Flu knew? More vaccine options this year than ever before

Dr. Charles Callahan [Photo: Denise Ritchie]

If you think ‘the flu’ is nothing more than an annoying cold, think again.

According to the Centers for Disease Control and Prevention, 80,000 people in the U.S. were killed by influenza viruses during the 2017-18 flu season.

Colds don’t do that.

Dr. Charles Callahan, an infectious disease specialist at the Cleveland Clinic Indian River Hospital, says bluntly of the danger flu poses, “I think the most important thing is to get vaccinated.”


Today, with near universal availability at easily accessible places including Walgreens, CVS, Target and Publix there is no excuse for not getting vaccinated – and it probably won’t cost you a dime, according to Callahan.

“I would say every single private insurance company that I’m aware of pays for the flu shot,” he says. Indeed, many flu shot locations even reward you with free gift cards.

And, this year, according to Callahan, there are more vaccine options than ever before.

For starters, after a three-year hiatus, the nasal spray vaccine is back and it may have some benefits flu shots don’t.

The nasal spray contains a “live” virus, Callahan explains. “It’s the only vaccine that’s live. The thought process being that it generates what’s called IgA immunity, which is a secretory antibody that’s mostly found in the upper airways and in the lungs and nasopharyngeal where the flu first infects. And that’s how it prevents the flu.”

“All of the other vaccines,” Callahan continues, “are IgG mediated, so they’re an actual blood antibody. And we know that [while] the flu shot helps prevent death and helps prevent hospitalization, it doesn’t do as good a job at preventing the actual flu infection.”

Callahan says the live vaccine can be used by “anyone except people who are immunocompromised, pregnant women, children under the age of 2 and people over the age of 49.”

That last age limit obviously excludes Vero’s many seniors.

Nevertheless, getting an annual flu vaccination – in the form of a shot or nasal spray – may benefit you in other ways besides reducing the risks posed by influenza.

“There have been some good studies,” says Callahan, “that suggest that getting the flu vaccine yearly prevents overall hospitalization for people who have chronic diabetes or chronic heart disease. We think the flu vaccine has an immune up-regulation effect, which basically wakes up your immune system and prompts it to do its job. And that halo effect kind of protects you against all other kinds of upper respiratory infections.”

And speaking of infections, Callahan points out that here in Florida the flu season is actually 12 months long, because “influenza B is a year-round disease.”

That’s an important consideration.

Generally, flu shots are either trivalent or quadrivalent, meaning they guard against either three or four different flu strains. Callahan recommends the quadrivalent option.

“All of them,” he says of the shots, “have H1N1, which is the old Spanish flu from the 1918 epidemic flu. And all of them have an H3N2 which is the current most common strain seen in the United States as well as the rest of the world. And then the quadrivalent vaccines have two influenza B types. The trivalent vaccines have one.

“I would recommend the quadrivalent because we have influenza A seasonally but … because we’re in a temperate and tropical climate, influenza B is pretty much year-round. We see spikes of influenza B in the summertime periodically. Last year we did see a pretty decent amount of influenza B. So, I would recommend the quadrivalent over the trivalent.”

Admittedly, no flu vaccine is ever 100 percent effective, but as Drugs.com points out, getting vaccinated “drastically reduces your chances of getting the flu and passing it on to others, and it dramatically lessens the severity of flu symptoms if you should be infected with the virus.”

Finally, if you happen to be one of the less-than-1-percent of the population with an egg allergy, you likely still have nothing to worry about despite the fact that most flu vaccines are grown or “cultured” in eggs.

As the Mayo Clinic says, “if you have had an allergic reaction to eggs in the past, talk to your doctor before getting a flu vaccination. Your doctor may choose to give you the vaccine made without eggs or send you to a physician who specializes in allergies,” but adds, “you’ll still probably be able to get the flu vaccine.”

Dr. Charles Callahan is an infectious disease specialist with the Cleveland Clinic Indian River Hospital with offices in the Patient Pavilion just east of the hospital’s emergency department. The phone number is 772-567-4311.

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