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House Call: Prep your immune system – flu season is coming

UPDATED: Wed., Sept. 8, 2021

A pharmacist administers a flu shot in a drugstore in Paris, France, on Oct. 14. A flu vaccine is typically easy, safe and effective.  (Lewis Joly/Associated Press)
A pharmacist administers a flu shot in a drugstore in Paris, France, on Oct. 14. A flu vaccine is typically easy, safe and effective. (Lewis Joly/Associated Press)
By Dr. Jeff Markin For The Spokesman-Review

We’ve been focused on the novel coronavirus, the delta variant and new vaccines. As the weather turns, a more familiar threat is right around the corner: influenza season. It might not sound so bad, but the flu isn’t just the sniffles. It’s a serious illness that could not only take you down for a miserable week or two, but like coronavirus, it is highly contagious and can be deadly.

Influenza, coronavirus, colds and other viruses are a lot for your winter immune system to contend with, and vaccinations are your best shot (pun intended) at protecting yourself and those around you. A number of years ago as a medical student, I personally experienced influenza. I tested positive for influenza B and, quite honestly, I’ve never been sicker in my life.

For three solid days, I had high fevers, shaking chills and severe muscle and joint aches. I felt like I’d been beat with a baseball bat. After that experience, I could see why some people die from influenza, and from that point forward, I vowed to get my annual flu vaccine, which I have consistently done. I’ve not been sick with it ever since.

What will flu season look like this year?

We don’t know yet. Last winter, people were more socially distanced and wearing masks, and fewer people got the flu. The downside to that less severe flu season is that more people will likely be susceptible to the flu this year, and we could have a larger-than-average epidemic of flu and other respiratory viruses. As there continues to be a COVID-19 surge driven by the delta variant, influenza becomes an extra risk, as well.

The upside is we have a flu vaccine, and it’s easy, safe and effective. Virtually everyone older than 6 months can benefit from the flu vaccine. Flu vaccine, whether nasal or injection, is widely available now; you can get it at your health care provider or at pharmacies and flu clinics often free or low-cost.

If you do get your flu shot somewhere other than your usual health care provider, send a copy of your record to your provider. You can initiate your COVID-19 vaccine at the same time as your flu shot if you haven’t already. If it’s been eight months after your first COVID-19 immunization, you might be eligible get a booster after Sept. 20.

Deadlier than World War I

Influenza kills tens of thousands of people in the U.S. every year, or more accurately, deaths are caused by influenza or the complications that arise when the virus severely weakens your body and bacteria can take over, like Streptococcus pneumonia.

I also recommend a bacterial pneumonia vaccine for those ages 65 and older. Flu vaccination effectively prevents some of the widespread damage a flu epidemic can cause. It’s estimated that in the 2019-2020 flu season, vaccination prevented 7.5 million illnesses in the U.S. That was considered a moderate flu year. But every so often, an extra virulent or deadly strain of influenza emerges and doesn’t spare the young and healthy.

The 1918 flu pandemic is estimated to have killed at least 50 million people worldwide; nearly half of the dead were younger adults ages 20 to 40. World War I overlapped with the flu pandemic, and ultimately more U.S. soldiers died from the flu than in combat. We never know when one of those severe mutant strains will come along, so vaccination is still your best protection.

Effective, safe vaccines get a jump on flu mutations

Like the delta variant with COVID-19, the flu virus mutates every year. Every year, scientists adapt the vaccine to the mutation, which is why you may have heard that effectiveness can vary from year to year, and it’s another reason to get it every single year. Even if you don’t get 100% protection, you will have partial protection and are much more likely to fight off a serious strain if you have gotten vaccinated.

To be clear, the flu vaccine does not cause the flu. The vaccine uses an inactivated virus (a virus that has been killed) and are mostly “quadrivalent,” which means they give immunity to four different strains of influenza. This “flu shot” is used for kids older than 6 months and all adults. There is also a vaccine with a severely weakened virus that can’t cause the flu (also aimed at four strains of flu).

The nasal spray is available for kids older than 2. You might also hear about a “high dose” vaccine used primarily for adults older than 65 that includes additional protection for people in that age group, although the CDC is not recommending the FluZone High-Dose vaccine over the standard vaccine for people ages 65 and older.

The vaccines are designed to teach your immune system to recognize the real thing and react with a robust immune response. Some people have mild side effects after the vaccine as their immune system responds, which go away in a day or two.

I don’t usually get the flu, so why vaccinate?

Got kids? You need the flu vaccine. Kids are curious and likely to touch contaminated surfaces, so consequently they are a major reservoir for influenza. Children older than 5 don’t tend to get as sick, but grandparents and seniors do. That’s part of the reason we recommend kids get a flu shot.

Symptoms may not start for a couple of days, and you or your kids could pass it on before you know you have it. Other reasons might include wanting to not miss work from the flu, to prevent giving the flu to grandparents or elderly parents you like to visit and to help protect the community as a whole.

The flu vaccine also reduces hospitalizations for people with diabetes and chronic lung disease and has even been associated with lower rates of some cardiac events among people with heart disease, especially among those who had had a cardiac event in the past year.

How else can I boost my immune system?

You’ve heard it before: Get plenty of sleep, stay hydrated and manage your stress. Why? Stress and lack of quality sleep are major triggers for weakening the immune system. It can be difficult to eliminate stress, as it happens in real time in real life.

I like to tell patients that “life is 90% attitude and 10% circumstance” – even when you don’t have control over your external environment, you do have control over how you react to it.

If you have a stressful day or are coping with a stressor, find someone to talk with about it (and congratulate yourself for the bonus immune booster while you process it).

I get asked about supplements and multivitamins. While a daily multivitamin is reasonable, unless you have specific vitamin deficiency, a healthy diet, sleep, exercise and lowering stress are the best boosts for your immune system.

Due to the droplet nature of viruses, the masking we are doing for COVID-19, and handwashing, along with flu shots, are likely all going to help in preventing the flu. By continuing these precautions during flu season, it will mean less flu misery for all of us and less danger for seniors and kids this winter.

Dr. Jeff Markin is a family medicine physician practicing at Kaiser Permanente’s Veradale Medical Center.

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