Is There Any Reason Not To Get A Flu Vaccine?


It’s that time of the year to get a flu vaccine again. Routine vaccination against influenza A and B viruses is recommended for everyone 6 months of age and older unless there is a specific reason not to. (More on that later.)

In spite of the recommendations, fewer than 50% of Americans got a flu vaccine last year. In order to minimize the risk of an epidemic of influenza, officials would like for at least 70% of Americans to get vaccinated. There are many choices of vaccine. Unfortunately, for those who hate needles, the nasal spray vaccine is no longer available. It was found to be less effective than inactivated vaccines (flu shots) in preventing influenza illness in children. Due to that, the ACIP (Advisory Committee on Immunization Practices–a part of the Centers for Disease Control) advises against using the live intranasal flu vaccine for anyone this year.

As health care providers, we hear a lot of reasons (excuses) for not getting the flu vaccine. Here are a few…

I’m tough. I have never had the flu.

We hope that all of our patients have an immune system to be proud of. But the fact is that 5 to 20 percent of the US population gets influenza each year. The influenza virus doesn’t care if you have had it before or not. As our friends in advertisement would say, “Past performance is no guarantee of future returns.” So if you don’t get a flu vaccine, you are gambling that you will be lucky. There is a very good chance that one of these years your luck will run out. And if you lose, you can expect at best to feel crummy and miss a week of school or work. At its worst, you can die from influenza (even if you are healthy before you get it). The rate of death for influenza is 1.4 people for every 100,000 persons. In the greater St. Louis area of about 3 million people, that is 42 people. Ask someone who works in a hospital. People die of influenza each year. It is best to protect yourself and your friends and family that you are exposed to.

Can’t I get the flu from the vaccine?

Nope. Other than the nasal vaccine (which is no longer available), NONE of the influenza vaccines contain any live virus, and cannot cause influenza. They are either inactivated virus vaccines or a recombinant vaccine that is produced without the use of influenza virus or chicken eggs.

But people say that the flu vaccine made them sick.

An influenza vaccine can cause soreness at the injection site, and rarely it can cause aches or fever. But it cannot cause an infection. Influenza vaccine is commonly given in the late fall and early winter when people get a lot of viral infections that are not influenza. When millions of people get a vaccine, it is likely that some of them will get a cold shortly after which is not caused by the flu vaccine.

How do I know the flu vaccine will really work?

You really don’t; however it does significantly increase your odds of staying healthy. The decision of what strains of virus go in the vaccine is made months before the influenza season. Some years the educated guess of what should be in the vaccine is better than others. If the match between the vaccine and the viruses in the community is good then you reduce your risk of getting sick by 40 to 60%   Even when it is a poor match, vaccination has been shown to reduce the risk of hospitalization and death from influenza.

How do I know which influenza vaccine I should get?

Your healthcare provider can advise which vaccine is best for you.
In our practice (because we see a lot of people with allergies) we use only preservative free vaccines. If you are 65 or older, a high dose vaccine is recommended. It has four times the amount of antigen (inactivated virus) as the standard dose vaccines. It has been shown to be more effective than the standard dose vaccine for those 65 and older.

What about the vaccine during pregnancy?

Vaccination of pregnant women not only protects them against influenza-associated illness, but also protects their infants for up to the first 6 months of life.

What about egg allergy and the vaccine? Doesn’t it contain egg?

Studies have shown that even people with severe allergy to egg can tolerate the influenza vaccine, and egg allergy is NOT a contraindication for Influenza vaccination.

So who should NOT get the vaccine?

Influenza vaccination has been associated with Guillain-Barre syndrome (a disorder in which the body’s immune system attacks the peripheral nerves resulting in weakness and tingling), but the risk is very low and the influenza infection itself has also caused this syndrome. If someone has had Guillain-Barre syndrome, then they should not get the influenza vaccine.

We hope for your sake (and ours too) that you and your family get the influenza vaccine this season.

In addition, this article by Dr. Aaron Carroll explains why getting vaccinated is important for the whole community.