Hellobee

The flu really needs no introduction. We all know the symptoms – fever, chills, a cough, and body aches. It strikes fast and it hits hard. And when I’m talking about the flu, I’m referring to influenza and not the stomach flu. Some people use the word “flu” interchangeably, but they’re totally different bugs. Influenza is a respiratory virus that usually becomes prevalent in the fall and winter months. The stomach flu (or gastroenteritis) on the other hand involves nausea, vomiting, cramping, and sometimes a fever for a day or two.

Around this time each year, we start hearing about influenza and seeing ads and warnings to get our yearly flu shot. Being a nurse and having worked in a hospital setting for a couple of years, I’ve been getting my annual flu shot for quite some time. I’ve never experienced any side effects or problems from the vaccine other than a little bit of a sore arm for a few days. And I’ve never gotten the flu. So in my book, it’s definitely been worth getting vaccinated.

It’s one thing to make decisions about your own health though, and totally another to make decisions for your child. Though I was happy to get my annual flu shot, I hadn’t really thought about vaccinating Little Deer. Now that flu season has started, I really need to get on it. I’ve seen first-hand children that were hospitalized from the flu and it definitely weighs heavy on my mind. Though modern medicine has come a long way, seeing just how sick little ones can become from the flu is pretty terrifying. Though most children that contract the flu recover and are just fine, others require hospitalization and some do not survive. Overall it’s pretty scary and something I don’t believe should be taken lightly.

This past September was Little Deer’s nine month well-child appointment. At that point I knew that the flu season was right around the corner, so I thought it would be the perfect opportunity to get her vaccinated. I definitely didn’t want to risk LD getting as sick as those children I had cared for in the past. Seeing as it’s now recommended for infants six months and up, I thought she was ready. This was our first visit with our new pediatrician since moving, and although I knew he was a bit more on the natural side, I was pretty surprised at his thoughts on getting her vaccinated. I assumed her doctor would recommend she get one, but as the appointment ended and he hadn’t mentioned it, I brought it up. Well, it turned out he wasn’t a fan.

Now don’t get me wrong — I know there’s controversy surrounding vaccines, but the flu vaccine wasn’t on my radar as something to really question. Yes, I know the flu vaccine isn’t perfect and there’s no guarantee you won’t get the flu just because you’ve been vaccinated, but still, it had to be better than nothing right? Not according to our pediatrician. He mentioned studies that have shown Vitamin D and its benefits in protecting against the flu. He referred to the flu shot as “an experiment being conducted on the population” each year. He then asked us if that sounded like a good idea. Well when he put it that way… No, I guess it didn’t sound like a good idea.

I really wish I had spoken up and talked with the doctor more, but in the end we headed home sans the flu shot. Later that day the whole thing still didn’t sit well with me, so I decided that I would do a little research. Honestly, I also wondered if I was missing something. Maybe getting her vaccinated for the flu really wasn’t necessary. I just wasn’t sure.

I inadvertently started my research when a friend of mine posted this article on Facebook: Johns Hopkins Scientist Slams Flu Vaccine. After reading the post, I was pretty shocked. Though I didn’t have access to the actual article that was written by Dr. Doshi and published in the British Medical Journal, this post touched on the main points of his writing. Here’s a few snippets of what he said that surprised me:

• The flu vaccine is less effective and has more side effects than what the Center for Disease Control (CDC) states.
• The threat of influenza seems to be overstated since the numbers the CDC reports each year don’t add up.
• The only randomized clinical trial on older adults found that there was no decrease in deaths among those that were vaccinated, which means we don’t have good evidence backing up our current recommendations.
• Randomized clinical trials on healthy adults where between 33-100 people were vaccinated showed only one less case of influenza compared to those that were not vaccinated.
• There have been serious side effects of the flu vaccine that most people aren’t aware of, such as convulsions (1:110 children in an Australian study) and narcolepsy (from an H1N1 strain).
• Mercury found in the flu vaccine is toxic and is an immune suppressant, making you more vulnerable to getting sick.
• Vaccines are a pharmaceutical company’s dream because both the government and media will help them sell it and they’re protected against any complications.

Yikes! Talk about some scary stuff. I remember finishing that article and then texting it to Mr. Deer with the message: Well maybe we shouldn’t get her the flu vaccine! As with most things though, you can’t always trust everything you read. A few days after reading that article, I saw a post on the Hellobee boards about the flu shot. I posted the link to the article by Dr. Doshi, curious what others would think. Awesomely enough, I got a response back with an article that was written as a direct rebuttal to Dr. Doshi’s post called: Non-epidemiologist tries to do epidemiology, feeds anti-vaccine activists. The author of this article is an epidemiologist and is very familiar with the flu vaccine. In his post he points out flaws with Dr. Doshi’s article and sheds some light on a few issues. Here are the highlights:

• There’s a reason why the reported number of influenza cases and related deaths don’t always add up – because they’re estimated. States are not required to report cases of the flu (or related deaths) for people over the age of 18. This means that the number of cases and related deaths are usually estimations. Many times people die from influenza due to secondary infections. It may start as the flu, but then they might develop bacterial pneumonia. Or perhaps they’re already sick or have a chronic medical condition that becomes exacerbated. Not only is it tricky to see that the main culprit was likely influenza, but often they’re not even tested for it. All in all it’s not a perfect system, so with many numbers being estimated sometimes things don’t quite add up.
• There is a difference in how effective the flu vaccine can be for certain age groups, but that doesn’t mean that they do not work well. The nasal spray does a better job at protecting the young, the injection does better at protecting those 18 and older (I’ll touch more on that in a bit).
• A reduction in cases of Influenza, even if it’s just by 1 out of 33-100 people, is a lot. If you think about that ratio spread over our entire population, that may mean a few million people. That’s definitely not something to put-down.

So there I was, I went from questioning the flu vaccine to feeling like I was back on-board. Still though, the seed of doubt had been planted in my mind. I decided I would make a pros and cons list to really map things out. I thought I would share it with you, in case any of you are also on the fence or questioning getting your little ones vaccinated against the flu.

Disclaimer: just because I have been researching and reading about the flu vaccine does not mean that I am suddenly an expert. I am not trying to give any medical advice in this post. I am just a nurse and a mom who is trying to figure out what is best for Little Deer.

Ok, let’s look at the positives and negative aspects of the flu vaccine as I see them:

THE POSITIVES

• Protection from Influenza: Every year hundreds of thousands of people are hospitalized from the flu and many thousands die. It’s estimated by the CDC (Children, the Flu, and the Flu Vaccine) that around 20,000 children under the age of 5 are hospitalized due to the flu. Last year during the 2012-2013 flu season there were 165 flu-related pediatric deaths. And of those that died, about ninety percent were not vaccinated. Though the flu vaccine does not cover all strains of Influenza (more on that in a minute), it does usually contain the ones that are estimated to be the heaviest hitters.
• The flu shot doesn’t cause the flu: The flu shot is made from inactivated forms of the different influenza viral strains (meaning they’re essentially “dead”). The nasal spray is different in that it contains a live attenuated version of the virus, meaning it’s alive but weakened enough that it won’t cause you to become sick. Some people have said that right after they’ve gotten the flu shot they’ve come down with the flu. My understanding is that sometimes people catch the flu just prior to getting the vaccine. It could also be that they became infected by a different strain than what was available in the vaccine. And it may not even be the flu all together, but just a bad respiratory virus or stomach bug. You can read more here: Misconceptions about the Seasonal Flu and Flu Vaccines. There’s also answers to other common questions on the Seasonal Flu Shot.
• If you’re worried about Thimerosal, then skip it: In the past it had been thought that there might be a link between thimerosal (a preservative found in vaccines) and autism. I know some people genuinely still believe there may be a link between the two (I’m not trying to start a big debate) but todays research has found no connection. And even so, there are formulations that are available without thimerosal, so if you’re worried about its effects on your child then request the thimerosal-free version. You can read more about thimerosal and the related research here: Thimerosal and 2013-2014 Seasonal Flu Vaccines. (Side note: even adults can request the thimerosal-free vaccine if they’d like!).

THE NEGATIVES

• The flu shot isn’t 100% effective, especially in young children: Part of this is because there is more than one flu virus, and each year it’s impossible to predict exactly which strains will rise in which community. Every year they select three strains for the flu vaccine (or now even four) that they think will be the biggest, but you can see how that may not always be perfect. When reading the Recommendations for Prevention and Control of Influenza in Children, 2013-2014 you can see which three or four strains have been selected for this year’s flu shot. Not only is there the issue of proper coverage, but studies have also shown that inactivated flu vaccine (the shot) may not be effective in children under the age of two. A review of past studies done in 2008 (Vaccines for preventing influenza in health children) found that the efficacy of the vaccine in children under the age of two was similar to the placebo group. So coverage for infants may not be as great as we thought.
• The side effects and risks: The possible side effects associated with the flu vaccine include mild pain, tenderness, and redness at the injection site, as well as possible fever, aches, headache, itching, or fatigue. More severe side effects could include an allergic reaction, seizures, or even Guillain-Barré Syndrome (1-2 per million vaccinated). Though the chances of suffering those severe side effects are rare, there is always still a risk. Even the mild side effects are still enough to disrupt Little Deer’s sleep, which is already fragile enough as it is. She’s gotten a fever from vaccines in the past, and it definitely wasn’t a fun time.
• Needing two shots: Not only would we need to deal with the possible side effects once, but we’d have to do it twice. This is the new guideline for children ages six months to eight years that haven’t received the flu shot in the past (these CDC guidelines can be read here). Because LD is so young and hasn’t been vaccinated before, she falls into this category and would need two shots, the second one being about one month after the first. The more shots the bigger the bummer in my book.