Now, confronted with H1N1 influenza, even more are saying they won't get the shot.
Here are some sample reasons:
A) I got the flu immediately after my shot last time, and I'm not going through that again.
B) My arm was sore for a week.
C) This H1N1 vaccine was hastily prepared, and hasn't been thoroughly tested. I don't want to be a guinea pig.
D) I might be pregnant.
E) Flu shots don't work on me.
Let's deal with the concerns in order.
Injected influenza vaccines are made from killed virus material. They are not infectious.
Some people get the flu after they've been immunized, but they also get the flu after eating spaghetti, or taking a morning walk. In other words, the flu infection and the immunization are unrelated.
People do have pain or swelling at the injection site. That's the most frequent complication of immunization. By far, the discomfort is less than the discomfort of actually getting the flu.
The H1N1 vaccine was prepared by the same company that makes the seasonal flu vaccine, and it was prepared by the same methods as the seasonal flu vaccine. This family of vaccines has been in use worldwide for decades, and has established a record of safety.
Authorities responsible for its development and distribution report that they have tested it in the same way that previous flu vaccines have been tested, and it has been found to be safe.
Unless something very unusual happens, the H1N1 vaccine will be included in the seasonal flu vaccine we get next year.
If you're pregnant, the flu shot is recommended. It won't infect your baby, it won't infect you — and it will protect you and your baby from H1N1, which has been shown to cause more serious illness in pregnant than non-pregnant women.
People who say flu shots don't work might be right. Seasonal flu vaccine is designed, based on the flu strains in circulation in the preceding year. It's an educated prediction of which strain will predominate in the coming year. When the epidemiologists guess wrong, or the virus mutates significantly, the vaccine may be less effective in protecting you from the flu strain actually in circulation.
With H1N1, the vaccine is not based on prediction. Today more than 98% of the influenza virus illness is caused by H1N1, so we know the vaccine is well-matched, and will be effective.
The bottom line, though, is that people in general and healthcare workers in particular should get immunized, unless there are clear contraindications.
So let's wash our hands, cover sneezes, stop touching our eyes, noses and mouths, and get the H1N1 and seasonal flu vaccines when they become available.
Brian Johnston, MD
Medical Director
White Memorial Medical Center
Emergency Department
Photo from cdc.gov.
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