So what about the flu shot?

Every year a few patients ask me about what I think of the flu shot. This year a few people haven't asked me what I think about the flu shot.

My answer to this has not changed in recent years, and it won't change this year, even in the face of H1N1 (which you and your child are more likely to catch at the mall than from licking a pig.)

I am not pro or anti-vaccination on principal. I do believe that there are risks with vaccination and I weigh each vaccination very carefully before I move forward with any of them, recommended or not. Whether or not to get vaccinated is a decision that each person needs to make based on both facts and personal values. There is no one right answer for everyone.

With a healthy immune system, most people fare the flu reasonably well, and this includes young children. If I personally was not at high risk for complications of the flu, I would not get the vaccination(s.) If my child was not at high risk for complications of the flu, I would not get him the vaccination(s.)

Re: H1N1 though, there is a bit of a catch. The greatest concern with this particular flu is its affinity for the lungs, and the risk of what is called a 'cytokine storm.' This is an overreaction of the immune system which causes a cycle of inflammation in the lungs. This can happen to people (and may even be more likely to happen to people) with strong immune systems. And, for people with existing lung conditions, such as asthma, this situation is particularly concerning.

So do I think that all people with asthma should get the H1N1 vaccination? I'm not going that far yet. Although they are making the majority of the H1N1 vaccine in the same manner that they make the regular flu vaccine, we understand that backup supply may contain the chemical squalene. This is a potent chemical that increases one's immune response to the vaccination. Although it is too much to get into here, there are many folks in the medical community who have concern about this chemical causing an overreaction of the immune system that may be harmful to the body. Additionally, the last time a vaccination was prepared for the swine flu, there was a slight increase in the risk for a condition where the body attacks its own nerve cells causing muscle weakness or paralysis. The catch is that we don't yet know if that will happen in this case, and if it does, how much risk is worth taking? 1 in 100,000? 1 in 50,000?

Feel free to make an appointment to discuss your own concerns or questions about the flu or about the flu vaccines. We are happy to work with patients to come up with a game plan to help prevent the flu, as well as a game plan to treat it if it does occur.

* Please note, we are not currently treating active flu patients at the clinic as we do have staff and patients who are at high risk for complications. We are happy to do phone consultations to discuss treatment, or refer you to a practitioner who can see patients who are currently experiencing flu symptoms.*