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The Truth Behind The Flu Vaccine

Debunking the common misconceptions about the flu vaccine being more dangerous than the flu. A VaxFacts Blog Post for USciences Modern Issues in Vaccinology course.

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Every year, health care providers encourage their patients, six months and older, to receive the annual flu vaccine. Yet, according to the Center for Disease Control (CDC), only approximately 47% of the population receive the vaccine yearly. Though incredibly safe and effective, many people are hesitant when it comes to the flu vaccine, but why?


The flu vaccine is more dangerous than the flu.

FALSE

Though there’s no concrete evidence or proof of this statement, many people fear that the flu vaccine can do more harm than good, thus refusing to get the vaccine. Whether or not the low vaccination rates are due to common misconceptions, such as you can contract the flu from the vaccine, or natural immunity is better, or that the flu is not a ‘serious’ illness, or even that the vaccine can cause other problems, such as increased risk of narcolepsy (chronic sleep disorder), many people are misinformed about the flu vaccine and how important getting vaccinated truly is.

The common fear of ‘getting the flu from the vaccine’ is simply untrue. The flu vaccine is an inactivated vaccine, meaning that all components used in the vaccine are no longer ‘alive’ or able to infect you, they are simply components of the virus that can initiate the body into making antibodies, and contrary to popular belief, there is absolutely no way to contract the flu from the vaccine itself.

Many view the flu vaccine as unneeded and believe natural immunity—contracting the flu virus itself, provides a better immune response than the vaccine. Though natural immunity to a virus or bacteria is known to generate higher immune responses, the benefits of the flu vaccine are far superior than the risks associated with the virus that can develop from a natural infection.

But what many people are unaware of is that although patients who contract the flu, generally get better in about a week or so, and escape the sickness unharmed, to some, this virus can result in several complications, such as pneumonia, organ failure, respiratory problems and in the most severe cases, death. Unfortunately, Pegy Lowery, a mother of two, and now a strong proponent of flu vaccinations, frequently shares her story to help increase awareness and spread knowledge about how important the flu vaccine really is.

“It hurt for her to walk, and she was breathing heavily, her mother said. She was also bleeding from her nose and vomiting blood. On Jan. 16, just four days after she got sick, Piper collapsed in the parking lot of a children's hospital in Tacoma, Wash. By then, the H1N1 flu had already attacked her kidneys.

Piper died shortly before 12:30 p.m. that day. She was 12 years old.

Her mother, Pegy Lowery, is now urging other parents to get flu shots for their children.

Lowery's own daughter was afraid of needles, often bawling when they touched her skin; so she never pushed Piper to get a flu shot, she said. And Lowery, of Port Orchard, Wash., said she always thought they were optional, not a necessity.

That view has since changed.

“I don't want it to happen to somebody else,” Lowery told The Washington Post. “I don't want them to lose their child. It's pretty devastating. There's nothing like
it.””

Even though the vaccine is recommended for all patients 6 months of age and older, certain populations are at higher risks for developing complications. These populations include, young children, elderly, and pregnant women. In addition to the general hesitancy towards the flu vaccine, there is even more pushback from the high-dose influenza vaccine, which is recommended for the elderly. This specific population is most at risk for developing pneumonia, heart disease, lung disease and even death as a result of flu complications. Whether it be fear of the vaccine due to common misconceptions, the side effects, or something else, currently vaccination rates in the elderly is extremely low.

As we get older, our bodies lose the ability to fight infections and produce antibodies—a process known as immunosenescence, and as a result, elderly patients are known to have reduced responses to vaccines. Due to this knowledge, vaccine manufacturers created a high-dose influenza vaccine to help boost the immune response of elderly patients and increase their protection from the flu. In a clinical trial, posted in the Vaccine journal, Diazgranados et. al., found that the high-dose vaccine in elderly patients generates a greater number of antibodies, and was generally well-tolerated, with only a slight increase in temporary side effects, such as tenderness at the injection site and muscle pain. This clinical trial further proves that the vaccine is safe and well-tolerated, and high-dose vaccinations should be considered in elderly patients to help increase their level of protection.

In 2009, an influenza pandemic swept across the world, and the need for flu vaccinations was at an all-time high. In Europe, the flu vaccine Pandermix was being used, and it contained a squalene adjuvant. (An adjuvant, is an added component to the vaccine, which helps to generate an immune response, since there is no live virus, only inactivated parts, in the vaccine.) While this vaccine was being administered across Europe, incidences of narcolepsy were on the rise—automatically correlating the flu vaccine to increased risks of narcolepsy. However, during this same time, another vaccine, Focetria, also using the same squalene adjuvant, was being administered, and there were no observed incidences of narcolepsy in patients receiving this vaccination. Many studies were conducted on these vaccines and it was found that there were different flu protein components that resulted in these different responses. Unfortunately, the combination of the proteins and adjuvant in the Pandemrix vaccine resulted in cross-reactivity of proteins, tricking the body, thus an increased risk of narcolepsy, which ranged from 1 in every 16,000 to 1 in every 50,000 patients. However, since this discovery, the vaccine has been discontinued and scientists now know what to avoid when creating new influenza vaccines. Although there was an increased risk of narcolepsy in the one vaccine group, the incidence rate was still very low and patients should be assured that all flu vaccinations currently administered have no increased risk of narcolepsy post-vaccination.

All in all, the flu vaccine is a safe and effective preventative measure from the flu and should be received by all eligible patients. Though a needle in the arm may not always be the best feeling in the world, yearly protection from this virus is a must to keep yourself happy and healthy. Be sure to give vaccines a shot and encourage all your friends and family to do the same!

References

Center for Disease Control. Flu Vaccination Coverage, United States, 2014-15 Influenza Season. (2016, June 23). Retrieved April 14, 2017, from https://www.cdc.gov/flu/fluvaxview/coverage-1415estimates.htm

McCarthy, K. (2016, October 28). Does the Flu Provide Better Immunity Than a Flu Shot? Retrieved March 03, 2017, from https://well.blogs.nytimes.com/2016/10/28/does-the-flu- provide-better-immunity-than-a-flu-shot/

Phillips K [Internet]. Washington D.C.: Washington Post; Oct. 27, 2016 [cited 2017 Mar 31]. Available from: https://www.washingtonpost.com/news/to-your-health/wp/2016/10/27/she-didnt-think-a-flu-shot-was-necessary-until-her-daughter-died/?utm_term=.3ffebafdc4ac

Diazgranados, C. A., Saway, W., Gouaux, J., Baron, M., Baker, J., Denis, M, et. al. (2015). Safety and immunogenicity of high-dose trivalent inactivated influenza vaccine in adults 50–64 years of age. Vaccine, 33(51), 7188-7193. doi:10.1016/j.vaccine.2015.10.131

Offit , P. December 11, 2015. New Adjuvanted Flu Vaccine: No Concerns About Narcolepsy . Retrieved March 3, 2017, from http://www.medscape.com/viewarticle/855558

Ahmed, S. S., Volkmuth, W., Duca, J., Corti, L., Pallaoro, M., Pezzicoli, A. et. al. (2015). Antibodies to influenza nucleoprotein cross-react with human hypocretin receptor 2. Science Translational Medicine, 7(294). doi:10.1126/scitranslmed.aab2354

Johansen, K., Brasseur, D., Macdonald, N., Nohynek, H., Vandeputte, J., Wood, D., & Neels, P. (2016). Where are we in our understanding of the association between narcolepsy and one of the 2009 adjuvanted influenza A (H1N1) vaccines? Biologicals, 44(4), 276-280. doi:10.1016/j.biologicals.2016.04.007

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