- I sometimes hear these words: ‘I never get a flu shot, and I never get the flu.’  

O.K. Let’s play that game. What if people said:

• ‘I never wear seat belts, and I never get killed in car crashes’;
  
  
• ‘I never use condoms, and I never become infected with sexually transmitted diseases’;
  
  
• ‘I eat red meat seven times a week, only exercise once a year, and I’ve never had a heart attack or a stroke.’
  
  

Injected flu vaccines only contain dead virus, and a dead virus is, well, dead: it cannot infect you. There is one type of live virus flu vaccine, the nasal vaccine, FluMist. But in this case, the virus is specially engineered to remove the parts of the virus that make people sick.

Despite the scientific impossibility of getting the flu from the flu vaccines, this widespread flu myth still won’t die. Experts suspect two reasons for its persistence.  

1. people mistake the side effects of the vaccine for flu. While side effects to the vaccine these days tend to be a sore arm, in the past, side effects often felt like mild symptoms of the flu.

2. flu season coincides with a time of year when bugs causing colds and other respiratory illnesses are in the air.  Many people get the vaccine and then, within a few days, SOME will get sick no matter what, with an unrelated cold virus. Some of these people immediately blame the innocent flu vaccine that they just received a day or a few days earlier, rather than their co-worker with a runny nose and cough. It’s statistically guaranteed that of all the 135 million people in the USA who get the flu shot every year, some are going to get sick anyway, either with the flu that had already infected them before the vaccine was given, or with another virus or bacteria, and then this vocal minority is going to spread the falsehood that “the flu shot gives people the flu”, which is utter nonsense. Most doctors know this. All hospitals know this and that is why 99% of healthcare workers, including medstudents and nursing students, are required to get the flu vaccine if they are to continue employment.


2. Surely getting seasonal flu is just annoying but mostly harmless?

Unfortunately, many think of the flu as a very bad cold, but it’s much worse than that.

In addition to the congestion and cough, you’ll have nasty body aches and fever and you usually feel terrible. You feel like you’ve been hit by a truck.

Aside from the short-term misery and lost workdays, flu can have more serious implications. Although, most people who get the seasonal flu recover just fine, the seasonal flu hospitalizes 200,000 people in the U.S. each year. It kills between 3,000 and 50,000 people each year. That’s close to the number of women killed by breast cancer each year.

3. But isn’t flu only dangerous for the elderly or people with chronic medical conditions?

It’s true that the people most likely to become seriously ill or die from the seasonal flu are aged over age 65, but flu is risky for anyone, even healthy young adults. Some of the most susceptible people to seasonal influenza are young children.

Children under 2 have some of the highest rates of hospitalization from seasonal flu. Children under 6 months are at the most risk from the seasonal flu because their immune system is too undeveloped to properly process the vaccine.

To protect infants from the flu, keep babies away from people who have the flu. Parents and caretakers of infants should get vaccinated, and first time parents are [tellingly] far more willing to get a flu shot than other young healthy people. Perhaps people will do what they know is the right thing more often to protect a loved one, like their own newborn, than they will to protect themselves.

4. What would you say to young and healthy people, who think they don’t need to worry about getting the vaccine?

First of all, we should all get the seasonal flu vaccine. Sure, if you’re in good health, you’ll probably recover from the seasonal flu just fine if you get it. But why suffer through the flu if you can avoid it? Second, protecting yourself isn’t the only reason to get vaccinated.

Healthy adults forget that while they themselves might be at low risk for getting serious flu complications, other people in their family might not. If you have a small child at home, or an older parent, your failure to get yourself vaccinated could endanger them.

And that’s true on a larger, societal level. People with the weakest defenses, like children under 6 months, can’t get the flu vaccine. Their safety depends on the rest of us getting immunized. Let me rephrase that: THE SAFETY OF THOSE AROUND US WHO ARE LESS STRONG, DEPENDS ON THE STRONGEST AMONG US GETTING VACCINATED.

5. How do you respond to those who say vaccines are dangerous?

In recent years, there’s been growing mistrust of vaccines, including the flu vaccine. Some believe that there could be a link between vaccines -- specifically the ingredient thimerosal -- and developmental disorders in children, like autism.  However, there is no evidence that vaccines cause autism, and many healthcare professionals feel we’re losing sight of how important vaccines are.

Vaccines are, arguably, the greatest medical advance in history AND IN HOMELAND SECURITY. They’ve prevented more illness and death than any other implemented strategy or protocol.

If you’re still concerned despite the evidence, you should know that there are thimerosal-free flu vaccines available. In fact, every year, manufacturers produce more of this vaccine than people use. If you want your child to get it, just ask your doctor.

The flu vaccine is not out best vaccine for at least three reasons:

(1) every year the immunologists developing the vaccine have to make an educated guess as to which which influenza strains will be circulating 9 months in the future.  The better the guess, the better the protection the vaccine should provide.  Some years they choose better than others. But often the match between the vaccine and the disease is not optimal, so vaccine efficacy can be decreased.  The vaccine works best when there is a good match between the vaccine and circulating strain of influenza.

(2) response to the vaccine is not 100%.  The older and those with weaker immunity are the least likely to develop a good antibody response to the vaccine, and yet they need this vaccine the most.

(3) vaccination rates are often suboptimal to get benefit in populations, i.e. herd immunity.  The elderly will more likely benefit if they are not exposed to influenza at all rather than relying of vaccine mediated protection. It may be more important if those around them, say their health care provider or family, receives the vaccine and as a result does not pass flu on to more vulnerable people. But we rarely get vaccination rates at levels for herd immunity to kick in.

There are some anti-vaccine people who seem to require that vaccines either be perfect, with 100% efficacy and 100% safe, or they are not worth taking.

The influenza vaccine is not 100% efficacious in preventing disease, but it is as close to 100% safe, and much safer than the disease.

Or you can look at the preponderance of data, with all the flaws,  nuance, subtleties and qualifiers, and conclude the flu vaccine is of benefit.  The vaccine decreases the probability of morbidity and mortality.  It is a good thing.

6. Does cold weather cause the flu?

No matter what your grandma may have said, going outside in the winter without a hat or warm coat does NOT increase your risk of flu. While there might seem to be a connection -- since flu season coincides with colder months in the U.S. -- there isn’t. Flu season is the same throughout the whole country: even if it’s freezing in Minnesota while still warm in Florida. Colder weather might increase the risk of flu in one way: We do come into closer contact with other people because we’re all stuck inside. That does make it easier for the virus to spread.

7. I’ve heard people say that if you haven’t gotten the seasonal flu vaccine by November, there’s no point getting vaccinated at all. Is that true?

While supplies of vaccine used to run out by November, that’s not the case anymore. Nowadays, there should be enough vaccine for anyone who wants it, and you should be able to get it as late as December or January.  Besides, the flu often doesn’t hit its peak until February or sometimes as late as March. The flu vaccine will protect you for the strain that is going around, even if it’s 6 months later, so I say get it as early as possible, like this week!

No matter what month it is, if you haven’t had your flu vaccine yet, go get it. You could spare yourself -- and your family -- a lot of misery.

8. So where is the best place to get a flu shot?

You can get your influenza vaccine from your local pharmacy, although they’ll typically charge you $30, which is another annoying part of getting a vaccine. One thing we do at all four of our clinics is to offer patients who comes in for any other problem, such as a sprained ankle, a flu shot, at no extra charge, meaning if their insurance doesn’t pay, the patient won’t have to pay anything more for the shot. Yes, it costs us, but we believe in doing whatever we can to get the whole community vaccinated, so this is our strategy, as well as a marketing ploy to come to us for your illness or injury, instead of anywhere else! You can find out more at STLFluShots.com

3. What are the symptoms?

It is not always easy to know if someone has a concussion. 

Symptoms of concussion can last for hours, days, weeks, or even months, and they fit into four main categories:

• Thinking and memory
  
  
• Not thinking clearly
  
  
• Feeling slowed down
  
  
• Not being able to concentrate
  
  
• Not being able to remember new information
  
  
• Physical
  
  
• Headache
  
  
• Fuzzy or blurry vision
  
  
• Nausea and vomiting
  
  
• Dizziness
  
  
• Sensitivity to light or noise
  
  
• Balance problems
  
  
• Feeling tired or having no energy
  
  
• Emotional and mood
  
  
• Easily upset or angered
  
  
• Sad
  
  
• Nervous or anxious
  
  
• More emotional
  
  
• Sleep
  
  
• Sleeping more than usual; increased drowsiness
  
  
• Sleeping less than usual; Having a hard time falling asleep (insomnia)
  
  

Young children can have the same symptoms of a concussion as older children and adults, but it’s harder to tell if a small child has a concussion. Young children may also have symptoms like:

• Crying more than usual.
  
  
• Headache that does not go away.
  
  
• Changes in the way they play or act.
  
  
• Changes in the way they nurse, eat, or sleep.
  
  
• Being upset easily or having more temper tantrums.
  
  
• A sad mood.
  
  
• Lack of interest in their usual activities or favorite toys.
  
  
• Loss of new skills, such as toilet training.
  
  
• Loss of balance and trouble walking.
  
  
• Not being able to pay attention.
  
  

If your child has had a head injury and has an alteration in behavior (‘not acting right’), call your doctor immediately, or come and see us at STLSportsClinic.com and get assessed, which may result in further testing, and hopefully will result in reassurance that everything is actually okay. 

Concussions in the elderly can also be dangerous and these too are often missed. If you are caring for an older adult who has had a fall, check him or her for symptoms of a concussion. Signs of a serious problem include a headache that gets worse and/or increasing confusion. See a doctor right away if you notice these signs. If you are caring for an older adult who takes blood thinners—warfarin (Coumadin) is an example—and who has had a fall, take him or her to a doctor right away, even if you don't see any symptoms of a concussion. If you can’t get in to see your doctor immediately, come and see us at STLSportsClinic.com, open 7 days a week. 

Sometimes after a concussion you may feel as if you are not functioning as well as you did before the injury. This is called postconcussive syndrome. New symptoms may develop, or you may continue to be bothered by symptoms from the injury, such as:

• Changes in your ability to think, concentrate, or remember.
  
  
• Headaches or blurry vision.
  
  
• Changes in your sleep patterns, such as not being able to sleep or sleeping all the time.
  
  
• Changes in your personality such as becoming angry or anxious for no clear reason.
  
  
• Lack of interest in your usual activities.
  
  
• Changes in your sex drive.
  
  
• Dizziness, lightheadedness, or unsteadiness that makes standing or walking difficult.
  
  

If you have symptoms that might be postconcussive syndrome, call your doctor or come and see us at STLSportsClinic.com.

5. How is a concussion treated?

Any person who may have had a concussion needs to see a doctor. Some people have to stay in the hospital to be monitored overnight. People who go home still need to be watched closely for warning signs or changes in behavior. Call your doctor or come and see us, or go to the ER if you are watching a person after a concussion and the person has:

• A headache that gets worse or does not go away.
  
  
• Weakness, numbness, or decreased coordination.
  
  
• Repeated vomiting or nausea.
  
  
• Slurred speech.
  
  
• Extreme drowsiness or you cannot wake them.
  
  
• One pupil that is larger than the other.
  
  
• Convulsions or seizures.
  
  
• A problem recognizing people or places.
  
  
• Increasing confusion, restlessness, or agitation.
  
  
• Loss of consciousness.
  
  

Warning signs in children are the same as those listed above for adults. Take your child to the emergency department if he or she has any of the warnings signs listed above or:

• Will not stop crying.
  
  
• Will not nurse or eat.
  
  

A person who might have a concussion needs to immediately stop any kind of activity or sport. Being active again too soon increases the person's risk of having a more serious brain injury. Be sure you get a doctor’s approval before returning to play.

Rest is the best way to recover from a concussion. You need to rest your body and your brain. Here are some tips to help you get better:

• Get plenty of sleep at night, and take it easy during the day.
  
  
• Avoid alcohol and illegal drugs.
  
  
• Do not take any other medicines unless your doctor says it’s okay.
  
  
• Avoid activities that are physically or mentally demanding (including housework, exercise, schoolwork, video games, text messaging, or using the computer). You may need to change your school or work schedule while you recover.
  
  
• Ask your doctor when it's okay for you to drive a car, ride a bike, or operate machinery.
  
  
• Use pain medicine only as directed. Your doctor may give you a prescription for pain medicine or recommend you use an over-the-counter pain medicine, such as acetaminophen (for example, Tylenol) or ibuprofen (for example, Advil or Motrin).
  
  

Some people feel normal again in a few hours. Others have symptoms for weeks or months. It is very important to allow yourself time to get better and to slowly return to your regular activities. If your symptoms come back when you are doing an activity, stop and rest for a day. This is a sign that you are pushing yourself too hard. It is also important to call your doctor or nurse practitioner, or come and see us at STLSportsClinic.com, if you’re not improving as expected or if you think that you are getting worse instead of better.

6. How can you prevent a concussion?

Reduce your chances of getting a concussion:

• Wear a seat-belt every time you drive or ride in a car or other motor vehicle.
  
  
• Never drive when you are under the influence of drugs or alcohol.
  
  
• Wear a helmet and safety equipment when you:
  
  
• Play sports, such as baseball, hockey, and football.
  
  
• Drive or ride on a motorcycle, scooter, snowmobile, or ATV.
  
  
• Do other activities where you could injure yourself, such as biking, skateboarding, skiing, or riding a horse.
  
  
• Make your home safer to prevent falls.
  
  

Reduce your child's chances of getting a concussion:

• Use child car seats and booster seats correctly.
  
  
• Teach your child bicycle safety.
  
  
• Teach your child how to be safe around streets and cars.
  
  
• Keep your child safe from falls.
  
  
• Teach your child playground safety.
  
  
• Help your child prevent injury from sports and other activities.