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The Flu and Flu Shots: Misery, Myths, and Misconceptions

Columnist: James Devore, M.D.
October, 2016 Issue

James Devore, M.D.
All articles by columnist

A case of the real flu is putting you in the octagon with the biggest, meanest bully on the block. You’re going to take a beating.

Brad was a sick puppy—absolutely miserable. Normally a strapping, athletic jokester with energy to burn, Brad rarely came in to see me unless it was bad. This was bad. You could see it in his eyes. There’s something about the way a patient with the flu looks that often makes the diagnosis easy, even from across the exam room. It’s not just the toxic haze in the air or the ragged, spine-racking cough that gives it away. Nor is it the crushing, almost visibly-throbbing headache. It’s the eyes: Once you’ve seen those hollow, glazed, sunken and altogether pathetic eyes you know it’s the real flu…and you know it’s bad. Brad had the real thing.

 Many people make the mistake of equating influenza with some other respiratory virus, but it’s not the same. During the year, there are hundreds of different viral strains that work their way through the respiratory tracts’ of every community. Almost everyone will get a “cold” like this now and again—a scratchy throat followed by nasal congestion, low-grade fever, malaise and (almost always) an irritating cough. It may last a week or so; you’re grumpy and disagreeable, but probably still trying to go to work and carry on the best you can. It’s no fun, for sure, but you can manage with some over-the-counter decongestants and cough meds, and you’re basically OK. Some people might call this a “bug” or maybe even a “flu bug.” But it isn’t really a flu virus at all.

What you had was a URI, just another “upper respiratory infection,” strictly in the minor leagues of viruses. It wouldn’t even make Triple-A let alone the big leagues. An influenza virus, on the other hand, in terms of its ability to make you miserable, keep you out of work, cause serious complications like pneumonia, put you in the hospital or even kill you, is major. An influenza virus is a world-class wreaker of havoc, year after year. A case of the real flu is putting you in the octagon with the biggest, meanest bully on the block. You’re going to take a beating.

If you’ve never had the flu, you may not understand. But it’s highly contagious, so it’s only a matter of time. Brad understands now, and is always first in line for the flu shot when it becomes available each fall. Let’s talk about flu shots and discuss some of the common misconceptions and myths.

Misconception: “The flu shot doesn’t work.” Fact: It usually works pretty well, but it’s far from perfect. Since different strains of this type of virus are constantly evolving and mutating, it’s hard to predict which particular strains will be most active in the coming year. And since the vaccines are produced in advance, this means inconsistent results. But it’s still effective, worthwhile and definitely reduces infection rates and flu-related mortality. Besides, even if it’s only partially effective, what’s wrong with the idea that some benefit is better than no benefit?

Myth: “The flu shot causes the flu.” Fact: Since it’s not a live virus vaccine, the flu shot absolutely will not cause the flu.

Misconception: “There are major risks associated with the flu shot.” Fact: There can be some very minor side effect, like a sore arm for a few days. But serious side effects are extremely rare. Statistically, the very small risks of a negative reaction are overwhelmingly outweighed by the considerable benefits.

Myth: “I’m naturally immune because I never get the flu.” Fact: Just because you haven’t been really sick with the flu in your recent memory, don’t think you’re naturally immune. No one is, with the possible exceptions of Superman and LeBron James—but don’t get me started!  

Misconception: “I take supplements like echinacea and Airborne, and these will protect me.” Fact: These products have no scientific validity whatsoever. If there’s any benefit at all, it’s minimal and won’t prevent you from getting the flu.

Myth: “The flu shot contains formaldehyde that will pickle me.” Fact: Yes, the flu shot (in some formulations) contains a miniscule amount of formaldehyde as a preservative. But that’s a non-issue. Your body contains a million times more formaldehyde from natural processes than any from the flu shot. Relax, and if you’re really worried about being “pickled” let’s discuss martinis!

I ran into Brad the other day and we reminisced about his mother-of-all-illnesses. “That was the sickest I’ve ever been in my life!” he reported. “I really thought I was going to die.”

“I’m really glad you didn’t” I replied with a sly grin. “That would have been bad for my quality scores.”

That’s it for now. The flu shot is widely available: What are you waiting for?




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