The flu shot: Did you get yours?

If you think having CML exempts you from the flu shot, you\’re wrong.

Here we are in the thick of it; the season for colds, coughs and the dreaded flu. And though we all know what to do cut the chances of getting sick -wash your hands often, cough in your sleeve and don’t go to work if you are sick – chances are still good that you’ll have some form of season-related illness this winter. And while most of us can handle the sniffles that come with a cold, the shivers, fever, unrelenting nausea and vomiting that come with the flu can bring even the strongest among us to their knees.

So if I told you there was a way to avoid the paralyzing curse of this year’s flu, you’d want to know all about it, and how you can sign up. Right?

Probably not. According to a recent Statistics Canada survey, in 2013-2014, just under a third of Canadians received the flu shot. Of those who didn’t, 56 per cent said they felt it was unnecessary and 26 per cent said they “didn’t get around to it.” That’s roughly 28 million people who took a chance that they’d spend a few days with their head in the toilet.

“Part of the reason that some people don’t get the flu shot is that we expect a vaccine to work perfectly,” says Dr. Allison McGeer, referring to the belief that you get the flu after getting the flu shot. Quoting a randomized study in which half the participants received the flu shot and half received a placebo, McGeer, who is a microbiologist and infectious disease consultant at Mount Sinai Hospital in Toronto, says both groups complained of lethargy and other flu-like symptoms.

“People don’t get the flu from the flu shot,” she says. “They get sick because they get the shot in October and November when there are viruses all around them, this is the time that most people get sick. It has nothing to do with the vaccine.”

And though she concedes that you can get the flu even if you have been vaccinated, statistically, the illness will be less severe.

“Is it possible to get sick even if you have been vaccinated? Yes. But we know for sure that you will be less ill. People say, ‘Why should I get the flu shot if it isn’t going to work?’” she says. “But this is the wrong question. The right question is: which is safer, getting the vaccination or not?”

So, Dr. McGeer. Which is safer?

“First, let’s talk about how we view risk,” she says. “We don’t think rationally about risk. We don’t feel risks as they actually are. For example, if we are going on a trip, the greatest risk is driving to the airport, but we actually worry about the plane crashing. We tend to fear things that are rare, but that have high consequences. So a car kills one person and a plane kills 200.”

The second thing that influences our decision is trust.

“Who do we trust? The information age makes it hard to know who to trust. There is a substantial group of people who don’t trust public health,” she says, adding that there is a common perception that public health employees are focused on boosting the profits of pharmaceutical companies.

“Public health people care a great deal about the safety of vaccines,” says McGeer. “They would never approve a vaccine that would harm someone. Sure, vaccine manufacturers make money, but public health organizations make recommendations to improve your life, not to help these companies make money.”

That said, we can’t be expected to have blind confidence in public health. Past public health disasters like the tainted blood scandal, in which thousands of blood transfusion recipients were infected with HIV and hepatitis-C, or the “Thalidomide babies,” who were born with severe birth defects as a result of an approved nausea drug, hauntingly illustrate how public health services can fail us.

But for those who decide to pass on vaccinations because they don’t trust public health, it may not be the most sound decision.

“In the 20^th century, our life expectancy has increased by 32 years, almost doubling, and almost all of this is because of recommendations from public health,” says McGeer. “It would be just plain foolish not to follow their advice. ”

 One of the concerns surrounding vaccines is the fact that some use live viruses, and let’s be honest, the idea of injecting a live virus into one’s body isn’t that appealing. But, as McGeer points out, the flu shot does not contain a live virus, using dead bacteria to create immunity, unlike the measles and chicken pox vaccines, which contain live bacteria.

And while we are talking about injecting things into our bodies, what about chemicals like mercury?

“Mercury has been talked about a lot when it comes to vaccines,” she says. “Mercury is not a man-made substance, it is a natural chemical. It is in the food you eat and what you drink, so it’s not like you are not already exposed to it. Also, single dose vaccines don’t contain mercury, and for those that do, the levels are not a danger.”

Which brings us back to the perception of risk.

“It is silly to think that the vaccine is more dangerous than not having it,” says McGeer. “It is more sensible to be afraid of influenza.”

This is probably most true for people with compromised immune systems like those undergoing active cancer treatment like radiation or chemotherapy. And while it is recommended that cancer patients get the flu shot, McGeer points out that a suppressed immune system means that the vaccine may not be as effective. This makes it more critical for family and friends to be vaccinated, a process McGeer refers to as “cocooning” because it essentially creates a barrier between the patient and illness, reducing the chance of the patient getting sick. Which, as we all know, could have serious, life-threatening implications.

While this notion of “cocooning” does not generally apply to most people living with CML, since many are in remission and are generally considered to have a normal immune system, the flu shot is still important.

 “All vaccines, containing live viruses or not, are safe for CML patients,” says Dr. Jeff Lipton, a staff oncologist at Princess Margaret Cancer Centre in Toronto. “Their immune system is virtually normal, regardless of whether they are newly diagnosed or have been on therapy for years, unless they are in blast phase.”

Lipton also points out that for patients who have had a transplant, some live vaccines are not allowed, like the ones for shingles, yellow fever and typhoid. However, others, like chicken pox, are considered safe.

“We highly recommend the flu shot for everyone,” he says. “You cannot get the flu from a flu shot.”

Despite the clear benefits of getting the flu shot, there will always be those who choose not to get it. And since, according to McGeer, a healthy person has a one in 100,000 chance of getting a nasty version of the flu that lands them in the hospital, she acknowledges that it isn’t an absolutely terrible decision for these people not to get the vaccine. However, after pondering the horrible effects of the flu, she asks, “But why wouldn’t you just get the shot?”

 

Note: This article does not take the place of medical advice. Consult your doctor before making a decision on whether or not the flu shot, or other vaccinations, are right for you.