Tag Flu

An old fashion shoot ‘em up

Michael 11 Comments

I have to be honest at with you. This post was to be a critique of the debate. There was just so much ammunition. Enough to fill a year’s worth of blog posts. From hidden communication devices (Trumpican: She was wearing magic earrings to help her. Normal Person: How did her earrings make him say stupid shit?) to dinner menu choices (Trumpican: They are eating dogs and cats. All high and mighty one says so. Normal Person: He would know. He is a dirty dog who never skip a chance to grab some pus…..) …umm, but all that’s been done and it’s way too easy anyway.

So instead, I’m doing a normal person version of a public service announcement just in time for a real potential disaster. Cold and flu season and a return of covid.

It’s been a long time since I’ve encouraged people to get their flu shots. It’s pretty much not been necessary. Since 2016, flu vaccine rates have increased with some stagnation in 2020 and 2021 when a good chunk of the population was getting its medical information and recommendations from politicians and future billionaire social media platform owners. Even with those idiots attempting to sabotage the then new covid vaccine, flu vaccination rates remained stable.

Unfortunately, the actual flu vaccination rate has never reached the Office of Disease Prevention (of the Department of Health and Human Services) goal of 70% of the population. Most years, the actual percent of population receiving the seasonal flu vaccine is in the 50-56% range. Not good enough!

The flu vaccine repeatedly prevents 67% of potential hospitalizations. Extrapolating for the number of people who go unvaccinated, 44% of those hospitalized for flu do so unnecessarily. According to CDC data, over 18,000 patients were admitted to hospitals during the 2023-2024 flu season. This was the highest rate since 2010-2011. It may not seem like a lot of people, but these are those admitted admitted for flu, not those admitted for other conditions like pneumonia exacerbated by the flu virus.

Why are people still reluctant to get a flu shot? Not understanding the severity of the disease has always been a factor in noncompliance with available, effective vaccines. The emergence of antiviral medications to treat flu symptoms also gives people false confidence in being able to treat the flu if they get it. These are effective but only in a very specific window of virus activity, within 48 hours of infection which may leave only hours after symptoms appear.

If you’re older than 6 years old, there is a flu vaccine for you. Go get one.

Flu shots aside, there are other vaccines this season to seriously consider. The first is covid. Yes, since the pandemic has cooled, little has been heard of covid and only those most susceptible have routinely availed themselves to the annually updated vaccine. Although a large percentage of the population has some immunity to covid, that immunity is likely effective against earlier variants, no later than the delta variants. New strains of the omicron variant have been noticed with increasing frequency in at-risk patients, the young, the old, the immunocompromised. If you don’t know if you are in one if those groups, you probably are.

How bad is the new covid strain. Over 10 million Americans over 65 were treated in hospitable emergency rooms in June. That’s twice as many as last June. Over 60% of those presenting to an ER with covid symptoms are hospitalized and of those 10% die within 24 hours. But those who survive experience few immediate complications. The current most significant risk is developing long-covid and experiencing long-term respiratory problems, GI symptoms, and mental and cognition disturbances.

Regardless of how convincing the charts posted to social media seem to be in differentiating between flu and covid, in life, the differences are not so obvious. The best predictor of infection, and which infection, are home tests. If you are achy, tired, and running a fever, take a test. If you can’t tell if you have a fever, don’t go by the “if it’s not over 100°, it’s not a fever.” If you feel good right now, take your temperature. Do that a couple times a day for a couple days. That is your average normal temperature. If you take your temperature and it is 2° higher than your average normal temperature, you have a fever.

Now there is one more risk for my at-risk friends. RSV (Respiratory Syncytial Virus). RSV has been with us a long time. When I was a young pharmacy resident (yeah, that was a long time ago), we started seeing RSV in pediatric ICUs. Now it is responsible for the hospitalization of 240,000 Americans of all ages. Many  of those are still under 5 years old but now the highest demographic are those over 60. The CDC calls those most at risk are children under 6, adults over 75, adults with immunologic conditions or pulmonary disease over 65, and those routinely in contact with at-risk populations. Finally, a vaccine is out there. Let’s use it.

Those closes this year’s public service announcement. I now return you to your regularly scheduled routine.

flu

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It’s time to shoot up again

Michael 4 Comments

There’s so much happening in the world, in the country in the state and I can’t do anything about it. Really, I’ve tried and the world/country/state hasn’t budged. But I can do something about me, for me, and help the world/country/etc/etc/etc at the same time. I can see it in your eyes! You know where I’m going!! Yes, you are 100% right. I’m going to get a flu shot. Much more fun than getting the flu. Trust me, I’ve had both. I was going to write a whole new post about flu shots but I’ve already done did that a dozen times or so, so I reached back to 2016 and pulled this one out. It’s still good stuff. Then after you read it, go get your flu shot. It’s about that time again!

Just Shoot Me

(From October 24, 2016, slightly edited to remove unnecessarily big words)

I’ve been shot. I suppose it was about 10 days ago now. I got my flu shot. I can probably count on one hand the number of years I didn’t get a flu shot all the way back to when I can remember doctors keeping lollipops on their desks for the good boys and girls who got their flu shots.

For years I worked in a hospital and getting a flu shot was just something you did every year. It went along with doing annual evaluations, decorating for Halloween, and renewing your parking permit. Everyone grumbled about it but everyone did it.flu

Now that I’m not working I have to remind myself to get a flu shot. And while I was busy reminding myself I thought I’d remind you. Get your flu shot.  If you are a southern hemisphere resident hold that thought for 6 months.

I never understood people who would come up with a dozen different reasons not to get a flu shot when it’s so effective at preventing the flu and when getting the flu can be so devastating. No, you won’t get the flu from the flu shot. You can’t get the flu from a flu shot any more than a zombie will eat your brains. The virus in the flu shot is dead – even more dead than an undead zombie. It can’t come back to life and infect you. What can happen is that you can get a cold or a fall allergy or a seasonal bacterial sinus or respiratory infection at the same time you get the flu shot but it’s not the flu.

You can get the flu in the same year that you get the flu shot if you don’t get it at the right time. Now is the right time. The flu shot doesn’t start working the instant the needle pierces your skin. It takes about two weeks for the vaccine to work its magic on your immune system so it is at its peak in protecting you against a live flu infection. You should schedule your shot about a month before the anticipated beginning of the flu season. If you wait too long to get a flu shot and you are exposed to the flu virus before your body can adequately prepare enough antibodies to repel an assault you can get the flu. The high dose version of the flu shot may provide effective resistance a bit sooner but should not be used as an option to timely inoculation.

You can also get the flu late in the season even if you got a flu shot if the circulating viruses mutate more quickly than expected and if your immune system is weakened by age or compromised by other diseases or conditions. For individuals with compromised immune systems the flu vaccine should be active for about six months. If you have weakened immune system and the active flu season in your area is expected to last past March or April you might consider asking your physician if you should repeat the flu shot six months after your initial vaccination.

Sorry if this post sounded too much like a public service announcement. It’s probably just a result of those years I spent in public service

The Most Wonderful Time of the Year

Michael 4 Comments
It’s that time again. Actually tomorrow is that time again. Technically tomorrow morning, around 9:30 give or take is that time again. Specifically tomorrow morning around 9:30 if you live in the northern hemisphere is that time again. It’s fall! Autumn. The end of summer. The autumnal equinox. All that stuff. And flu shot time!!!
 
Yes it’s time for me to harass the unsuspecting, cajole the semi-suspecting, preach to the choir, and harangue whoever is left. Whomever? Whatever, just go get your flu shot.
 
The only legitimate reason to not getting a flu shot is because you don’t want to get a flu shot. And that isn’t. But really, if you don’t want want to get a flu shot just say you don’t want one, you don’t care that you may potentially infect billions of others, that you might contribute to trillions of dollars of economic losses or that you may be single handedly responsible for a facial tissue/acetaminophen shortage. But don’t say you will get sick, it doesn’t work, it’s too expensive, your doctor advises against it, or you are allergic to it.
 
Cue the harangue! 
 
Excuse 1. You won’t get sick from the shot. You might get sick at the same time you get the shot and if that happens you would have gotten sick had you not gotten the shot anyway. The other thing that might happen is you’ll have a slight reaction to it. Your arm will be sore because they are sticking a small neeedle in it. Yes, that will hurt. Get over it! You might feel chills a few hours after. That’s because you’re body is getting ready to make the antibodies. That will go away in an hour or two if you get it at all. You might be tired for 2 or 3 days. Again, that’s normal. Your body is working hard bulking up for the onslaught of flu viruses and that takes work. Don’t be a wimp! You won’t be any more tired than after a hard day at the gym or a hard night at the bar back in the day.
 
Number 2. It does work. With a few caveats. It is not a miracle cure. No vaccine is. (Keep that in mind when a COVID vaccine eventually reaches the public.) The flu virus changes and the folks making the vaccine have to think like a virus and decide what form it will take this year. (Keep that in mind at COVID vaccine time also.) Sometimes they hit the nail on the head and all ends up right in the world. Sometimes they are close and you might not completely escape the little buggers but what you get is much less severe than had you not gotten the shot and don’t ever forget the worst that could happen is death. Slow, fevered, shaking, quaking death.
 
fluNon-reason the Third. Even if you don’t have insurance you can get a free flu shot. Many hospital systems and county and state health departments have free flu shot days because it’s cheaper to give away a vaccine that to treat the disease. Some retail pharmacies give free flu shots and some give you a shopping coupon equal to your cost. If you have insurance you are covered. All insurance plans must cover vaccines. You might have to go to a doctor or clinic of your carrier’s choice and/or you may have a co-pay but you are covered.
 
Harangue Paragraph Four. If for some reason your doctor advises against a flu shot and you are certain he or she is a real doctor and didn’t just print a diploma down at Kinko’s, get a new doctor. You aren’t long for this world trusting your health to that person and not getting a flu shot is not increasing your odds.
 
Excuse the Fifth. There once was a time when egg allergies posed a serious limitation to the universal recommendation for flu shots. Likewise with gelatin and latex. Today’s flu shots are safe for almost all allergic patients. There are very very very very very very very very few exceptions. You may be one. You may also have won the Powerball. That does happen. If you are, you know you are and probably came close to death at some time and don’t want to do that again. 
 
Epilogue: Nothing is perfect. There are two groups of people who should not get the flu shot in addition to the analogous lucky lottery winner. Group 1 – If you are not yet six years old don’t get the flu shot. If you are not yet six years old and you are reading this immediately ask somebody to play the Powerball numbers you are thinking of right now! The second group of people who should not get the flu shot are a subgroup of those with Guillian-Barre Syndrome. If you have a history of Guillain-Barre Syndrome talk to your doctor specifically about the flu shot. (Doctors advising against the flu shot under these circumstances are exempt from Harangue Paragraph Four.)
 
A special word about immunosuppressed individuals (like me) and pregnant women (not like me). We know some vaccines for us can be as dangerous as getting the disease. These are the live virus vaccines. Some vaccines actually contain weakened strains of the virus and these can overrun the weakened immune system in these individuals. An example of this is the early form of the shingles vaccine. But the flu shot is not a live virus. All FDA approved injectable flu vaccines are inactivated vaccines with no live virus. However, the nasal form of the flu vaccine contains weakened strains of live virus and these should not be used by immunocompromised individuals or pregnant women whose immune systems are already working double time. But there is no reason for an immunosuppressed or immunocompromised person not to get an injectable form of the vaccine. The shot’s mild side effects may be exaggerated or prolonged but it is still very safe. I had my vaccine Friday and Friday night I had some chills and in Saturday I didn’t feel like doing much but by Sunday afternoon I was my old self. One of these days I’m going to feel like my young self and when that happens, look out world! Oh. Sorry. I digress.
 
A special word for everyone. If you are already sick don’t get your flu shot now. Wait until your cold or infection passes then get the flu shot. 
 
Now that all of that nonsense is out of the way, back to the business at hand. Do you remember when Fall would start on September 21? Fall was September 21, winter on December 21, Spring started March 21, and Summer came on June 21. Maybe the 22nd. None of this “Autumn begins at 9:31:27am September 22 when the sun is somewhere over the edge of the flat side of the world not visible by those perched on the pole pointing away from Venus while drinking a pumpkin latte on a horse drawn hay wagon.” Those were the good old days.
 
 

Stupid is as stupid does

Michael 4 Comments
It’s official, or as official as it can be on my say so. We can stop worrying about global warming, international terrorism, party politics, and the Game of Thrones unsatisfying ending (just bby what I hear, I never watched the show). We can forget about all of them because I am no so sure we will make it through February. Stupidity has finally caught up with us and we are surely going to perish.
 
Check out these symptoms.
 
The coronavirus is a horrible, unexpected, seemingly uncontrollable health disaster. According to this morning’s news over 8,000 cases have been confirmed by the World Health Organization resulting in 361 deaths and that will probably be higher by the time you read this. The interwebs are buzzing, as they should be. We should be trying to do what we can to understand how to prevent its spread. But you aren’t going to find it looking for Corona Beer Virus. That’s what people are searching for on Google trying to find out more about it. Maybe it was last week’s Superbowl hype that had everybody thinking beer instead of flu like pandemics.
 
Speaking of flu, according to the CDC, as of January 31 there had been 300,000 hospitalizations due to the “common” flu this season and over 10,000 deaths (that’s ten thousand) (one comma and lots of zeros), 80% of whom reported not having received this year’s flu shot. I would call that a horrible, unexpected, clearly controllable health disaster.
 
There was a report over the weekend that if former Vice President Joe Biden wins this year’s election the Republicans will begin impeachment immediately upon his inauguration for something or other. I found it telling that the news reports last month were that the Democrats voted to impeach Donald Trump. As I recall my civics class, admittedly many, many years ago, it is the House of Representatives who impeach. It’s a shame we have replaced a rather well thought out form of government with a couple herds of sheep.
 
Americans don’t have the market cornered on odd political stances – or odd politicians for that matter. British Prime Minister Boris Johnson was quoted in a Reuters report last month that he wants to lose weight but won’t join the 300,000+ who are expected to sign up for Veganuary 2020. (Yes, it’s a real thing and had been since 2014.) (Sigh) According to Johnson, “I thought about it but it requires so much concentration.” 
 
Speaking to The Financial Times, Mastercard’s CEO expressed his dismay at countries adopting or considering nationalizing payment systems saying consumers worried about their privacy may shift back to cash for purchases. Oh my, what would the world be if we were all reduced to being able to buy only what we can afford. Soon people would be forced to work for what they want. In case you are wondering, Mastercard reported $17 billion dollars in revenue for 2019. For comparison Americans spent $1.6 billion to treat the flu during the 2018-2019 flu season. Sorry, no word on if that was cash or charge.
 
Last month the Japanese billionaire selected to be the first civilian passenger to the moon aboard a SpaceX rocket halted his search for “a girlfriend to take on a voyage around the moon.” About 28,000 women applied. And I still have trouble getting a woman to go to the movies with me.
 
Finally back in the coronavirus world, a man was escorted off a Dallas to Houston American Airlines flight last Thursday when he refused to remove a full-face gas mask. According to a passenger, “My gut reaction was that he was probably worried about the coronavirus and had put on the gas mask as overkill kind of protection. But then I noticed it didn’t have the filter, so that didn’t really make sense. What we heard from the lady sitting next to him was he said he wanted to make a statement. I don’t know what the statement was. I’m not sure what his goals were. To me, it seemed inconsiderate.” That might be considered understatement! 
 
There you have it, living proof we’re never going to life long enough to see melting glaciers turn the midwest back into swamp land, California fall into the ocean, or cars flying themselves powered by dilithium crystals. Stupidity is the pandemic that is going to get us. 
 
(The real proof is that the best part of the Superbowl for me was the commercial starring Punxsutawney Phil and that Bill Murray guy. See, even I’m not immune to stupidity, but come on, that was good!)
 
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It’s All Falling In Place Now

Michael Leave a comment

Listen up…today is the first day of fall, the onset of autumn, the equinox (at 3:52am at my longitude). It’s also the best day to get your flu shot. Yes this post is going to be more PSA than post but if you can’t trust me, who can you trust.

It’s time you get a little background so you have at least a little faith in me when I say GET YOUR FLU SHOT! And I’ve been doing this blog for almost 8 years so I guess you deserve some background information. (Really, eight years. Can you believe that? My first post was on Nov. 7 2011.) (woah). November also marks my 40th year as a licensed pharmacist (Nov. 12 1979). (double woah) Of those 40 years I spent 32 of them working in hospitals and four of them I taught undergraduates at college of pharmacy and administered continuing education courses for registered pharmacists.Then last 4 I’ve been living the Life of Riley and let me tell you, Riley really doesn’t live a high life.

But I still have my license and keep up with my annual education requirements so I think I can still speak about drugs pretty well. And when that drug is the flu vaccine I can tell right now who should NOT legitimately get the annual flu shot. Nobody! Okay, as the people who give away free stuff, like your cell phone carrier, there are some exclusions. Maybe 10 of them. Not 10 exclusions, ten people. Not 10 groups of people, ten people. That’s how many people 2 years ago (the last year with complete data available) had anaphylatic reactions to some component of the flu vaccine in the United States. Ten. Out of almost 8 million vaccines administered.

To put that in perspective, out of 56 people who got the flu that year 10 were hospitalized. And almost eighty thousand people died. That’s 10,000 more people than were at the Super Bowl last January.

Considering those numbers, why would you not want to get a flu shot. Hmmm?

flu

“I never get the flu.” Lucky you but by getting the flu shot you help minimize the flu’s effect on the very young, the very old, and immunocompromised which depends on the “herd effect,” that is the more of the mass that is resistant to a pathogen the less severe its effect to the individual.

“I get the flu from the flu shot.” No you don’t. The flu vaccine is a dead vaccine and it cannot give you the flu. You may experience some discomfort at the injection site, it is a needle being stuck in you arm after all, and you may experience some tiredness while your immune system is doing its thing (which might go on for up to 48 hours), or you could be getting the flu because you waited too long to get the flu shot!

“I’m immunosuppressed or take immunosuppressive drugs.” So am I and so do I and I have and for almost 20 years. I’ve had a fkubsjotbgirveacj one of those years and I’m still here, other issues notwithstanding. The prohibition to vaccines for immunosuppressed individuals is restricted to live virus vaccines (MMR, Oral Polio (not used in the US any longer, the injectable vaccine is not a live virus), Chicken Pox (but not the new shingles vaccine). As we already noted, the flu vaccine is a dead, inactivated virus.

“I’m allergic to eggs.” Sorry, this excuse want out of business before I gave my first shot. Today’s flu vaccines are not grown in egg media. The initial antigen is still grown in eggs so there is the slightest chance that an egg allergic patient can experience a reaction. If that reaction is just hives or rash get the shot, if it’s shortness if breath have it done at a doctor’s office or hospital rather than at a campaign like at work unless you work at a doctor’s office or hospital. If you’re still concerned there is a product that is completely egg free. That is Flublok (r) by Sanofi Pasteur. While we’re talking about it, no vaccines contain aluminum, or mercury and most do not contain thimerosal. No single dose vaccines contain thimerosal or latex and some multi brands are stoppered with non-latex materials. Again, if you’re concerned about any allergies, ask. There is a flu vaccine right for you.

“I got the shot but still got the flu.” Unfortunately this can happen but if you should get the flu even though you had a flu shot for the season you are probably going to experience a less severe reaction. Why does this happen anyway? The flu virus is a cunning little critter and it can mutate during the season. Or you might have had the timing wrong when you got your shot, either too early or too late.

That brings us to timing and why the first day of fall is the best time for you to get that flu shot. Immunity from the shot does not happen as soon as the needle plunger squirts the solution into your arm muscle. It’s just there to get your own immune system ready to fight off the flu and that takes time, about 4 weeks to get to an effective level. Once your immunity is established it will stay at effective levels for up to 24 weeks. That takes us from October through April, bookending the usual flu season.

So, trust me. Get a flu shot today.

We now return you to your regular blog posts.

Just Shoot Me

Michael Leave a comment

I’ve been shot. I suppose it was about 10 days ago now. I got my flu shot. I can probably count on one hand the number of years I didn’t get a flu shot all the way back to when I can remember doctors keeping lollipops on their desks for the good boys and girls who got their flu shots.

For years I worked in a hospital and getting a flu shot was just something you did every year. It went along with doing annual evaluations, decorating for Halloween, complaining about getting a lousy turkey for a Christmas bonus, and renewing your parking permit. Everyone grumbled about it but everyone did it.flu

Now that I’m not working I have to remind myself to get a flu shot. And while I was busy reminding myself I thought I’d remind you. Get your flu shot.  If you are a southern hemisphere resident hold that thought for 6 months.

I never understood people who would come up with a dozen different reasons not to get a flu shot when it’s so effective at preventing the flu and when getting the flu can be so devastating. No, you won’t get the flu from the flu shot. You can’t get the flu from a flu shot any more than a zombie will eat your brains. The virus in the flu shot is dead – even more dead than an undead zombie. It can’t come back to life and infect you. What can happen is that you can get a cold or a fall allergy or a seasonal bacterial sinus or respiratory infection coincidentally to when you get the flu shot but it’s not the flu.

You can get the flu in the same year that you get the flu shot if you don’t get it at the right time. Now is the right time. The flu shot doesn’t start working the instant the needle pierces your skin. It takes about two weeks for the vaccine to work its magic on your immune system so it is at its peak in protecting you against a live flu infection. You should schedule your shot about a month before the anticipated beginning of the flu season. If you wait too long to get a flu shot and you are exposed to the flu virus before your body can adequately prepare enough antibodies to repel an assault you can get the flu. The high dose version of the flu shot may provide effective resistance a bit sooner but should not be used as an option to timely inoculation.

You can also get the flu late in the season even if you got a flu shot if the circulating viruses mutate more quickly than expected and if your immune system is weakened by age or compromised by other diseases or conditions. For individuals with compromised immune systems the flu vaccine should be active for about six months. If you have weakened immune system and the active flu season in your area is expected to last past March or April you might consider asking your physician if you should repeat the flu shot six months after your initial vaccination.

Sorry if this post sounded too much like a public service announcement. It’s probably just a result of those years I spent in public service.

That’s what I think. Really. How ‘bout you?