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written by Tara Haelle
Brace yourselves: Flu season is coming! And with the coughing, fevers and aches come all the alarmist articles and blog posts on unreliable, misinformative websites questioning the flu vaccine’s safety and effectiveness. There are already some
some of these misconceptions about the vaccine so many love to hate (including the ), but none quite get around to addressing every last claim I’ve heard, and most don’t provide the citations right then and there to back up the accurate information provided.
And so I began this list last year, attempting to address every last myth about the flu vaccine I had come across and provide all the links needed to see where my information had come from. Admittedly, some of the “myths” aren’t exactly myths – they contain a morsel of truth in them – but they are misconceptions in that the morsel of truth has become twisted, misrepresented or misunderstood, and therefore important to address.
The post last year went unexpectedly, uh, viral, revealing just how much people are craving accurate information about the flu vaccine. Hopefully it convinced at least some people to
since last season’s
particularly hard. Either way, I’ve decided to update the posts for the . So far this year, of course, Ebola has upstaged the flu and stolen most of the headlines about a killer virus. But flu season has not really quite begun just yet, so it remains to be seen which one will dominate the media throughout the winter. What’s ironic is that the flu kills more people in one year – in the U.S. alone – than Ebola has killed ever in history worldwide.
But I’m already getting ahead of myself – I’ve bumped Ebola to #1 on this year’s list – so let’s get to it with two quick, important notes: First, for those who prefer to do their own research, I’ve provided all my sources in hyperlinks. More than half of these go directly to peer-reviewed medical research, and a fair number go to the Centers for Disease Control and Prevention or the World Health Organization.
Second, but very important: I am a science journalist but not a medical doctor or other health care professional. I’ve compiled research here to debunk common myths about the flu vaccine. You should always consult a reliable, trusted medical professional with questions that pertain specifically to you. For the CDC recommendations on the
flu vaccines (including information on which vaccines pregnant women, the elderly and children under 2 should *not* get), please . There are indeed people who .
To make it easier to navigate, I’ve listed all 31 myths at the top followed by the factual information in parentheses, which is also a link to jump to that explanation. I use “flu shot” and “flu vaccine” interchangeably to refer to any type of flu vaccine, including the nasal vaccine. For those familiar with last year’s post, although I have made a couple updates and changes throughout, the completely newly added myths are #1 through #5 and #28, #32 and #33.
Myth #1: You should fear Ebola more than the flu.
Myth #2: You don’t need the flu vaccine this year if you got it last year.
Myth #3: The flu shot is a “one size fits all” approach that doesn’t make sense for everyone.
Myth #4: People die from the flu shot.
Myth #5: Deaths from the flu are exaggerated.
Myth #6: The flu vaccine gives you the flu or makes you sick.
Myth #7: Flu vaccines contains dangerous ingredients, such as mercury, formaldehyde and antifreeze.
Pregnant women should not get the flu shot. The flu shot can cause miscarriages. Pregnant should only get the preservative-free flu shot.
Myth #9: Flu vaccines can cause Alzheimer’s disease.
Myth #10: Pharmaceutical companies make a massive profit off flu vaccines.
Myth #11: Flu vaccines don’t work.
Myth #12: Flu vaccines don’t work for children.
Myth #13: Flu vaccines make it easier for people to catch pneumonia or other infectious diseases.
Myth #14: Flu vaccines cause vascular or cardiovascular disorders.
Myth #15: Flu vaccines can break the “blood brain barrier” of young children, hindering their development.
Myth #16: Flu vaccines cause narcolepsy.
Myth #17: The flu vaccine weakens your body’s immune response.
Myth #18: The flu vaccine causes nerve disorders such as Guillain Barre syndrome.
Myth #19: The flu vaccine can make you walk backwards or cause other neurological disorders.
Myth #20: Influenza isn’t that bad. Or, people recover quickly from it.
Myth #21: People don’t die from the flu unless they have another underlying condition already.
Myth #22: People with egg allergies cannot get the flu shot.
Myth #23: If I get the flu, antibiotics will take care of me.
Myth #24: The flu shot doesn’t work for me, personally, because last time I got it, I got the flu anyway.
Myth #25: I never get the flu, so I don’t need the shot.
Myth #26: I can protect myself from the flu by eating right and washing my hands regularly.
Myth #27: It’s okay if I get the flu because it will make my immune system stronger.
Myth #28: If I do get the flu, I’ll just stay home so I’m not infecting others.
Myth #29: Making a new vaccine each year only makes influenza strains stronger.
Myth #30: The side effects of the flu shot are worse than the flu.
Myth #31: The “stomach flu” is the flu.
Myth #32: If you haven’t gotten a flu shot by November, there’s no point in getting one.
Myth #33: The flu vaccine causes Bell’s palsy.
Myth #1: You should fear Ebola more than the flu. (Fact: The flu poses greater risk to you than Ebola.)
Whether Ebola or the flu is worse depends on how you compare them – I’m certainly not going to claim a person should prefer Ebola to flu. But by most measures, we have far more to worry about with influenza . As I mentioned above, in historical and annual terms, the flu wallops Ebola in total death count. Until this year, Ebola had , according to WHO. So far this year,
from Ebola, making this year’s outbreak by far the worst ever (though it has ), and that’s no small thing for the thousands suffering in the west African countries of Guinea, Liberia and Sierra Leone. But that gives us 5,021 total deaths from Ebola in the history of the world.
By comparison, deaths from the flu in the U.S. alone have ranged from
(more on those estimates in Myth #5). The WHO estimates a
people die worldwide from the flu each year, and the infamous 1918 flu epidemic killed approximately
worldwide. 50 MILLION, with an M, compared to just over 5,000 THOUSAND from Ebola. In terms of contagiousness,
(helpfully ), of about 2. But flu is airborne and harder to contain, whereas Ebola is transmitted only through direct contact with infected bodily fluids (it’s , folks) and therefore easier to contain, relatively speaking.
Of course, measured in terms of the mortality rate, Ebola certainly beats out flu with a far, far higher risk of death once you have the disease. One of the things that makes Ebola so frightening is the mortality rate, estimated by the WHO as . However, there’s a huge caveat to that mortality rate: note the
who have suffered Ebola outbreaks. They are all African nations with a less developed health care system than in the U.S. or most other developed nations. You cannot compare a disease’s death rate in poorly resourced, lower-income countries in Africa to what it would be in the U.S. Ebola’s death rate in Africa still significantly exceeds the , so it is a more dangerous disease in Africa, but not in the U.S.
Myth #2: You don’t need the flu vaccine this year if you got it last year. (Fact: You need a new flu shot each year.)
This is one of those less clear-cut misconceptions – not quite a myth but not quite true either. Typically, the strains included in each year’s flu vaccine , based on the
on which strains are most likely to circulate. That’s why you need a new flu shot each year, to be sure your body is making antibodies for the strains most likely – the experts think – to be floating around. But this year’s strains, unusually, happen to be the same ones included in last year’s flu shot:
an A/California/7/2009 (H1N1)pdm09-like virus
an A/Texas/50/2012 (H3N2)-like virus
a B/Massachusetts/2/2012-like virus
B/Brisbane/60/2008-like virus (in the quadrivalent vaccines only)
It’s therefore a pretty reasonable question: if I got the flu shot last year, do I really need the same one again this year? The best answer is “probably.” It’s true that flu antibodies against one particular strain have the potential to , at least if you had the flu. A
found that people who survived the 1918 flu pandemic still had antibodies for that specific strain decades later. But that was the flu, not the seasonal flu vaccine, stimulating the body’s antibody production (and it was only against that *one* strain, of which there are thousands).
Because it’s so rare to have the same exact strains in consecutive years’ vaccines, there isn’t enough evidence to know whether last year’s shot will protect you this year or not. We know that the
with the intent to protect you for only one season, and we know some
(sometimes even ). In fact, the flu vaccine’s effectiveness , particularly . On the other hand, a
found similar levels of protection from both the current year’s flu vaccine and the previous year’s vaccine (but those who benefitted most from the shot were those who hadn’t had one in the past five years). So you may have some protection if you got the shot last year, but we don’t know how much and there’s no guarantee that you have any.
Myth #3: The flu shot is a “one size fits all” approach that doesn’t make sense for everyone. (Fact: You have many flu vaccine options.)
This one couldn’t be further from the truth. While there are definitely some people who should , most people have
than ever before in choosing the vaccine that’s best for them. Last year,
while pregnant. This year,
live nasal vaccine, but there are potentially
this year. There’s the good old-fashioned , with or without the preservative thimerosal, or an
that goes into the skin instead of your muscle. If you’re over 65, you can get the , and if you are concerned about egg allergies, you can get the
flu vaccine. Or you could get the
(with or without thimerosal) instead of the . Or, if you hate needles and don’t want a live vaccine, you could get vaccinated with . Whatever you want,
and see if they have your preferred vaccine.
Myth #4: People die from the flu shot. (Fact: There have been no confirmed deaths from the flu shot.)
In late November of last year,
reported a young Utah man’s death that his mother attributed to the flu vaccine. It is possible –very, very, very, very rare but technically possible – to die from the flu vaccine if you have a severe allergy to gelatin, but such anaphylactic reactions to the gelatin in a vaccine only occur to about
people, and they don’t typically die. It’s
that this man’s tragic death was caused by the flu vaccine, . It’s not impossible, but there is no evidence for the assertion, and no confirmed death due to the flu vaccine has ever been recorded. Certainly, people have died after getting a flu shot, just as people have gotten into car accidents right after buying ice cream sundaes. But simply dying after getting the flu shot doesn’t mean the death was caused by the flu shot, as a friend once said, any more than dying after swigging a pumpkin spice latte means the pumpkin spice latte killed you.
Myth #5: Deaths from the flu are exaggerated. (Fact: Thousands die from flu in a typical year.)
While some have claimed that
each year, they’re taking advantage of the fact that it’s
because of the flu. First, states aren’t required to . Second, not everyone who dies due to a respiratory illness is tested for the flu, and not everyone who is . Third, and most importantly, people tend to die from complications of the flu, not the flu itself. (Or, as one friend put it, no one dies from falling off a building. They die from deceleration when they hit the ground.) People can also die from a pre-existing condition, such as heart disease, because their body is weakened from fighting flu.
In the U.S., an estimated
occurred from flu and pneumonia combined in 2010 and
making combined influenza and pneumonia the eighth leading cause of death that year. But only about
are flu-related, so those numbers cannot tell us precisely how many died only from just the flu and its complications. Flu deaths actually vary wildly from one year to the next, depending on the dominant strains ( to the most deaths). A
found they’ve ranged from a low of 3,349 deaths in 1986-87 to a high of 48,614 deaths in 2003-04. The average is probably about
deaths a year.
Myth #6: The flu vaccine gives you the flu or makes you sick. (Fact: The flu shot can’t give you the flu.)
This is by far the most common myth I hear – even though it’s biologically not possible to catch an illness from the inactivated vaccine. Do some people become sick right after getting a flu shot? Of course – they probably caught that bug before getting the shot, and it took a few days for symptoms to appear, or they could have coincidentally caught it after the shot. Just as likely, they could have caught the bug *at* the doctor’s office or pharmacy while waiting to get the vaccine. But they didn’t get the flu from the vaccine. The flu shot takes two weeks to confer protection, and it takes 2-5 days to incubate a flu virus. A person who does come down with the flu within a week of getting the shot was already infected when they got the vaccine.
Even with the live vaccine in the nasal spray, the
cannot cause the flu in you. However, it is theoretically possible to
after receiving the live vaccine, thereby infecting others, though no serious cases have been reported of this occurring. When I got my nasal vaccine, the pharmacist explained that if I sneezed directly on my 6-month-old in the hour after getting the shot, it was technically possible – though highly unlikely – for my son to get ill.
Aside from an actual illness caused by a virus or bacteria, it is certainly possible for people to just feel “under the weather” or “unwell” from the
of the flu shot. As the immune system ramps up to produce antibodies against those influenza strains, you might experience a headache, nausea, a low fever, etc. You might feel “sick,” but you have no fallen ill from a pathogen in the flu shot, nor did you catch the flu from the shot.
Myth #7: The flu shot contains dangerous ingredients, such as mercury, formaldehyde and antifreeze. (Fact: Flu shot ingredients are safe.)
Single dose-shots of the flu vaccine and the flu vaccine nasal sprays do not contain any mercury compounds. The multi-dose flu shot does contain a preservative called , which breaks down into 49%
and used to prevent bacterial contamination of the vaccine container. Ethylmercury, as
before, is processed differently by the body than methylmercury, the neurotoxin that can build up in the body and is found in fish. (Keep in mind the difference a letter can make in chemistry: methanol is anti-freeze while ethanol is a Chardonnay.) Ethylmercury is made of
that cannot enter the brain and
within a week.
There is no danger in receiving a
– they’re given all over the world and it’s been extensively studied, even for
over several years. If you want to avoid it anyway, or if you’re allergic to thimerosal, you can simply request a flu shot without the preservative.
is used in
in several flu vaccines (Fluarix, FluLaval, Agriflu and Fluzone) to
so it cannot cause disease. It is not in other influenza vaccines (Afluria, FluMist and Fluvirin). Formaldehyde, as , also occurs naturally in : about 2,000 mcg of formaldehyde in an
and anywhere from 8600 to 13200 mcg . Yet the amount of formaldehyde in flu vaccines ranges from 5 ug per dose (Fluarix) to 25 ug per dose (FluLaval) to 100 ug per dose (Fluzone). For those concerned that the formaldehyde in flu shots is injected rather than consumed, consider that the
produces formaldehyde for a variety of functions, such as making amino acids, and has about 2,600 mcg of formaldehyde per liter of blood. So the tiny amount from the flu shot – which does not stick around and accumulate – will make little difference to your body.
The claim of antifreeze being in vaccines appears to come from the use of
(in Fluzone) or octoxynol-10 (Triton X-100) (in Fluarix) since this name looks similar to . Polyethylene glycol is one component of antifreeze but not antifreeze itself, just as water is a component of antifreeze. But polyethylene glycol isn’t Triton X-100 anyway.
is a splitting agent used to break up the virus components, and it’s been .
Some people may have allergies to flu vaccine ingredients, such as gelatin, thimerosal or antibiotics. See Myth #22 for more on this. Find out more about specific
or, for Fluzone in particular, see my “What’s Inside” piece in the October issue of Wired Magazine. Remember, however, that ONE LETTER can make a huge difference in what you’re talking about.
Pregnant women should not get the flu shot. (Fact: Pregnant women should get the flu shot.)
Actually, the flu shot is one of the most important things a pregnant woman can get as part of her prenatal care. I got
last year, and the CDC recommends that
without medical contraindications get one. The flu shot is
mothers, and even after their child is born, mothers who got the flu shot while pregnant have provided their babies with a bit of extra protection against . They also may reduce children’s risk of other conditions, such as , associated with prenatal influenza exposure. And, moms who get the flu shot also offer their babies some protection against the flu from birth, even if they plan to breastfeed.
Myth #8B: The flu shot can cause miscarriages. (Fact: The flu shot reduces miscarriage risk.)
Not only does the flu shot not cause miscarriage, this non-pharma-funded study in the New England Journal of Medicine actually shows that the flu shot
in pregnant women, not least because having influenza itself during pregnancy is linked to miscarriages. Interestingly, the flu shot can even , such as a preterm birth or an .
Myth #8C: Pregnant women should *only* get the preservative-free flu shot. (Fact: Pregnant women can get any inactivated flu vaccine.)
The inactivated flu vaccine, with or without the preservative thimerosal, is
quickly and
developmental problems,
or any other problems in the fetus, short-term or long-term. The shot I got last year had thimerosal, and my 6-month-old is continuing to develop normally. I discussed thimerosal in greater detail above at Myth #2. (Bonus side note: Even though ethylmercury and methylmercury are quite different, it’s worth noting that even a , which may expose a woman to more methylmercury, has not been found to have an effect on children’s development.)
For much more information (and research) about getting the flu shot while pregnant, check out my post specifically focused on .
Myth #9: Flu vaccines can cause Alzheimer’s disease. (Fact: There is no link between Alzheimer’s disease flu vaccines protect older adults.)
This myth is even addressed on the , where they note the
among those who had received flu vaccines, the polio vaccine and the tetanus and diphtheria vaccines. In fact, the risk for developing Alzheimer’s was half as much for those receiving these vaccines. This myth originated with a quack named
who has no evidence for the claim.
Meanwhile,
are at high risk for flu complications and
and are recommended to get the flu vaccine each year, specifically the high-dose flu vaccine, since it offers greater protection for adults aged 65 and older, . The live vaccine and the
are not recommended for those over 65. (Side note: some worry about aluminum in vaccines causing Alzheimer’s — except that flu shots
Myth #10: Pharmaceutical companies make a massive profit off flu vaccines. (Fact: They’re a tiny source of pharma profit.)
There is no question that pharmaceutical companies are for-profit companies taking in billions and billions of dollars. Making money, however, does not mean one is immoral by default. Car seat manufacturers turn a profit, but that doesn’t mean we refuse to buy car seats on principle. That said, there have been plenty enough shady dealings, lawsuits, investigations and other such incidents to support a healthy suspicion of Big Pharma and its motives. But vaccines simply don’t offer enough revenue to a difference here.
If pharmaceutical companies didn’t make a profit off vaccines, they wouldn’t manufacture them. At the same time, vaccine profits are a drop in the bucket compared to profits from medications for chronic conditions such as high blood pressure and mental illnesses, not to mention the cash flow from drugs like Viagra. In fact, the top three flu vaccine manufacturers – Sanofi Pasteur, Glaxo SmithKline and Novartis – pulled in about
from flu vaccines in 2013. Yep, that’s billions. But total pharmaceutical companies revenues last year were nearly
– making the bulk of flu vaccine revenue only about . For those big three companies, flu vaccines comprise about 4.5% of total annual revenue. (Meanwhile, cholesterol-lowering drugs such as
back in 2011.) For an even more in-depth look at these numbers, check out
from flu vaccines. He’s run the numbers and made it clear that flu vaccines just aren’t profitable enough to justify some grand conspiracy.
Meanwhile, the
for vaccines come from public health organizations such as the CDC and similar public health, government and academic institutions across the world. Unless you think all those countries’ governments and public health officials are involved in a huge conspiracy or money-making scheme with Big Pharma (and if you think that, ), then the fact that vaccines offer a profit to pharma companies isn’t a reason not to get vaccinated. In fact, influenza itself is , costing the US about
annually in direct medical costs and as much as
annually in all costs.
Myth #11: Flu vaccines don’t work. (Fact: Flu vaccines reduce the risk of flu.)
Flu vaccines are not 100% effective. (Actually, no vaccine is 100% effective.) But they do
of catching the flu even if they cannot eliminate the risk. And there are
showing this (and yes, many of these are not funded by Pharma). Unfortunately, the effectiveness of the
quite a bit from year to year, and it’s among the less effective vaccines compared to ones such as the measles-mumps-rubella vaccine, whose effectiveness for measles is in the high upper 90%s. (The more people who get the vaccine, though, the better
is and the more effective it can be.)
There are a couple things to keep in mind about the effectiveness of the flu vaccine that vaccine researcher
explained. First, the flu vaccine has historically protected against only three strains each year (though the four-strain vaccines are becoming more popular), but there are many more strains circulating each year. The World Health Organization make
by February about which strains will be circulating later that fall: some years their algorithms for picking the strains are better than others. Last year, they did pretty well. Of more than
during the
season, 99.8% of the H1N1 viruses were the strain in the vaccine that year, 95.3% of the H3N2 viruses were the vaccine strain, and 70.3% of the influenza B viruses were the vaccine strain. Another 29.4% of the influenza B viruses were the strain included in last year’s quadrivalent vaccine.
Yet even in the years when their estimates fall short, the flu shot is worthwhile:
across 47 flu seasons found that even when the strains in the flu vaccine
that year, the flu vaccine offered a measure of protection against the circulating strains.
Next, the effectiveness of the flu vaccine varies for different age groups, partly because of the way the immune system ages. “Generally speaking, your immune system peaks in early adulthood and goes downhill from there – hence less than ideal efficacy of standard flu vaccines in the ,” Atwell said. (Though, again, the high-dose flu vaccine shows better effectiveness in the elderly in an .) Yet even studies showing
effectiveness — this one found
each year to prevent one case of the flu — still show a reduced risk of the flu in vaccinated individuals. Coming at it from a different angle, another recent study
anywhere from 1.1 million to 5 million flu infections during each flu season over six years.
Again, some years, the flu vaccine’s effectiveness is very low. Other years, it’s better. But just because it does not work 100% all the time for all people does not mean it’s worthless or ineffective. Some days, I feel like I’m only operating at 50% human capacity — but I still need to be a mother to my son, and I’m better than no parent at all for him. Or, for a simpler analogy: If there is a 50% chance it’s going to rain, do you take along the umbrella even if it’s an inconvenience? Some do because they don’t want to get wet if it does rain. Some bring it, but it’s a bad storm and they get a little wet anyway. Others don’t bring the umbrella. The difference? If you don’t bring an umbrella, it’s just you getting wet, but by not getting yourself vaccinated, you potentially put others at risk for catching the flu from you, if you catch it.
The Holy Grail, of course, is a universal flu vaccine to provide protection against many or all influenza strains. It’s a goal that many flu vaccine researchers have been working toward for years, but there are many challenges to such a vaccine and success has been elusive.
Myth #12: Flu vaccines don’t work for children. (Fact: Flu vaccines reduce children’s risk of flu.)
As noted above, the effectiveness of the flu vaccine varies by age and by which vaccine (live or inactivated) a person gets, but there is no doubt that it offers some protection against the flu. As
in this Slate piece, the live vaccine (FluMist) is more effective for kids aged 2 to 7, up to
(meaning kids who get the vaccine are 83% less likely to get the flu than gets who aren’t vaccinated). To put that study’s finding in absolute number terms, 16% of unvaxed kids got the flu compared to 3.4% of those who received the live vaccine. In fact, the higher effectiveness of the nasal vaccine – found again in
– is what led to the
and not contraindicated because it’s about
for kids in this age group than the flu shot is. (A recent study found that even
did well with the live vaccine.)
In fact, the (inactivated) shot only offered
in another study. (Moyer’s article is worth reading in full for more details about flu vaccine effectiveness in children and teens.)
of the research found that, for children under 6 years old, one child would be prevented from contracting influenza for every six who were vaccinated with the live vaccine. For children over 6, one case of flu could be prevented for every 28 kids who received the inactivated vaccine.
Moyer also notes that the research on the effectiveness of the flu for kids aged 6 months to 2 years is weak, mostly because there isn’t much data available. (That’s based on a Cochrane review whose only data set on children under 2 was a .) It’s true the data is thin, but it’s not entirely nonexistent, and new research, such as
and , has come out showing flu vaccine effectiveness in kids since the Cochrane Review. The
found the flu vaccine to be 66% effective in preventing lab-confirmed influenza in children aged 6 months to 2 years old. (While this study did not find the flu vaccine to help prevent ear infections,
found that.)
has found a good immune response to the vaccine among children (including infants). In another, focused specifically on children aged 9 months to 3 years, only
under age 2 caught the flu compared to 12% of the unvaccinated children, for another finding of 66% effectiveness.
Myth #13: Flu vaccines make it easier for people to catch pneumonia or other infectious diseases. (Fact: Flu vaccines reduce the risk of pneumonia and other illnesses.)
This myth is just bizarre. For one thing, catching the flu will weaken your immune system while you’re sick, during which it’s easier to become ill from other bugs. But more importantly, pneumonia is among the
to occur as a result of a flu infection, so getting the flu shot *reduces* your , a leading cause of death among those who die from influenza complications.
Myth #14: Flu vaccines cause vascular or cardiovascular disorders. (Fact: Flu shots reduce the risk of heart attacks and stroke.)
This is another myth that should be flipped on its head. There is no evidence that the flu vaccine causes vascular disorders. Meanwhile, the vaccine has been shown in multiple studies to , stroke and .
Myth #15: Flu vaccines can break the “blood brain barrier” of young children, hindering their development. (Fact: Flu vaccines have been found safe for children 6 months and older.)
There is no evidence that flu vaccines can hurt children’s development or that children’s neurovascular structure are affected by flu vaccines. A child’s
is formed in utero and is
in regulating what can and cannot . Researchers at Stanford University and the University of California – San Francisco discovered in 2010 that pericytes are required for blood-brain barrier development and that
in the fetal brain. This research shows that an
is developed before birth. The physiology of the blood brain barrier and how it functions at that level of development make it highly implausible that any vaccine components could penetrate the barrier.
Myth #16: Flu vaccines cause narcolepsy. (Fact: The U.S. seasonal flu vaccine does not cause narcolepsy.)
This is one of the few misconceptions that is rooted in a small amount of fact, though it’s often misrepresented or blown out of proportion. Narcolepsy is a neurological disorder in which the brain in unable to regulate sleep-wake cycles. Several studies, first in
and then in other European countries,
a link between narcolepsy and the
flu vaccine called Pandemrix, manufactured by GlaxoSmithKline Europe and used in
(but not in the U.S. or Canada). It was not used before 2009 or since the
season, and no links to narcolepsy have been found for U.S.-manufactured H1N1 or seasonal flu vaccines. The
an international study on the link between the
flu vaccines and narcolepsy, expected to be completed in 2014.
One hypothesis for the link relates to an adjuvant called ASO3, an oil-in-water emulsion. Adjuvants are substances added to a vaccine to increase the body’s immune resp U.S. influenza vaccines do not contain adjuvants. Other possibilities for the narcolepsy risk include immune stimulation from the vaccine itself, immune activation from H1N1 infection or another infection present at the time, or a combination of these factors. It’s also possible the narcolepsy risk is related to the H1N1 virus itself, which could means the flu infection could increase the risk of narcolepsy — but these are all conjectures at the moment.
for the vaccine and then Pandemrix was suspended after the evidence came to light. The increased risk was estimated at an additional 3 to 7 cases of narcolepsy for every 100,000 vaccinated children (the link was only seen in those under 21).
Myth #17: The flu vaccine weakens your body’s immune response. (Fact: The flu vaccine prepares your immune system to fight influenza.)
Vaccines do not weaken the body’s immunological responses or cause other infections. They actually strengthen the immune system, activating a response that leads to the production of specific antibodies against the disease the vaccine is designed to protect against. The immune system is like a muscle and vaccines are like the exercise. The vaccines train your immune system for a future attack just like exercise strengthens your muscles and makes you body stronger.
(The flu, on the other hand, does weaken your immune system while your body tries to fight it.)
Myth #18: The flu vaccine causes nerve disorders such as Guillain-Barré syndrome. (Fact: Influenza is more likely than the flu shot to cause Guillain-Barré syndrome.)
(GBS) is an autoimmune disorder in which the immune system mistakenly attacks a person’s own nerve tissue, causing muscle weakness and sometimes temporary paralysis. The disorder affects approximately one person out of every 100,000 individuals. Causes are not well understood, though the disorder has been linked to viruses including cytomegalovirus, Epstein Barr and influenza (as well as the bacteria campylobacter).
This misconception, like the one about narcolepsy, is partly based on fact because the
flu vaccine was found to be linked to a higher risk of GBS that year – approximately 10 additional cases of GBS for every 1 million people vaccinated. Since then, GBS risk has probably been the single most studied adverse event from the flu shot in the history of flu shot research, and the majority of it has shown no increased risk with seasonal flu vaccinations. One
from the flu shot among “person-years” (30 million people over an 11-year period) found no increased risk for the flu shot. , the independent Institute of Medicine “concluded that there was sufficient evidence to reject an association between influenza vaccination and GBS.”
Another study specifically on the
H1N1 vaccine did find an increased risk of GBS — but not as high as the risk of GBS from the flu itself (or the risk of death from the flu). It
of 1 additional case of GBS per every 1 million vaccinations and 17 additional cases of GBS for every 1 million influenza infections. That flu season, the H1N1 influenza killed about 280,000 worldwide (more than 12,000 of whom were in the U.S., which recorded 61 million H1N1 infections during 2009). Finally, one study did find a slightly higher risk –
– for seasonal flu vaccines and the H1N1, but this increased risk in seasonal vaccines has not been found in other studies.
Myth #19: The flu vaccine can make you walk backwards or cause other neurological disorders. (Fact: Neurological side effects linked to flu vaccination are extremely rare (see Myth #18), but influenza can cause neurological complications.)
Remember that bizarre case of the cheerleader who said she got a flu shot and then she could only walk normally backwards, not forwards? She claimed she had developed a neurological disorder called
that was triggered by the flu shot. There was a pretty significant problems with her story, however: all the
of the young woman said her symptoms appeared “,” which means they were , in origin. That doesn’t make them less real, but it means the flu shot didn’t cause them. In fact, epidemiologist Rene Najera looked up the
in the Vaccine Adverse Event Reporting System () and found this: “The admitting neurologist felt that there was a strong psychogenic component to the symptomology, and made a final diagnosis of weakness.” So even the physician who directly examined her concluded her symptoms were most likely psychological.
Excluding Guillain-Barré syndrome, which Myth #18 addresses above, there is no evidence that the flu vaccine can cause neurological disorders, but there is evidence that . In fact,
or other neurodevelopmental conditions are especially encouraged to get the vaccine because they are at a
from influenza than other children. Almost half of the children who died from the flu during the 2009 season had underlying neurological disorders, such as epilepsy or cognitive dysfunction.
Myth #20: Influenza isn’t that bad. Or, people recover quickly from it. (Fact: Influenza knocks most people down *hard*.)
Influenza is a . The
are similar to other illnesses, so people often mistake milder illnesses for the flu. Some lucky folks do recover in a day or two, but most are down for a week or two, and complications can be life-threatening, especially . A
that half the children hospitalized in Australia during the 2009 pandemic had previously been healthy with no underlying conditions. Not everyone gets a fever, but having the flu isn’t pleasant, especially given the minor side effects or low risks for
from the vaccine.
During last year’s
were reported as a result of laboratory-confirmed flu during the
season – but those are just lab-confirmed flu (many cases of the flu are never lab tested), and the reported cases represent only about 8.5% of the U.S. population. If we assume – in a very rough estimate – that
are evenly distributed throughout the U.S., that means there were likely more than 113,000 hospitalizations from just laboratory-confirmed flu during the
season. Among adults aged 65 and older,
were flu-related. The next highest rates were for adults aged 50 to 64, who were hospitalized at a rate of 54 per 100,000 admissions, and children younger than 5 years old: 47 of every 100,000 hospitalization was flu-related. But even healthy young adults ended up in the hospital with flu: Almost two-thirds of the hospitalizations (60%) were adults between 18 and 64 years old.
Myth #21: People don’t die from the flu unless they have another underlying condition already. (Fact: Otherwise healthy people DO die from the flu.)
People . Every year. This includes adults who are healthy up until getting the flu and it
with no underlying conditions (). In 2013, in fact,
from the flu had not been vaccinated. The annual numbers of
are not high, but they are potentially preventable. A study published in
of the more than 800 children who died from the flu between 2004 and 2012 had no underlying medical conditions. Often,
to a death but not be listed on the death certificate if the individual died from complications of the flu, such as pneumonia. And last year in particular, the H1N1 strains of the
– the “young invincibles” – particularly hard. So yes, the flu can kill you. Even if you take vitamins, eat healthfully, exercise daily, drink water and practice good hygiene.
Myth #22: People with egg allergies cannot get the flu shot. (Fact: People with egg allergies can get a flu shot.)
First of all, as explained in Myth #3, there are a variety of flu vaccine options, including two that are manufactured without using eggs. The recombinant , first made available last year for those , and the cell-culture-based , approved in 2012, are both egg-free. For those not in that age ranges, or if one of these vaccines is unavailable in your area, the , “People with egg allergy are not at any additional risk of having a reaction when given the flu vaccine even though the vaccine may contain some amount of egg protein.” This statement is based on the
in their , summarized . This also refers to , and the CDC has provided a
for those with egg allergies planning to get the flu vaccine.
There are some allergic reactions that can occur with the flu shot. Some people are allergic to thimerosal and should get the preservative-free shot. Some people are allergic to antibiotics and should get flu vaccines without added antibiotics. (The antibiotic polymyxin is in Afluria and Flurvirin, for example, and Fluvirin also contains neomycin.) And in very rare cases – about 1 in every 1-2 million doses of all vaccines – individuals with severe allergies to gelatin can have an anaphylactic reaction. If you have an egg allergy that causes an anaphylactic reaction, ask your allergist to administer the shot.
Myth #23: If I get the flu, antibiotics will take care of me. (Fact: Antibiotics can’t treat a viral infection.)
Influenza is a virus. Antibiotics fight bacteria (anti = “against”; biotics = “of life,” referring to living bacteria). All the antibiotics in the world won’t help you fight off a flu infection. (P.S. Neither there is no evidence to support any essential oils curing the flu.)
Myth #24: The flu shot doesn’t work for me, personally, because last time I got it, I got the flu anyway. (Fact: The flu shot cannot guarantee you won’t get the flu, but it reduces your risk.)
As noted further up, getting the flu vaccine does not guarantee you won’t catch the flu. It does reduce your risk of getting the flu, and it can lead you to have a milder course of the illness than if you hadn’t been vaccinated. It’s also entirely possible that you catch a strain of the flu not covered in the vaccine.
Myth #25: I never get the flu, so I don’t need the shot. (Fact: You can’t predict whether you’ll get the flu.)
Millions of people have never gotten into car accidents. They still wear seat belts and carry car insurance. I’ve never been struck by lightning. But if there’s a thunderstorm raging, I avoid standing outside in wide open fields. It’s estimated that
and about 20% of children under 5 get the flu each year. The past is no indicator of whether you’ll end up in that percentage this year any more than flipping a coin to heads tells me what the next flip will be.
Myth #26: I can protect myself from the flu by eating right and washing my hands regularly. (Fact: A good diet and good hygiene alone cannot prevent the flu.)
Influenza is an airborne virus, so although hand-washing is important and can reduce your risk of becoming ill from germs in general, all the hand-washing in the world won’t guarantee you don’t catch the flu. Eating a healthy, balanced diet is also important, and certainly being healthy makes it easier for your immune system to fight off new infections. But simply eating well cannot magically prevent you from being exposed to the flu virus.
Myth #27: It’s okay if I get the flu because it will make my immune system stronger. (Fact: The flu weakens your immune system while you’re body is fighting it and puts others at risk.)
As noted above, your immune system is weakened while you’re ill from the flu. While your immune system may be strengthened after you recover against that particular strain or a (theoretical) , a vaccine primes your immune system to fight off influenza strains in the same way (without the week of fever, chills and vomiting). Additionally, if you catch the flu, you are contagious to others. Being vaccinated helps keep
levels higher in your community, especially protecting those who are weaker or cannot be vaccinated.
Myth #28: If I do get the flu, I’ll just stay home so I’m not infecting others. (Fact: You can transmit the flu without showing symptoms.)
I’m glad you’ll stay home, but there are two problems with this plan. First, you’re contagious , so you could infect someone
you’re sick. Second, you could catch the flu but
– showing no symptoms. That’s lucky for you but not for those around you whom you could infect. It’s , but you’re still putting others at risk.
Myth #29: Making a new vaccine each year only makes influenza strains stronger. (Fact: There’s no evidence flu vaccines have a major effect on virus mutations.)
This myth is a challenging one to address succinctly without oversimplifying the science. The short answer is that current vaccines are not going to create more dangerous variants of a flu strain.
Influenza virus strains are evolving and changing on a regular basis in two main ways: “.” Drifts are small, gradual changes that happen all the time in response to environmental pressure and even within our own bodies. The influenza virus has a segmented genome: its genome is in eight parts which can randomly re-assort. When the virus infects an individual, it can “exchange” these gene segments and change within that one individual. Our own immune response can invoke a selective pressure on the virus that contributes to drifting, with or without a vaccine. If the virus didn’t change at all from year to year, the flu vaccine would never need to be
each year (and that Holy Grail of a universal flu vaccine would be ).
It is possible that a vaccine could be among the environmental pressures influencing antigenic drifts, but no more so than what already occurs in our own bodies and most likely to a lesser extent. There is not evidence that vaccines cause major changes in the virus, such as an antigenic shift. A shift is much more troublesome change, leading to a dramatically different strain that our immune systems are not usually prepared for. A shift is what happened with the , and it’s what happened with the
in . That pandemic , but it was far worse than a typical flu season, killing an estimated population. (More on this in .)
Interestingly, some believe it’s possible that high levels of herd immunity could reduce antigenic drift. This , “As herd immunity increases, we should expect to see
however, if immunity is high enough to prevent the population-wide spread of the pathogen, the epidemic cannot take off and the virus does not evolve.” Regardless, current vaccines are not going to create more dangerous variants of a flu strain.
The most common
of the flu vaccine are aches, itching, fatigue, headache, fever, hoarseness, sore or red and itchy eyes, a cough and soreness, redness or swelling where the shot was given and aches. Young children may, in rare cases, develop a high fever (a ) that can result in a short seizure,
long-term . (Febrile seizures are not uncommon in young children generally.) The most serious risk is an allergic reaction, possible in approximately 1 out of every 1 to 2 million doses. In the H1N1 vaccines already noted above, Guillan Barre syndrome may be an increased risk for 1 to 2 of every 1 million doses, though it’s many times more common from influenza itself.
The flu itself, as noted above, is much more serious and can cause death.
Myth #31: The “stomach flu” is the flu. (Fact: The “stomach flu” is a generic term for gastrointestinal illnesses unrelated to influenza.)
Ever heard someone talk about a bad case of the “stomach flu?” People refer to any number of gastrointestinal illnesses that way, but the “stomach flu” isn’t related to the actual influenza virus. It’s just sloppy use of language. Most people talking about the stomach flu have diarrhea and vomiting, but without the fever and aches, that’s unlikely to be the real-deal flu.
Myth #32: If you haven’t gotten a flu shot by November, there’s no point in getting one. (Fact: Getting a flu shot at any time during flu season will reduce your risk of getting the flu.)
Flu season continues well into January and February, not really petering out until late March or April, and flu vaccines
throughout that time. It only takes two weeks for your immune system to make the antibodies that offer protection, so it’s basically never too late to get the flu shot until flu season is over.
Myth #33: The flu vaccine causes Bell’s palsy. (Fact: The flu shot does not cause Bell’s palsy.)
One of the many conditions once thought potentially linked to the flu vaccine is , a condition of uncertain origins, though it’s been linked to a . It appears that one flu vaccine used in Switzerland during the
season might have been linked to an
of Bell’s palsy (46 cases). An
in the decade prior also appeared to show a risk, which led to a more in-depth study. That in-depth one found , which a
found as well. In addition, a study looking specifically for
after a flu vaccination found no increased risk. Sometimes it can be tough to separate
and to determine whether two things that happen at the same time are related or coincidence — hence the reason for multiple studies.
However, it is important that adverse events occurring after any vaccine is given are reported to the
(VAERS) so that researchers can follow up on conditions that are reported multiple times. It’s best that a doctor make the report since medically confirmed events are generally given better weight. This is how new associations, such as the narcolepsy link with the European
Pandemrix vaccine, are identified.
Please ask questions, provide new information, etc. in the comments. However, any comments which include inaccurate information posing as “warnings” or “countering” accurate info will be deleted. I encourage debate but not the dispersal of misinformation.
If you’ve read the alarmist “Should I Get the Flu Shot?” post from “Food Babe,” here’s a great,
of that piece.
Special thanks to the extensive research for this post goes to Kathy McGrath, Nathan Boonstra, Jessica Atwell, Rene Najera, Amber Bickford Cox, Karen Ernst and Emily Willingham.
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