Why You Need Your Flu and Pneumonia Shots

(November 2008) - The weather is getting cooler and football season is in full swing. It’s time for an annual fall ritual – flu and pneumonia shots. Every year without fail, I am asked, “why do I need a flu shot again?” and “doesn’t the flu shot just give me the flu?”

It is always amazing to me the decreasing faith the general public has in vaccines. In just the last 20 years, a major cause of neonatal and infant infectious mortality has been almost completely eliminated by vaccination -- Haemophilus Influenza Type B. The varicella (chicken pox) vaccine has also dramatically reduced the incidence of the disease in our pediatric population. Unfortunately, as people choose not to vaccinate their children, we have seen a resurgence of the measles virus in pockets of the nation. In the past year, 131 cases of measles were reported in the U.S., and 91 percent of those cases occurred in people who had not been vaccinated.

One of the chief reasons people tell me they do not want the flu shot is that they believe they can get the disease from the shot. This is not true. The vaccination is made from an inactivated/killed influenza virus that cannot cause the flu. What generally happens is that, because the shot is given in the winter months, people contract a cold or other respiratory illness around the same time the flu shot is given. Mistakenly, people associate their cold with the flu shot they received. It only takes one time for this to become a permanent association in most people’s mind.

Another reason people do not want the flu shot is that they have heard on the news or from friends that it doesn’t work. It’s true that sometimes the strains of influenza selected for the immunization do not exactly match the strains causing the disease in a particular year. However, studies have shown that the flu shot is still protective in these years and can work to lessen the severity of the illness. The strain of influenza virus to be used for the vaccination is chosen in February of each year by a collaboration of the World Health Organization, Centers for Disease Control and Prevention (CDC), and the Food and Drug Administration. It must be selected early to allow sufficient time for the six-month manufacturing process.

What the general public forgets when they skip the flu shot is that influenza causes 36,000 deaths and 200,000 hospitalizations each year (based on information from the CDC). Ninety percent of these reported deaths occur in people over age 65. Last year, 83 children died because of complications from influenza. Sadly, only 33 percent of the most at-risk patients get the flu shot annually.

The CDC recommends the following people get a flu shot every year:
· Children between 6 months and 18 years of age
· Pregnant women
· People over the age of 50
· Any person with a chronic medical condition such as heart or lung diseases, diabetes, anemia, kidney disease, or impaired immunity
· Individuals who live in nursing homes, chronic care facilities, and assisted living or retirement communities

The peak incidence of influenza occurs from late December through February. Therefore, the vaccination should be given between September and November. It takes two weeks after immunization for the immune system to develop antibodies to the virus.

The immunization is covered by Medicare and most other insurance companies. People who have an allergy to egg proteins should avoid the flu shot as it is manufactured with these proteins. Most side effects include soreness at the injection site and potential fever during the first 48 hours after injection. If there is an allergic reaction to the vaccination, it generally occurs within the first 15 to 30 minutes, while the patient is still in the doctor’s office.

Of equal importance is the pneumococcal vaccination or “the pneumonia shot.” Each year, nearly 40,000 people die from pneumococcal infections such as meningitis and pneumonia. The overall mortality of a patient with a pneumococcal infection is 15 to 20 percent, especially in the elderly and people with compromised immune systems. The rate of infection is highest in adults older than 65, children under 2 years of age, and African-Americans. In one study, 86 percent of the pneumococcal infections were caused by strains that would have been covered by the pneumococcal vaccination. Still, only 66 percent of individuals over the age of 65 are vaccinated.
In one study of 3,400 patients in 2007, people who had pneumonia and required hospitalization were 40 percent less likely to die or need to be in the intensive care unit than those who had not been vaccinated.

The CDC recommends the following people receive the pneumococcal vaccination:
· All adults over 65 years of age
· Under age 65, people with chronic cardiovascular disease, pulmonary disease, diabetes mellitus, alcoholism, cirrhosis, cerebrospinal fluid leaks, cochlear implants, HIV, chronic kidney disease, or cancer
· People receiving chemotherapy or long-term corticosteroids
· People living in nursing homes, chronic care facilities, and assisted living or retirement communities
· If a person receives the pneumonia shot for one the conditions above before the age of 65, a second immunization should be given after the age of 65 as long as five years have passed between injections
Make plans to get your flu and pneumonia vaccine in October or November. It will only take a few minutes, and it could literally save your life. It’s no fun to get a shot, but it’s better than spending a week in the hospital. If you don’t do it for yourself, do it for the people you love. These diseases are contagious. If you get them, you could give them to your spouse, children, or grandchildren. Influenza and pneumonia are preventable illnesses. Nobody should suffer from them.

Written by John Moore, M.D., Memorial Health University Physicians – Memorial Medical Associates. To schedule an appointment with Moore, call 912-350-6000. This article first appeared in Savannah Health Perspective magazine's November/December 2008 issue.