Rx For Readers: Flu shot, or not?

Soroka University Medical Center doctors encourage most of us to roll up our sleeves.

By JUDY SIEGEL-ITZKOVICH
Flu ahead sign (photo credit: ING IMAGE/ASAP)
Flu ahead sign
(photo credit: ING IMAGE/ASAP)
My husband and I (in our early 30s) and our four children have never been vaccinated against influenza. My parents have always gone to their health fund clinic in September or October to get their flu shots, but we think it is unnecessary because flu endangers only the elderly. We always thought it is unnecessary for young, healthy adults and for children. And both of us don’t like getting shots. But our health fund, by phone and in writing, has been sending messages encouraging all of us to be vaccinated. Is it important to get a flu shot at any age? Are there complications from the shot?
T.N., Netivot
Dr. Ehud Davidson, director-general of Beersheba’s Soroka University Medical Center, who is an internal medicine specialist; Prof. Klaris Riesenberg, director of the hospital’s infectious diseases institute; and Prof. David Greenberg, head of pediatrics and the pediatric infectious disease unit, answer:
In recent weeks, our medical staffers have been lining up to get flu vaccine, and we were among the first to roll up our sleeves. Flu is a very common and very infectious virus that can cause serious complications and even death in many people. We encourage people of all ages over the age of six months to get the shot – and not only those who work or are under treatment in hospitals.
Every year, between 10% and 40% of the entire population contracts flu, whose virus initially attacks the respiratory system. One out of 10 adults and one out of three children contract complications of flu. Not only the elderly but also infants and young children and people with chronic illnesses are endangered by the virus, which is passed from one to the other via sneezing at a distance of less than a meter or by touching surfaces that have been exposed to the virus.
Symptoms of flu include high and sudden fever, headaches, muscle aches, weakness, sore throat, cough, shortness of breath and a runny nose. Complications include a worsening of chronic illness, viral or bacterial pneumonia, pericarditis (inflammation of the pericardium, which is the fibrous sac surrounding the heart) inflammation of the heart muscle and various neurological syndromes.
If one is infected, it can take up to a week to develop symptoms, which continue for five to 10 days. It usually passes of itself, but it can cause complications and you can infect other people who have weak immune systems, such as infants, the elderly or people of any age with chronic illnesses. Why be responsible for that? The most effective way to prevent morbidity and mortality from flu is getting the vaccination. It is made from a killed virus, and the shot could have short-term side effects such as minimal pain in the arm. But the vaccine does not – contrary to popular opinion – cause flu. Even if you had flu last year, the antibodies you developed do not protect you from the combination of strains this year. As the flu virus mutates and every year there is a different combination of strains, the shot must be taken every year.
A study carried out by Clalit Health Services found that people who have previously contracted flu are 10 times more likely to get it again than the average person. The reason is that if you had it before, you are in a “social network” that tends to pass the virus on.
In the fall and winter, our pediatrics wards are filled with children up to the age of five years who suffer from complications of the virus.
It is vital for pregnant women to be vaccinated as well because they are more susceptible to complications. In addition, the fetus, who cannot get the shot until it is six months old, receives antibodies in the womb.
My American daughter is spending the year in Israel and wants to get the flu shot. I am a senior professor of pediatrics, so I deeply care about protecting her from flu. Her school has contracted with an insurance company, and I am working with them but was trying to better understand access to the flu vaccine for pupils who are not Israeli citizens.
In the states anyone can walk into their local pharmacy and pay for the vaccine.
What is the arrangement in Israel? Does the Health Ministry provide access to the vaccine for a fee? Could she walk into any local health-fund pharmacy and pay for the shot on arrival?
D.B., Washington, DC
Howard Rice, a veteran consultant pharmacist and pharmaceutical consultant, replies: The influenza vaccine is available at any Israeli pharmacy, if it is given a prescription and still has stock. It would be prudent to call the pharmacy first. I include any pharmacy of the four health funds as well as pharmacy chains and private pharmacies, but not hospital pharmacies.
At present, vaccinating with the flu shot is restricted to physicians and nurses, although the Health Ministry plans to allow qualified pharmacists to do this starting from next year.
This would be a private sale of vaccine.
If she were Israeli and automatically a member of one of the health funds, it would be free, but for nonresidents the price is prohibitive.
Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting.
Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 9100002, fax your question to Judy Siegel-Itzkovich at (02) 538- 9527, or email it to jsiegel@jpost.com, giving your initials, age and place of residence.