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 Topic: The Flu Vaccine

Influenza:

1. Why do we need a flu shot every year?

     a. Virus and vaccine

          i. Virus is constantly mutating/changing

          ii. Vaccine only works against one portion of a protein on the surface

          iii. WHO/CDC basically makes an educated guess as to which virus will be the most likely

     b. Even in a “bad” year when the vaccine doesn’t match well, the effectiveness is still about as good as most medications at preventing/treating their corresponding diseases.

2. Why should people get the flu shot?

     a. Because it decreases your chance of getting flu, getting a severe case of the flu, being hospitalized for the flu and even dying from the flu

     b. The “but I am a healthy adult” excuse…

          i. Healthy adults can die from influenza (e.g., WWI and many cases reported with H1N1)

          ii. Some evidence that certain strains can cause more severe disease in adults versus elderly or children due to a more robust immune response that causes more lung damage

          iii. You can still spread influenza even if you only have mild to almost no symptoms

3. So what are the symptoms of influenza?

     a. First, it isn’t a cold… typically no runny nose, doesn’t start slowly and take a few weeks to kick

     b. It also isn’t the “stomach flu”… this is caused by enteroviruses and other pathogens.  

          i. Patients with influenza may have vomiting and diarrhea, but it isn’t a classical symptom.  (also can have multiple viruses circulating)

     c. Influenza is typically fever (therefore chills), malaise, sore throat and headache.  If someone comes in and says they don’t feel well and is sniffling/sneezing, it isn’t the flu.  If they come in and say they feel like they are going to die, that’s the flu.

4. Who is most at risk for having complications or more severe influenza?

     a. Age… young children and elderly

     b. Other diseases… asthma, COPD, diabetes, heart disease, basically any other chronic disease that compromises any organ, including taking medications that lower your immune system.

     c. What else? Morbid obesity, neurological compromise, 

 PREGNANCY!

5. Why is pregnancy a risk?

     a. Basically causes both immunosuppression and puts strain on the mother’s organs

     b. We saw very high rates of hospitalization and mortality with H1N1.

     c. Numerous studies have shown it is safe and also protects the baby after birth (along with Tdap!)

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