Roberta Heale, Associate Editor EBN @robertaheale @EBNursingBMJ

Here we go again. Influenza vaccines are now available at my clinic. The queues to receive it start on one side.   On the other side, the rest of the patients either avoid the discussion completely or vehemently oppose getting it. Now, don’t get me wrong. I welcome and encourage discussions with my patients about evidence in the decision to accept any treatment. My concern over the years is that many people who strongly oppose the influenza vaccine are not making their decision from evidence. Things I say over and over again during flu season:

“No, the flu shot doesn’t give you the flu. You might have a sore arm, mild achiness or mild fever afterward, which lasts a day or two and is very much less than the flu itself”….”The flu makes you very, very sick. You may have to be hospitalized. Some people die from the flu. Having the flu shot can protect you and those you love from getting the flu”…”No, it doesn’t protect 100%. It’s made from the best estimate about what the flu strain will be this year. It might not give you 100% protection, but can help to lessen the flu if you do get it.”…. “Yes, it’s safe for children, pregnant women, and a really good idea for both those groups of people along with high risk people like those with chronic conditions”…”there are some serious side effects, but they are very rare and we are equipped at the clinic to deal with them”….” https://www.cdc.gov/flu/about/qa/misconceptions.htm

Here are just a few of the commentaries included in EBN and BMJ over the years specific to influenza and the immunization.

Review: vaccines prevent influenza and influenza-like illness in healthy children <16 years of age http://ebn.bmj.com/content/9/4/107

Increased city-level influenza mortality and state-level influenza severity is associated with greater functional decline among nursing home residents http://ebn.bmj.com/content/16/4/122

Review: vaccination reduces the incidence of serologically confirmed influenza in healthy adults http://ebn.bmj.com/content/8/2/47

Inactivated influenza vaccine in first trimester does not appear to increase risk of birth defects.http://ebn.bmj.com/content/20/4/107

Inactivated influenza vaccine is safe for children and adults with stable asthma http://ebn.bmj.com/content/5/3/77

School closures and influenza:  systematic review of epidemiological studies. http://bmjopen.bmj.com/content/3/2/e002149

I’m always concerned for patients who don’t get the flu shot and this year is particularly concerning. Every year the flu virus mutates and the severity of the flu each year fluctuates. This year looks like it’s going to be a bad one, based on the data arising from Australia and Southern Asia, where the virus activity begins. In fact, countries in the Northern hemisphere are bracing for what might be the worst flu season ever.

https://globalnews.ca/news/3782452/heres-why-canada-may-be-in-for-a-miserable-2017-18-flu-season/

http://www.telegraph.co.uk/news/2017/09/12/nhs-fears-worst-flu-season-history/

There will always be people who decline the jab and I respect the decision of these people. However, the reality in healthcare is that as we brace for the onslaught of people wanting the flu shot we also prepare to care for the people who get the flu. Fingers crossed that this season won’t be as bad as predicted.