Options Against the Flu

This season’s flu shots will be more individualized, but immunization can begin in summer

By Megy Karydes

Patients who have avoided getting the flu shot because of their fear of needles or allergies to eggs (egg protein is among the ingredients of some influenza vaccines) will have other options this season: seven of them.

According to vaccine expert Dr. Gregory Poland of the Mayo Clinic in Rochester, Minnesota, the new choices move influenza vaccinations closer to the personalized approach long sought by immunologists, including Poland, but they may also prove bewildering to patients.

The new influenza vaccine options available for the upcoming flu season include:

·         A shot with four strains of influenza rather than the traditional three strains

·         Nasal sprays with four strains rather than the usual three strains

·         A high-dose vaccine for the elderly, to boost their immune response and protection

·         For those with egg allergies, two new vaccines without egg proteins

·         For the needle-phobic, a new vaccine delivered by a tiny needle called a micro-needle into the skin, rather than by a regular needle under the skin

“Instead of ‘one size fits all,’ this is a very real example of the incredible advances happening in medicine, where there’s not one choice for everybody, there’s a best choice for each individual, and that’s what’s happening with flu vaccines,” Poland says.

Dr. James Malow, infection control specialist and chair of the medical center’s Department of Internal Medicine at Advocate Illinois Masonic Medical Center in Chicago is aware of the new vaccine options and will primarily be providing the egg-based vaccines to inpatients and associates.

Malow says that having so many options poses advantages and disadvantages. “It is unclear how effective the senior preparation is,” he says. “The subcutaneous preparation is primarily for those who are needle-phobic. Having the recombinant preparation is especially useful for those with severe egg allergy. I’m concerned that the average primary care physician will not keep all of the options straight.”

Malow admits that they are still waiting for the CDC’s final recommendations for the 2013–2014 season and awaiting shipment from their buyer, so they are not sure whether the quadrivalent or trivalent vaccine will be shipped for hospital use.

“The trivalent injectable vaccine will be used for immunizing associates along with the quadrivalent nasal spray,” he says. “We will not be offering the senior, recombinant or subcutaneous vaccine for inpatients or associates.”

But is getting the flu vaccine, even if we’re provided with seven options, the only way to minimize our chances of getting the flu this season?

Allan Stevo, 33, from Blue Island, stopped taking the flu vaccine when he became health conscious and wanted to reduce his reliance on what he feels are needless pharmaceuticals. He has not been vaccinated against influenza for over a decade.

“Eating a higher amount of vegetables and pastured meats and a diet richer in saturated fats as well as a lower amount of processed starches, sugars and fruits, along with having higher blood serum levels of Vitamin D are changes I have made that appear to have collectively or individually reduced my likelihood of contracting a seasonal illness,” says Stevo.

“These changes are consistent with the scientific community’s understanding of methods of developing a more robust immune system,” he adds. “I am unable to say whether this reduction in seasonal illness is coincidental or causal. It appears that I do not presently need a flu vaccine to prevent me from having the flu.”

This type of preventative care doesn’t surprise Dr. Theri Griego Raby, ABIHM, founder and medical director of the Raby Institute for Integrative Medicine at Northwestern, who often recommends that patients start optimizing their immunity during the summer months rather than defaulting and getting the flu shot because everyone is doing it.

“Eat more fruits and vegetables with higher rates of antioxidants during the summer months such as berries, take a multivitamin, keep your hydration levels up, increase your Vitamin A, C and D,” she rattles off as just some ways in which the summer months can help prepare us for the cold and flu season. Once the cold and flu season hits, drink green tea and take probiotics, she says.

Malow agrees that while the flu vaccine is one way to minimize your chances of getting the flu, good old proper hygiene can go a long way, too, including proper hand hygiene, staying home if you’re ill, and covering your coughs and sneezes.

Raby reminds her patients that getting the cold or the flu isn’t necessarily a bad thing either. “Our bodies will get over it,” she says. “We need to allow ourselves to be exposed to things so we can build a healthy immune system. I’m a primary care physician and treat sick patients all the time and rarely get sick,” she says, noting that she has built immunity to many different viruses through her line of work simply by being exposed to them and being vigilant in her preventative care.

While there are more options than ever to help us to stay healthy during the flu season, as Poland says, there is not one choice for everybody but the best choice for each individual. Raby recommends that people discuss their options with their healthcare provider to find the one that makes most sense for them.

Allergies
Prevention
Vaccines
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