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Dr. Patricia Yarberry Allen is a collaborative physician who writes a weekly “Medical Monday” column for Women’s Voices for Change. (Search our archives for her posts, calling on the expertise of medical specialists, on topics from angiography to vulvar melanoma.)

This is National Influenza Vaccination Week. To address the concerns of a woman who is worried about the flu shot’s rumored “nasty complications”—indeed, who questions the usefulness of the shot—Dr. Pat turns for expertise to a member of Women’s Voices’ Medical Advisory Board, Jason S. Kendler, M.D., a Clinical Associate Professor of Medicine at the Weill Medical College of Cornell University.


Dear Dr. Pat:

I hate getting the influenza vaccination because I am afraid that I will get one of those nasty complications from it. I smoked a pack a day from age 18 to age 40, but never have a cold or get sick.  I am 52 and in good health.  I read that this year’s vaccine doesn’t even cover the viruses that are likely to cause the flu.  Is this a year that I can avoid the flu vaccine?



Dr. Kendler Responds:

Dear Jennie:

This is definitely not the year you should avoid the flu vaccine, and I will tell you why.

But before I do, I want to remind you of the terrible symptoms that patients with the flu can experience. The flu generally causes an illness that is a full week long and is characterized by fatigue, high fever, headache, cough, sore throat, runny nose, and muscle aches. Patients with influenza often spend much of the time in bed. Although most patients recover, do not forget that each year, tens of thousands of people in the U.S. will die as a result of influenza infection

The main reason why you should not avoid the flu vaccine is simply the fact that vaccination has been proved to decrease influenza illness and its complications. Last year’s vaccine lowered the risk of getting the flu by about 50 percent.

Jennie, you are absolutely correct that this year’s vaccine does not provide maximum protection against one of the strains that is currently causing cases of flu. However, even in a year like this, when the vaccine is not a perfect match, some degree of protection is generally offered. Historically, the risk of death is reduced by vaccination even when there is not a perfect match between the vaccine and circulating strains of the flu. Imperfect as the flu shot may be, getting one is the best way you can lower your risk of getting the flu and suffering from its complications.

What about side effects? The fact is, aside from soreness at the site of injection—which tends to be mild—side effects are very rare. The high-dose flu vaccine which is an option for patients 65 years of age and older may have a higher incidence of side effects (but may be slightly more effective for older patients). And here’s the most important point: No one can get the flu from any injectable form of the vaccine. 

Currently, many different flu vaccines are available to patients. Choices include a trivalent vaccine (containing 3 strains of inactivated flu virus), a quadrivalent vaccine (containing 4 strains of inactivated flu virus), a high-dose vaccine (for patients 65 years of age and older), an intradermal vaccine (injected under the surface of the skin), egg-free vaccine (for patients allergic to eggs), and an intranasal vaccine. Note that the intranasal vaccine—often given to children, since it is inhaled as a mist—contains weakened, live virus and cannot be given to all patients. I typically offer the trivalent vaccine to my patients, and this is the vaccine that I myself received this year.

Because of its protective effects and low risk of side effects, the Centers for Disease Control (CDC) has advised that everyone 6 months of age and older (including pregnant women) get a flu vaccine unless there are medical reasons for not doing so. The CDC does not preferentially recommend any of the specific vaccines that I have mentioned over the others.

Whether you have had the vaccine or not, if you are exposed to someone with the flu or if you have flu-like symptoms, you should call your doctor immediately, because there are medicines that can be given to lower your risk of developing the flu if you are exposed or treat you if you are sick with the flu.

As of this writing, there have not been many cases of influenza in the U.S., but unfortunately, many more people will get sick. Since maximal protection from the flu vaccine does not occur until 2 weeks after vaccination, my advice to you, Jennie, is to get your flu shot now! 

Jason S. Kendler, M.D.

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  • Roz Warren December 8, 2014 at 10:37 am

    Getting a flu shot will also help prevent you from getting the flu and thereby endangering the life of anyone you encounter whose immune system is compromised by a serious illness.