Thursday, October 1, 2015
Frequently raised objections to the flu shot
In August our office received our batch of flu shots for the upcoming flu season. Every fall I urge my readers to get a flu shot. If you'd like to know the different kinds of flu vaccines available, and which is right for you, read my post from last year.
This year I'd like to address the most common objections that patients raise when I recommend a flu shot.
The flu shot might make my arm sore.
I'll get the flu.
That's not true. The injectable vaccine has no live virus. It might make you achy or have a low-grade temperature for a couple of days, but it can't give you the flu. And you can't transmit the aches and low-grade temperature to anyone else.
I'm young and healthy and nothing terrible would happen if I contracted the flu.
Fair enough. I usually only harangue patients over 65 and those with chronic illnesses about getting a flu shot. But you should know that the CDC recommends the flu shot for everyone over 6 months who doesn't have a specific contraindication. Even if you get through the flu just fine and aren't worried about the misery and lost productivity, consider that you might infect someone much frailer than you.
I got a flu shot 4 years ago and my hair caught on fire, or I got a flu shot 4 years ago and later that day my boss yelled at me, or I got a flu shot 4 years ago and right after that came down with syphilis. I haven't had a flu shot since then.
This is such an old and well known logical flaw that the ancient Romans had a name for it. Something that happens after something else wasn't necessarily caused by that first thing. That's why we need randomized trials to figure out the effects of any intervention. I assure you that the flu shot does not lead to more hair catching on fire / bosses yelling at you / syphilis than placebo. (Though I suspect those specific effects weren't specifically tested in randomized trials, so I guess we should both keep an open mind.) But I also understand that the mind creates nearly unbreakable bonds between perceived causes and perceived effects so my only suggestion would be to try it again and see if you have better luck this time.
You can't tell me what to do. This isn't North Korea.
That's true, assuming you're an adult. (If you're a child, what are you doing in my office without your parents? I don't take care of children. Take it up with your pediatrician. Go on. Scram.) I'll only give you good advice. You can refuse. But I don't think they have flu shots in North Korea.
The last time I got a flu shot the area around the flu shot was red and swollen and painful.
Reactions around the injection area can happen. They usually resolve in a few days and they don't mean that you can't have a flu shot again. You shouldn't have a flu shot if you have an allergy to eggs or have had a severe allergic reaction (hives, swelling around your mouth, trouble breathing) to a previous flu shot.
You're just a shill for Big Pharma which is trying to inject us with chemicals.
Well, I'm not a very well paid shill. I only get money from my patients. I'm a big proponent of evidence-based medicine which is neither for nor against Big Pharma, but rather for whatever medicines have been proven to be safe and effective. I've been advocating vaccine use on my blog for years and have yet to receive a promotional fee from any shell corporation, bogus front, or slush fund of Big Pharma. I don't even know who manufactures flu shots, but whoever they are, they haven't even bought me a tuna sandwich. This is patently unjust. If any of you have connections to Big Pharma, please put in a good word for me.
And get your flu shots.
Vaccination: Who Should Do It, Who Should Not and Who Should Take Precautions(Centers for Disease Control and Prevention)
Key Facts About Seasonal Flu Vaccine (Centers for Disease Control and Prevention)
Albert Fuchs, MD, FACP, graduated from the University of California, Los Angeles School of Medicine, where he also did his internal medicine training. Certified by the American Board of Internal Medicine, Dr. Fuchs spent three years as a full-time faculty member at UCLA School of Medicine before opening his private practice in Beverly Hills in 2000. Holding privileges at Cedars-Sinai Medical Center, he is also an assistant clinical professor at UCLA's Department of Medicine. This post originally appeared at his blog.
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Albert Fuchs, MD, FACP, graduated from the University of California, Los Angeles School of Medicine, where he also did his internal medicine training. Certified by the American Board of Internal Medicine, Dr. Fuchs spent three years as a full-time faculty member at UCLA School of Medicine before opening his private practice in Beverly Hills in 2000.
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Ira S. Nash, MD, FACP, is the senior vice president and executive director of the North Shore-LIJ Medical Group, and a professor of Cardiology and Population Health at Hofstra North Shore-LIJ School of Medicine. He is Board Certified in Internal Medicine and Cardiovascular Diseases and was in the private practice of cardiology before joining the full-time faculty of Massachusetts General Hospital.
Zackary Berger, MD, ACP Member, is a primary care doctor and general internist in the Division of General Internal Medicine at Johns Hopkins. His research interests include doctor-patient communication, bioethics, and systematic reviews.
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