It’s the time of year when it seems like everyone’s recommending that you get a flu shot. There’s a lot of misinformation out there, and it can be confusing. How do you know if you need a flu vaccine? Could it cause more harm than good? It's a personal decision, and one you should take time to research thoroughly. My hope is that you're as informed as possible, and after reading this piece, I wanted to join the conversation.
Vaccinations have been some of our biggest public health successes in the past century and they’re a big reason why most of us are living much longer than our great-grandparents. A white male born in 1900 could expect to live to age 47, whereas a white male born in 2000 can expect to live to age 75. Many improvements in longevity are because we now have vaccines to control infectious diseases such as polio, measles, mumps, and the flu.
While many of us don’t think of the flu as a deadly disease, keep in mind that the influenza pandemic of 1918 killed 20 million people worldwide, 675,000 of them in the US.
Today, influenza is still a significant health threat: it’s estimated that anywhere between 3,000 to 49,000 people die every year from influenza or its complications. Many of them are people with underlying medical issues, but a substantial number are otherwise, young healthy people.
This was the case with the 2009 H1N1 (Swine Flu) pandemic, which affected young people to a much greater extent than older people. In fact, 10,000 people died from H1N1 or its complications, and the vast majority of them were between the ages of 18 and 64. Typically flus kill older people, but with H1N1, it was thought that many elderly people had been exposed to an earlier strain of that flu in their youth (and thus had antibodies to defend against it), whereas young people had never been exposed at all, and thus had no internal defenses against it.
Unfortunately, I had the opportunity to care for many of these folks at my hospital and on some days, I had multiple family members in the ICU at the same time. What’s even more tragic about this is that these deaths were preventable: people who’d received the flu vaccine for H1N1 that year were protected from this deadly flu.
While it’s true that receiving the influenza vaccine does not prevent the flu in 100% of people, it is associated with a significant reduction in the risk of death and other medical complications. Among elderly people who are vaccinated, for example, there is a 27% reduction in hospitalizations and a 48% reduction in deaths during an influenza epidemic. And, as we saw in 2009, it can also save lives among young people.
So, I am among the physicians who recommend my patients get a flu shot each year. I also receive a flu shot each year, so that if I am protected and provide care for elderly or frail people, I am unlikely to spread the disease. This is called “herd immunity” and may be one of the best ways to protect the elderly and those whose immune systems may not allow them to have a robust response to the flu shot.