent to weigh the risk [versus] benefit analysis.

“I believe that vaccines—the ones we have now, the ones that are recommended—always come down on the side of benefit.”

Regarding the flu vaccine specifically, Lundberg and Benson field a common set of concerns:

“I got the flu from the flu shot.”

Since the flu shot contains dead virus, and the flu mist has what Lundberg referred to as “attenuated live virus” (a virus that’s been weakened), the vaccine does not deliver the illness; rather, it stimulates the immune system to create antibodies.

The process of building resistance can take two weeks, so a person exposed to the flu before then can come down with the disease.

Often, though, the illness a person develops is not actually the flu. “There are a lot of respiratory viruses circulating,” Benson said, which can have symptoms similar to influenza. In addition, what people call “the stomach flu” is not actually flu because influenza viruses cause respiratory—not gastrointestinal—sickness.

“The flu vaccine doesn’t work.”

No vaccine—or any medical treatment, for that matter—is effective 100 percent of the time for 100 percent of people. “But, even if [flu vaccine is] effective only at 60 percent, and even if it doesn’t prevent the flu for certain populations, it actually can prevent a person getting a severe complication or death,” Benson said.

Flu viruses do mutate, and each year’s vaccine includes only strains that immunologists predict will be widespread for the particular flu season. So far this winter, Lundberg said, all the positive flu tests analyzed by the state have been for anticipated strains.

“I’m allergic to eggs, so I can’t get the flu shot.”

That was true in the past, Benson said, but now the risk of reaction is seen as “so minute that unless you have a true egg allergy where you have an anaphylaxis reaction, it’s not a contraindication for the flu shot.” She added that a vaccine grown in a nonegg medium called Flublok hit the market this year.

“If everyone else is getting vaccinated, perhaps I can sneak through.”

The concept of “herd immunity” suggests that people who get flu shots and don’t get the flu protect those who don’t get vaccinated because the illness won’t spread. That, of course, is a numbers game. “The more we can get people vaccinated,” Benson said, “the more we protect the age-6-months-or-less child who can’t get vaccinated.”

Beyond a sense of social responsibility, there’s also a self-centered reason for considering a flu shot.

“The flu will mess your life up,” Lundberg said. “I think people should view [the vaccine] as an insurance policy, that your life will not be impacted by this illness that can stick you in bed for any number of days.”