Getting a flu vaccine is a personal decision. This newsletter is intended to provide you with information that can help you make an informed decision. This will include the official Canadian Government perspective (see http://www.phac-aspc.gc.ca/publicat/ccdr-rmtc/05vol31/asc-dcc-6/, Statement on Influenza Vaccination for 2005-2006 Season) as well as additional information from recent studies as well as my own clinical experience

What is in your vaccine? Anyone getting the flu vaccine this year should be aware that several vaccines marketed in Canada contain mercury (thimerosal). This is a known deadly toxin. You might consider asking about the Thimerosal-free version of FluZone (the Sanofi Pasteur, Inc. vaccine). There will also be a preservative-free version of Fluvirin (Chiron’s product), but it still contains trace amounts of thimerosal, although far less than the more common flu shots. There is also a nasal spray vaccine that contains no mercury, but it is only approved for healthy, non-pregnant people between the ages of 5 and 49.

What do most recent studies indicate about the efficacy of the flu vaccines? 90% of people that develop complications or die from the virus are over 65 years of age. A 2005 study published in the Archives of Internal Medicine concluded the following: “We could not correlate increasing vaccination coverage after 1980 with declining mortality rates in any age group. Because fewer than 10% of all winter deaths were attributable to influenza in any season, we conclude that observational studies substantially overestimate vaccination benefit.” I found it interesting that this study was not referenced in the Canadian government’s statement of vaccines for this year. They did admit, however, that protection provided to the elderly may fall below protective levels within 4 months. They also mention the following two studies. First, Demicheli et al. estimated vaccine efficacy to be 24% in preventing Influenza like Illness and 68% in preventing laboratory confirmed influenza infections. Fifteen randomized controlled studies of healthy children aged 6 months to 19 years showed a relative risk reduction of 31% to 83%.

How does the flu affect most of us? Millions develop the flu each year and experience just mild symptoms. Symptoms usually subside after two to three days and disappear within a week. Infection complications (pneumonia, hospitalization, death) are very rare and may occur in individuals with an underlying medical condition, those greater than 65 years of age, and young children with a predisposition to respiratory infections.

Does a vaccine guarantee immunity? There are no guarantees that you will not get the flu if vaccinated. While over 500 viruses can cause the flu, and these viruses are constantly evolving, the vaccine is based on the three most common strains seen in the previous year. You are only protected against those strains selected. Even those strains evolve very rapidly and you are not immune to their evolved subtypes.

What is Health Canada’s View? Health Canada advises that vaccination programs should focus on those at high risk for influenza-related complications, those capable of transmitting influenza to individuals at high risk for complications, and those who provide essential community services. These include the following: (1) 65 and over, (2) serious long-term health problems , (3) travelers, (4) children six months or older with respiratory disorders, (5) persons with blood disorders, lung disease (asthma, COPD) and/or heart conditions (angina, CHF), (6) anyone exposed frequently to nursing homes and chronic-care facilities, (7) and women more than 3 months pregnant.

Who should avoid the vaccine? The vaccine is not recommended to anyone with acute infections or fevers, to those with egg or thimerosal (mercury) allergies, with unstable neurological disorders, with a history of Guillain-Barre Syndrome, with prior allergies to flu vaccines or those under six months.

What are the potential side effects of the flu vaccine? According to Health Canada, one may experience local short term irritation or systemic flu like symptoms for up to two days. Seizures are also possible in infants with high fevers caused by the vaccination. Allergic reactions, including anaphylaxis and death, are rare but can occur. In my clinical experience I have come across several cases of chronic illness, for example sinusitis, that began shortly after a flu vaccination. I have also had cases of unusually frequent colds and flu after the vaccine.

What do I think? Since the flu vaccine holds no guarantees, regardless of your choice, I think your best defense is to address the most common habits that weaken our immune system: diet, stress, alcohol, coffee, tobacco, medications, recreational drugs, allergies, chemical exposures and sugar. Good life style habits combined with some safe natural immune boosters will likely provide most healthy people with the ability to fight off the flu.

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