With all of the well-founded attention on COVID-19 over the past 6 months, it is important that as a community we not forget about seasonal influenza. Influenza is an acute respiratory illness caused by influenza A or influenza B viruses. It occurs in epidemics nearly every year, mainly during the winter season in our neck of the woods.
The influenza virus is transmitted by respiratory droplets through sneezing and coughing. Close contact with another person with influenza will put you at risk. Also, surfaces contaminated with respiratory droplets are another potential source of transmission.
Oftentimes, people feel like they got “hit by a truck” when they are infected with the flu. They can have a cough, shortness of breath, fever, sore throat, headache, achiness, and weakness. Most people with influenza will feel so miserable that they cannot go to school or will need to miss work. Generally, they will get better in 2 to 5 days.
However, some are not that “lucky.” Complications of the flu may include influenza pneumonia and bacterial pneumonia. The symptoms for influenza pneumonia can be bad enough to necessitate emergency room evaluation and treatment, admission to the hospital, and possibly admission to an intensive care unit.
Since 2010, the number of influenza cases in the U.S. has ranged from 9 to 45 million cases per year. For comparison, there have been just over 6.5 million COVID cases so far. For influenza, there are 140,000–810,000 hospitalizations per year and 12,000–61,000 deaths annually.
Getting a flu shot reduces the risk of hospitalization for pneumonia or other influenza symptoms, it decreases the length of hospitalization and the rate of intensive care unit admissions, and it reduces deaths from influenza.
Every year, a new influenza vaccine is developed, based upon global surveillance of flu viruses circulating at the end of the prior season. It takes about 6 months for the vaccine to be developed and manufactured. Some years, the efficacy of the vaccine is better than others. Having said that, even though the vaccine is never “perfect,” it is the best thing that we have to help prevent influenza and its complications.
The annual influenza vaccine is not a “live vaccine.” If someone gets the flu after getting the vaccine it is generally because they have already been exposed or the vaccine is not effective against the strain of influenza they have contracted.
Consistent with the United States advisory committee on immunization practices, I strongly recommend seasonal influenza vaccine for all of my patients, for everyone age 6 months and up. That includes me, my wife, my kids, my mom, my brother, my mother-in-law, and everyone else! Everyone!
And, while universal vaccination is recommended, people with lung disease such as asthma and emphysema, smokers, pregnant women, and people with heart disease, diabetes, cancer, chronic kidney disease, and immune deficiency are at even greater risk for complications from influenza and should make special effort to get the immunization.
It’s going to be interesting to see how the flu season plays out this year. Almost everyone in Vermont is wearing a mask and people are making special efforts to wash their hands and socially distance. School time is either completely online or in a hybrid version. Therefore, it might be predicted that the incidence of influenza will be less this year.
However, I would still strongly encourage everyone to be immunized against influenza this season. The symptoms of the flu and COVID are similar enough that people might downplay them until they become seriously ill. We need to do everything we can to ensure that hospital beds and medical resources are not overloaded from preventable illnesses.
This flu season, there is a “high dose” influenza vaccine for adults age 65 and over. There is also a “quadrivalent,” vaccine containing four strains indicated for those under the age of 65. A single dose of influenza vaccine should be administered annually and should be offered before the onset of influenza activity in the community – by the end of October.
When you get your flu shot, it is also a good time to review your immunization record to see if other immunizations are indicated for you — for instance, those that protect against the complications of bacterial pneumonia, shingles, tetanus, and whooping cough.
When you get a flu shot, you protect not only yourself, but also your family and the whole community. Let me say it again: yes, be sure to get a flu shot this year!
Dr. Moss Linder joined the Grace Cottage Hospital staff in 1997. He received his medical degree from the University of Vermont in 1991 and completed his Family Medicine residency at Oregon Health Services University. Prior to Grace Cottage, he worked as a family physician at the Acoma Cañoncito Laguna Hospital in New Mexico.
