Flu Season Starting Late but Expected to Increase for the Holidays

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Flu season is ramping up, and it’s important for everyone, especially health care professionals, to not only get the flu vaccine but also educate patients about what to expect.

The current flu season has started later and more gradually than last year, according to William Schaffner, MD, professor of Preventive Medicine at Vanderbilt University Medical Center (VUMC), although cases are expected to begin increasing in November before falling off in March.

“It is very difficult to predict how this flu season will be,” Schaffner said. “But there’s one thing for certain – there will be a flu season.”

During this gentle ramp-up, there is some additional cause for optimism: With the earliest cases already beginning, physicians have determined that the flu vaccine seems to be a good match for current viral strains.

“Vaccination remains a safe and reliable therapy at combating the spread and severity of illness caused by influenza,” said Jeffrey Barton, a Medical Intensive Care Unit (MICU) physician assistant at VUMC.

However, the rates of flu vaccination among the general public are declining, which may lead to a more severe spread. Some patients require further education to debunk myths and understand the importance of getting vaccinated. The most common concerns among patients are safety and whether the vaccine is a good enough match to even be worth it, Schaffner said.

“The flu vaccine isn’t perfect,” he added, “but it prevents severe disease. Yes, it is safe. Your arm might be sore, and some people may feel tired, but that is just your body responding to the vaccine.”

Many patients may confuse this common immune response – evidence that the vaccine is working – for becoming ill as a result of the vaccine. Health care professionals would do well to clear up this misconception when speaking with hesitant patients.

Whether the flu vaccine is a good match or not, data suggest that it will still provide protection against severe complications such as pneumonia – a top 10 leading cause of death in the U.S.

The flu vaccine stimulates the immune system to produce antibodies that attach to the invading virus and prevent it from affecting major organs. So, even though it’s not a full suit of armor, the flu vaccine protects the most important internal parts of the body.

Mild flu infections may still occur and cause a cough or sore throat despite vaccination, but that is because the virus has attached to the cells on the body’s surface, like mucous membranes in the nose and throat. None of the symptoms are caused by the vaccine itself.

Health care professionals should frequently assess a patient’s need for education regarding the vaccine and find out why they are hesitant in a supportive and nonjudgmental way, Schaffner said.

“Psychologists have told us that providing information is important, but frequently not sufficient, to change behavior – patients need to feelcomfortable and be reassured if they are going to get the vaccine,” he said.  “It is important to make vaccination feel normal, routine and personal.”

Along with emphasizing the importance of prevention, health care professionals should teach patients about what symptoms to look out for and when to seek medical attention.

“Signs of worsening respiratory illness include fever, shortness of breath, tachypnea (rapid breathing), productive sputum and hypoxia (low oxygen levels),” Barton said.

The populations at higher risk should also watch out for confusion, worsening lethargy, poor appetite and weakness, he added. If hospitalized, patients will receive supportive care treating their symptoms and antiviral therapy, if necessary.

Even though more flu hospitalizations come from those who are unvaccinated, patients who are at age extremes, immunosuppressed, or have comorbidities like lung disease, diabetes and heart and kidney failure, are more likely to be hospitalized despite being vaccinated.

Pregnant women are also at higher risk but, according to the American College of Obstetricians and Gynecologists, getting the flu vaccine can prevent severe disease in both the mother and the baby.

“If you’re older than 6 months, you should get your vaccine every year,” Schaffner said. “Don’t think about it, just do it.”

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