The end of summer means the start of flu season

Come on, folks, roll up your sleeves—and your kids’ sleeves, too. Summer’s officially over and it’s time for the flu shot.

Every year, I’m caught off guard by how many people don’t want to get a flu shot. There are lots of people who are happy to get them—anxious, even—but I’m always surprised by how much I end up being a flu shot salesman.

This puzzles me, because getting a flu shot makes abundant medical sense. Every year millions of people get influenza, and some of them get very sick; some get sick enough to die from it. It’s hard to get exact numbers on how many people die from the flu, but it can vary from just a few thousand to more than 40,000. Usually it’s the very young, the very old and people with health problems who get hit worst by the flu, but last year was different. H1N1 (called “swine flu” at the beginning, although you can’t catch it from pigs) ended up being the predominant flu virus, and it was children, young adults and pregnant women who were most affected by this strain. In fact, last season there were four times as many child deaths reported than in the previous five influenza seasons. Because of this, the Centers for Disease Control (CDC) and the American Academy of Pediatrics (AAP) are recommending that everyone over the age of 6 months (yes, everyone!) get a flu shot. Flu shots are a safe, effective way to protect yourself and your family. And when you keep yourselves healthy, you are protecting the people around you. This year, H1N1 was included in the seasonal flu vaccine, so there’s no need for two different vaccines. Seems like a straightforward decision.

But for some people, it’s not so straightforward. Here are some common reasons for balking—and my response to them.

The flu shot makes me sick. I hear this all the time, that people got the flu shot and then got sick, or had a bad winter of sickness afterward. You can certainly have side effects from the flu shot. Pain where you get the shot, aches, fever, nausea, and generally feeling yucky is entirely possible for a day or two afterward, although most people feel just fine. But the flu shot can’t give you the flu, and if you had a bad winter, it wasn’t the flu shot’s fault.

My kids and I are always healthy, so we don’t need it. Lucky you. I hope it continues to work out for you—but you should know that there is no guarantee it will. Plenty of the people who got really, really sick last year were people who were generally healthy.

I don’t trust the H1N1 vaccine, because it’s new. From the information collected last season, the H1N1 vaccine appears to be just as safe as any flu shot. Which is what it is. H1N1 is a type of influenza A, and the vaccine was made in the same way we’ve been making flu shots for years. It’s not a totally new vaccine, like many people seem to think.

I’m worried about thimerosal in flu shots, because I’ve heard it can cause autism. This has been studied really carefully, and there is really no good evidence that thimerosal (a preservative used in some immunizations) causes autism. For more information on thimerosal, visit the Food and Drug Administration page on it or the CDC’s page on thimerosal in vaccines. If you have lingering concerns, there is a thimerosal-free version.

I have (or my child has) an egg allergy. The flu shot is made using eggs, and so people who are allergic to chicken or eggs may have a reaction to it. The good news is that unless the allergy is severe, people with egg allergies usually tolerate the vaccine just fine. It may need to be given differently, or with some observation time afterward—talk to your doctor.

We got the shot last year. Yeah, well, that’s the bummer of flu shots: you have to get them every year, because every year the flu shot is slightly different, based on the strains of influenza that experts think are most likely to cause illness. Children under the age of 9 need two shots the first time they get it, and this year some may need two shots even if they got it last year, depending on how many of the seasonal and H1N1 shots they received. Your doctor will sort it out with you.

I heard that H1N1 didn’t end up being so bad last year. It’s true that H1N1 could have been much worse. Which is a good thing, given that it spread very quickly all over the world (and hasn’t gone away). But like I said before, some people got very, very sick from it—and we really don’t know what it will do this year. Better safe than sorry.

Some people will choose not to get the flu shot. I understand that. But what I hope is that people will make the decision based on real information, not misinformation or emotion. Three great places to get that real information are: the CDC’s flu web site, the new AAP health information site for parents, and the web site of the Immunization Action Coalition. And, of course, talk to your doctor—who, like you, wants you and your child to be healthy.