Last year was one of the deadliest flu seasons in U.S. history. About 48.8 million Americans were infected with influenza, and nearly 80,000 people died. In a time when we have an easily accessible vaccine that can prevent influenza infections, those numbers are appalling. Simply put: this should not be happening in 2018 in the United States of America. We can do better.
In the emergency department, my colleagues and I fight diseases on the front lines, and influenza is no exception. We diagnose and treat the flu at staggering rates throughout the winter, using appropriate precautions and isolation when needed.
Recipe for Disaster
But last year, the flu hit us like a tsunami, overwhelming and overcrowding our ERs nationwide. Regardless of a hospital reaching capacity, an ER can never close its doors, which leaves overcrowding inevitable during times of exceedingly high flow.
At one hospital in Atlanta, we saw overcrowding reach the ultimate tipping point this past flu season. At the peak, Grady Memorial Hospital was left with no choice but to deploy the nation’s first mobile surge unit in an outdoor tent to handle the excess of nearly 100 ER patients per day.
While hospitals are trained to handle hospital overflow, it is a very different and dangerous situation when an ER is crowded with patients who have a communicable disease. It’s a recipe for disaster, and a disaster is what it became this past flu season.
Flu Shot: Easy Cure?
So now that the 2018-2019 flu season is upon us, are we doing any better as a society to protect ourselves? Unfortunately, it doesn’t seem so. Two weeks ago C.S. Mott Children’s Hospital at the University of Michigan published a frightening report based on a poll sent to 1,977 parents. The report found that an abysmal 34 percent of American parents said their child was unlikely to get the flu shot this year. That’s 1 in every 3 parents.
The American Academy of Pediatrics recommends the flu vaccine in every child over six months of age, so what’s stopping us? According to the survey, parents’ top three reasons for declining the vaccine are concerns about side effects, doubts about the efficacy, and the claim that their child is “healthy enough” and does not need to be vaccinated.
Well, let’s start with addressing the “healthy enough” claim. In Florida, the first flu-related death for this season has already occurred, and the victim was an unvaccinated child with no other medical conditions. Here we have it, front and center: “healthy enough” is not an impenetrable cloak.
We must take accountability and do our due diligence as a society in protecting our children. They are too young to make medical decisions on their own behalf, and they depend on us to protect them from preventable death.
What about the fear of the vaccine “not working?” First and foremost, it is critical to understand that the benefits of the flu shot extend further than purely preventing the flu. Even if the virus manages to infect someone who has been vaccinated, the vaccine will help “trigger” the immune system to hopefully fight the virus better and faster.
Vaccine Efficacy
But let’s try to put the efficacy of the flu vaccine into perspective with some data. In medicine, we often use a statistical term “number needed to treat” (NNT) when weighing treatment options. In the most basic terms, this is the number of patients we must treat with a medication to get the desired result in one single patient.
Now let’s start with a simple example: daily Aspirin for heart attack prevention. The NNT to prevent one heart attack by giving daily aspirin is 1,667. In other words, 1,667 people would have to take Aspirin daily for one year to prevent just one heart attack. Keep in mind that Aspirin is a blood thinner, and thus holds potentially fatal risks in patients with injuries or other sources of bleeding. Knowing these risks and the likelihood of prevention, however, there is still little to no doubt in the medical community and among patients that daily Aspirin is a vital tool to reduce the risk of a heart attack in selected patients.
So what’s the NNT for the flu vaccine, which has minimal side effects? Based on a meta-analysis of randomized control trials of 38,000 patients, if it’s a well-matched vaccine, only 12 patients need to be vaccinated in order to prevent one case of the flu. That’s 138 times fewer than the number of people we need to treat with Aspirin to prevent a heart attack. Yet despite this data, people are still more resistant to take the flu vaccine than to take Aspirin.
Can Flu Shot Cause Flu?
An extremely common reason for this vaccine opposition is the unsubstantiated fear of potential side effects.
Firstly, we must debunk the myth that the flu shot can cause the flu. The vaccine is made from either an inactivated virus or from the virus’ proteins. It is never from the virus itself, and it simply cannot infect you.
The potential side effects of the vaccine, as noted by the CDC, are soreness where the shot was given and “flu-like” symptoms, like body aches, low-grade fevers, and nausea. These side effects are rare, mild, treatable, and short-lived, and it is unquestionable that the benefits of immunization outweigh these risks.
The flu vaccine is an easily available, affordable, life-saving prevention that we have at our disposal. This is a luxury that we mustn’t take for granted.
Breaking the Chain
Immunizing one person does not only protect that individual, but it also protects every person they will come in contact with. If you are otherwise healthy you will likely recover from the flu quickly, but every person you are in contact with has the chance of catching it and spreading it to someone else. This causes a chain reaction that will inevitably reach a young child, an elderly grandparent, a pregnant woman, a cancer patient, and thousands of other people who may not have the same survivability that you do. Let’s work together to break this chain.
If you are looking for a way to give back this holiday season, give back by getting the flu vaccine and helping to prevent an illness in someone who may not be able to survive influenza. Let’s work together to keep our country strong, happy, and healthy this holiday season.