In our practice, doctors have the option to administer influenza vaccines right in the exam room. The truth is, giving the flu shot only takes a couple of seconds. The syringes are pre-filled, so all you have to do is pop on a needle, swipe the patient's upper arm with an alcohol pad, and jab.
It's the conversation that precedes the flu shot that takes time.
Take yesterday. A very intelligent middle-aged woman came in for her annual physical. She's got a graduate degree and works primarily with the elderly. Though virtually everyone over six months old is eligible for the influenza vaccine, an updated version of which is available in the U.S. every fall, it is especially recommended for people at particular risk of getting the flu, getting complications from the flu, or transmitting the flu to those most vulnerable: people over 65 and under five, those with diabetes, heart, lung, and immune diseases and other chronic conditions, health care workers, and those who have frequent contact with those at high risk. I explained to my patient that her job put her in the high risk group.
The conversation that ensued was similar to many I have every year around this time, and about which I wrote last year in this blog. The patient told me that she was leery of getting the flu shot after a bad experience she'd had with it many years ago. When I inquired about the "bad experience"--an allergic reaction?--she explained that she'd had more respiratory infections than usual the winter after she'd received the shot.
I barely had to mention that there's nothing in the flu vaccine, which contains no live virus and has no way to cause (or prevent) colds, bronchitis, sinusitis and other common infections. My patient knew all this...intellectually. She still had, as many of my patients do, a bad feeling about the flu shot and its potential side effects.
A new report from the University of Minnesota may help allay these concerns, and raise new ones. The report, nicely summarized in this article, asserts that while the current flu vaccine is safe and should still be used, it's not nearly as effective as it should be, especially in the elderly. It asserts that the effectiveness of the vaccine in the elderly may have been overestimated, in part, because older people who get the vaccine may be those who go to doctors and take better care of their health generally. The author of the report expresses concern that as long as we continue to be over-confident in the effectiveness of the current vaccine, researchers (and manufacturers) won't be motivated to improve it.
The Minnesota report is provocative and will no doubt raise eyebrows at the Centers For Disease Control, which strongly endorses widespread administration of the flu vaccine.
So I'm still giving flu shots...and bracing for even longer conversations about it this year.
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