What's all this buzz about flu shots...
Today’s blog is about the flu vaccine. It’s that time of year again and the vaccine for the 2019-2020 season is available. This is one of those topics I almost hate to talk about because there is so much controversy and emotion around vaccine decisions. Can’t we just talk about this calmly and rationally? I am avoiding “pro” and “anti” terms because I don’t find them helpful. I am only addressing the influenza vaccine today. Each other vaccine is a topic by itself!
Reminder:
The goal of this blog is education. I am not making medical recommendations for you-that is between you and your medical provider. But I believe it is important to be informed so that you can make those decisions for yourself and your family. My hope is that you learn something new today!
The first site I went to was the CDC. That website is filled with detailed information about all vaccines. First I wanted to learn more about how flu vaccines are made. There are egg based vaccines and cell based vaccines as well as recombinant vaccines. Egg based is the most common. The viruses each year are chosen by the World Health Organization based on what strains are prominent in the environment that year. The candidate vaccine viruses (CVV) are injected into fertilized hen’s eggs and incubated to allow the virus to grow. Then the virus containing fluid is harvested from the eggs. The virus is then killed, since you don’t want to inject people with live virus, and the virus antigen is purified. The killed virus is an antigen, which means it is what the body makes antibodies to to fight off any potential future exposure to that virus, hopefully allowing the body to not become infected with the flu. The challenge each year is deciding which strains of virus to pick for the vaccine. Typically it is 2 Influenza A strains and 2 Influenza B strains. Sometimes the vaccine is not as effective as desired because the strains mutate, or change over the course of the season, or a different strain shows up that wasn’t predicted. In those cases, the antibodies would not be protective. With the cell based vaccines, the CVVs are grown in animal cells instead of eggs. One of the common animal cells used for this is called Madin Darby Canine Kidney cells, which are cells from a dog kidney. There are also fetal cell lines that are used in the preparation of certain vaccines but I am not clear about whether the flu vaccine is one that uses fetal cells.
Other substances are sometimes added to vaccines as well such as squalene and aluminum salts-both of which are adjuvants that cause a strong inflammatory response to stimulate antibody production. Other potential ingredients are thimerosal, which is mercury as a preservative, formaldehyde as a preservative, antibiotics to prevent bacterial contamination, and polysorbate 80.
I want to know exactly what is in a substance that I am putting in my body, whether by ingestion or injection, so I always look for the ingredients. One of the current flu vaccines is called FLUARIX quadrivalent. Quadrivalent means that it was prepared with 4 influenza strains.
From the package insert: (2 A strains and 2 B strains): A/Singapore/GP1908/2015 (H1N1) IVR-180 (an A/Michigan/45/2015 [H1N1] pdm09-like virus), A/Singapore/INFIMH-16-0019/2016 (H3N2) NIB-104, B/Maryland/15/2016 NYMC BX-69A (a B/Colorado/06/2017-like virus), and B/Phuket/3073/2013.
This vaccine is a single dose vial rather than a multi dose vial so it does not contain thimerosal. If you receive your shot at your physician’s office, it is good to ask if it is a multi dose vial or not. I met a friend lately who is allergic to thimerosal and therefore can only receive the flu shot from a single dose vial. This vaccine, FLUARIX, contains octoxynol-10 (TRITON X-100) ≤0.115 mg, α- tocopheryl hydrogen succinate ≤0.135 mg, and polysorbate 80 (Tween 80) ≤0.550 mg. Each dose may also contain residual amounts of hydrocortisone ≤0.0015 mcg, gentamicin sulfate ≤0.15 mcg, ovalbumin ≤0.050 mcg, formaldehyde ≤5 mcg, and sodium deoxycholate ≤65 mcg from the manufacturing process. (also from the package insert)
By now you might be saying, “Yikes! way too much information!! Just tell me if I should take the flu shot or not!” It really depends on so many things. How old are you? What is your current health? Are you around fragile, compromised friends or family, or do you work in an area where there are immunocompromised people? Have you had a serious reaction to the flu shot in the past or are allergic to eggs or thimerosal? It is an individual decision that you and your provider should discuss. It is helpful to do what you can to stay healthy during the year by eating nutrient rich foods and washing your hands frequently during the day. Sorry it is not just a simple yes or no answer. For me personally there are years that I took the flu shot and years that I didn’t. There are people who don’t get the flu shot and never get sick, and others who get the flu despite taking the shot. and then there are flu like illnesses that are not Influenza A or B and are not prevented by the flu shot. There are no guarantees either way. With any medical procedure, I believe in looking at risk vs. benefit. If you are at high risk for developing influenza and it’s potential complications, then it is more important for you to discuss that with your provider.
Another valuable resource that is a go to site for me is the National Vaccine Information Center(nvic.org) You can research all of the available vaccines on this site, any potential side effects, vaccine injuries reported and scientific studies related to vaccines. As with any medical procedure, there are potential complications that you should be aware of when making decisions for yourself or your children.
My final request: be kind to each other, even when you disagree about vaccine decisions. I confess that I am at times afraid ( I am an enneagram 6 after all) of certain vaccines and respectful conversations are more helpful than critical ones.
Resources:
CDC.gov Center for Disease Control
NVIC.org National Vaccine Information Center
chriskresser.com podcast called Revolution Health Radio, search on his website for “flu shots” He takes a more alternative, functional medicine approach
Natural MD Radio with Aviva Romm, MD podcast 105 talks about vaccines in general, not just the flu vaccine, a very rational approach to decision making