The People’s Pharmacy: Do flu shots make influenza less severe?

Q. In most of the news coverage of flu outbreaks, I’ve seen a recommendation to get a flu shot even if it’s not a good match. The announcer always says that even if it doesn’t prevent illness, the vaccine will make your flu symptoms less severe. Is that true? Is there any good-quality research to support this assertion?

A. Public health officials encourage people to get a flu shot, even at this late date. They maintain that it will protect against influenza. Even if it doesn’t prevent infection, they claim it will lessen the severity of the illness.

Any discussion of the effectiveness of this year’s flu vaccine is based on speculation. Actual data won’t be available for months, although in Australia, the shot was only 10 percent effective against the influenza A H3N2 strain (New England Journal of Medicine, Nov. 29, 2017). Preliminary results from Canada, which uses the same vaccine as the U.S., also suggest 10 percent effectiveness against H3N2 among adults (Eurosurveillance, February 2018).

No one knows whether this year’s flu shot will lessen symptom severity. French scientists note, “Surprisingly, very few studies have addressed the question of whether the vaccine mitigates influenza severity among those who develop the illness despite being vaccinated.” In their study of more than 2,000 elderly French people, they found very little symptom reduction (Vaccine, April 11, 2017).

Q. I have taken zolpidem (Ambien) for years. You have written about the dangers of such sleep aids, so I decided to cut back. I spent several weeks hardly sleeping at all.

Melatonin has been helpful, though not perfect. Does it have side effects I should know about?

A. Melatonin is a hormone that the brain makes as it is getting ready to gear down for the night. That is why this compound has a reputation as helpful for sleep.

Melatonin has been used to help people like you reduce their reliance on benzodiazepine or Z-type sleeping pills such as zolpidem (European Journal of Pharmacology, Sept. 5, 2015). A randomized, double-blind, placebo-controlled trial showed that melatonin could improve sleep quality in people who have suffered traumatic brain injury (BMC Medicine, Jan. 19, 2018). It also has been used to help cancer patients sleep (Aging Clinical and Experimental Research, October 2013). A Cochrane Collaboration review suggests that night-shift workers may sleep longer after taking melatonin (Cochrane Database of Systematic Reviews, Aug. 12, 2014). Melatonin does not appear to trigger serious side effects, although some people report nausea, dizziness or headaches. You can learn more about melatonin and other approaches to overcoming insomnia in our online resource “Getting a Good Night’s Sleep.” It is available at www.PeoplesPharmacy.com.

Q. I wish you would write about the danger of lung complications from amiodarone. Lung toxicity occurs in significant numbers of users. This frequently leads to pulmonary fibrosis, which can be fatal.

Amiodarone even comes with a black box warning. I speak from first-hand experience, having lost my husband due to amiodarone lung toxicity three years ago.

A. The Food and Drug Administration cautions that amiodarone should be used only for life-threatening heart rhythm disturbances when other treatments don’t work. This medication has many serious side effects, including pulmonary fibrosis and other lung complications.

The drug also may cause nerve damage, digestive distress, visual problems, fatigue, liver damage, thyroid problems and serious skin reactions. No one should ever stop amiodarone without careful medical supervision.