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Regular Flu Shots Easier Sell in Time of Swine Flu

A Doctor's Word

New America Media, Commentary, Erin Marcus M.D. Posted: Oct 11, 2009

Editors Note: The fear of swine flu has made a lot more people open to getting flu shots this year, although the regular flu shot does not protect you against the H1N1 virus. But the flu shot is important, nonetheless, argues Dr. Erin Marcus. Dr. Marcus is associate professor of clinical medicine at the University of Miami Miller School of Medicine. A Doctor's Word is supported by a grant from the Ford Foundation.

This is the time of year when I usually perform my why you need the flu vaccine sales talk. Heres what I tell patients: You really should get this because the flu could make you very sick. This shot will protect you from a disease that kills several hundred thousand people each year. The pain from this one injection is nothing compared to the many jabs youll get if you end up in the hospital. And, the grand finale: No, it wont give you the flu.

About half the time, my cajoling works. But no matter how hard I try, theres always a core group of people who absolutely refuse, even if they have diabetes or lung problems or are elderly the very people who are at highest risk of dying if they get the flu.

This year, though, things are different. All of my patients immediately say yes when I ask them if they want the shot despite the fact that Im only offering them the vaccine for the usual seasonal flu. The H1N1--or swine--flu vaccine has not yet arrived at the public clinic where I work. And even though patients are usually in a rush to get out of the clinic, theyre willing to wait for this particular shot, which wont protect them from H1N1. Sometimes that means sitting in the waiting room for an extra hour or so because a lot of people want to get immunized, and the clinic lacks the resources to put more than one nurse on vaccine duty.

This newfound interest in seasonal flu shots isnt just happening at my clinic. Across the country, people who normally wouldnt get vaccinated are changing their minds this year. In an Associated Press poll released earlier this week, 57 percent of adults surveyed said they plan to get the seasonal flu shot, and 66 percent said they will vaccinate their kids against the seasonal flu. A slightly lower number 52 percent said they plan to get the H1N1 flu vaccine. Most years, only a third of people in the United States get vaccinated against the flu.

This surge in seasonal flu immunizations is one upside to the H1N1 pandemic. It likely will save many lives. In a typical year, the seasonal flu kills 36,000 people in the United States and 250,000 to 500,000 people worldwide. Teenagers are most likely to get the seasonal flu, but people at the extremes of age babies and older adults - are most likely to die from its complications. Thats why government flu vaccine programs usually focus on people older than 50, as well as people who have conditions that weaken their bodys ability to fight infection, such as chronic lung and heart problems, HIV, cancer, diabetes, and pregnancy. Despite these efforts, about a third of older people typically dont get the shot.

Unlike the seasonal flu, H1N1 has taken its worst toll on young people. So far this year, children and adults younger than 50 have been more likely to wind up in the hospital or die as a result of the H1N1 flu than older folks. Kids under the age of 4 and pregnant women have been at particularly high risk of complications. H1N1 has some similarities to flu viruses that circulated in the population many years ago, and many older people may have some immunity to it.

Because H1N1 has mostly been affecting younger people, the government is urging people ages 6 months to 24 years and not older adults - to get the shot. The other people who should be first in line for the H1N1 vaccine are pregnant women; people who live with or take care of babies younger than 6 months; people ages 25 to 64 who have diseases that weaken their immunity; and health care workers, who are at high risk of getting infected and spreading the flu to their patients.

The main side effect of the seasonal and the H1N1 flu vaccines is a sore arm. People with severe egg allergies and people who have had a severe reaction to past flu shots shouldnt get the vaccines. Some people have fainted right after getting the H1N1 shot, so it is a good idea to stay in the clinic for half an hour after receiving the shot.

There is a nasal form of the H1N1 vaccine, but it cant be given to people with asthma, pregnant women, or people with any immune-weakening conditions.

People who have diabetes or asthma or other illnesses that make them vulnerable to infections should also think about getting the pneumococcal vaccine, which protects against infection by the pneumococcal bacteria. Many of those who have died of H1N1 were killed because the virus made them more vulnerable to pneumococcal pneumonia, which overwhelmed their lungs.

Most people who get H1N1 dont need to go to the hospital or even see a doctor. Many get an illness like the influenza my 6-year-old daughter had this summer achy, feverish, and miserable, but able to keep drinking juice and soup and better in a few days (though she needed to stay home for a week because she could still spread the virus).

If you think you have the flu and are wondering about whether you should see a doctor, Emory University and Microsoft have a useful computer-based questionnaire. The federal governments flu website also has useful information, including links to information about public clinics that will be offering the H1N1 vaccine.

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