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Flu shot - yay or nay?

So, our big girl was down with a bad, bad something this week.  Four days straight of fever; temperatures ranging from 102 to over 104.  We went into the doctor on Day 5, knowing that the benchmark was: fever for > 4 days is often bacterial and fever < 4 days is viral.  Since the fever broke on Day 5, we were in good shape.  I guess.  The four days of fever were still pretty rough on the entire family.

When we went in to the doctor, I asked "Should we get the flu shot?"  Her thought was: "If the children are over 2 years old and are generally healthy, then I am not a big supporter of the shot."  The flu shot is designed to help out folks for whom the flu would cause other health complications, like I trust our pediatrician, pretty much.  I weigh her opinion pretty heavily.

My mother is a pediatrician.  She is a big proponent of the flu shot and flu mist.  Her rationale: why not prevent a potentially bad and terribly uncomfortable situation?  She's got a point.  Do I want to endure another almost week long of fevers and such sad, droopy, spontaneously-tearing eyes?

I don't know.  I'm torn.  I'm not big on meds.  Then again, I don't really question most of the major vaccinations.  The flu shot is a different matter.  For my girls, the flu probably won't be a life-threatening condition.  It will, however, be pretty darn inconvenient.  Then, ever vaccine has it's side effects.  Among the flu shots side effects: local soreness, low-grade fever, insomnia, irritability, some rashes.

Our big girl just suffered a bad virus that was almost flu-grade.  Who knows?  Maybe it was the flu.  Even though I was already at the doctor's office, I opted not to get the flu shot for myself or the girls.  I just may regret it come later in the season ...

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I, too, am not big on meds but my daughter (2.5 years) had her flu shot as did my husband and I because I cannot stand the thought of her (and potentially all of us at one time!) getting the flu. I remember the last time I had it and I wanted to die (okay, maybe just get knocked out until it was over). A week of fever, vomiting, extreme weakness and my softest blanket feeling like sandpaper ripping across my skin. And that was when I was young and single and could go home to have my mom take care of me! Other viruses that I've had (chicken pox, etc) were easy compared to that nasty.

My daughter is a real trooper and doesn't whine and carry on when she is sick, but I hate the thought of her being so miserable. Luckily, she had no side effects other than a long nap that day.

Does this make me unpopular?

I was at the doc's office with my two boys. The doc recommended it for families with very young infants - for all family members except my 4 month old son. I was ready to get the vaccine for myself and my son, and then the ped metioned that the flu vaccine contains thimerosal. Huh, what's that? Well, it's trace amount of mercury said to not cause any health problems. Now, I'm rethinking whether or not to get the shot. For more info, go here: http://www.mayoclinic.com/health/influenza/AN00680

There is a thimerosal-free flu vaccine available that my daughter was given (usually saved for young children). I believe it has to be refrigerated. Kaiser has it at their Nurse Treatment centers and I'm betting other clinics have it, too.

Another good source of info is http://www.cdc.gov/nip/vacsafe/concerns/thimerosal/faqs-availfree.htm

Thank you so much for the information, Amy! And, we have Kaiser insurance as well so this is a good thing.

I'm not big on meds either and won't even take a Tylenol or aspirin, but as a new mom last year, I was freaked out about the thought of my son getting sick. All of my other friends' babies had already had ear infections, colds, flus, pink eye...so our son got the flu shot last year as soon as he could, at 6 months old. Now he's 18 months old, and he has only had 2 colds his entire life (this last one he caught during his first week of daycare). We're going in to get a flu shot next week, in fact. I hear this season's supposed to be even more miserable than the last, but don't they say that every year?

Interesting NYT article today 10/10/07 in support of the concept with a good discussion on the pros and cons of exposure to childhood illnesses and long-term effects. Every year I hem and haw about it (and usually wind up on the 'no' side, for better of worse)! http://www.nytimes.com/2007/10/10/opinion/10sachs.html?ex=1349755200&en=758f0a0b8bc8a2cc&ei=5124&partner=permalink&exprod=permalink

Olivia-
I have been pretty non committal about flu shots in the past. Last year my son (then 3) got the flu and Pneumonia. It came on very quickly. He ended up being hospitalized. I hadn't given it much thought in the past but the actual Flu ( vs. bad colds) is a pretty serious illness. I don't know that all flu cases can lead to hospitalization but I do think it increases the odds of Pneumonia. We both got flu shots this year on the advice of my Dr and my son's pediatrician. If we hadn't had this experience I probably wouldn't have done the flu shots. I guess my feeling now is that if it can add some protection and prevent such a serious illness then I am ok taking it and being ambivalent at the same time.

Lisa,
Thanks for the NYT link. I will be giving my 2 yr old the flu shot next week. The article raised a concern for me though; my son has had 8 or 9 colds of varying degree since he began daycare 1 yr ago, most mild. Does this mean he has a higher risk for cancer later in life as the article suggests? He also has eczema, clearly an immune deficiency issue. I hope this year he will not be afflicted as much because we have an infant now!

From what I've read about the flu shot (granted, this was awhile back), what's in it is the maker's best guess as to what the major strain of flu this winter is going to be. There are many different strains of flu out there and in order to get the vaccine manufactured early enough for flu season, they have to make that guestimate based on past years.

So yeah, you might get lucky and get a shot that protects against the most prevalent strain going around this winter. But then, you might get some other strain of flu. Or, you might get the flu from the shot itself (I've heard of this).

So I'm with Olivia's pediatrician. I'll consider a flu shot when I'm an old lady, but not before and certainly not for my kids.

Re that NYT article. I don't know whether it's natural for kids to get sick a lot or not, but I was inclined to be skeptical about the author. He mentioned MRSA (methicillin-resistant Staphylococcus aureus) as a huge, lurking "new and deadly" threat, but he neglected to mention that MRSA is overwhelmingly contracted by patients in hospitals. It's not something that people routinely catch out and about.

Not to be patronizing, but this is my career as an Infectious Diseases physician...

Just to clarify zinemama's comment that MRSA is overwhelmingly caught by patients in hospitals...that is not quite the case these days. That WAS the case several years back.

What is getting so much press right now is Community Acquired MRSA. Some of the first causes of disease were seen in young children in Minnesota. Now it is commonly causing outbreaks in jails, sports teams and schools (typically when persons are sharing sporting equipment or towels, etc).

And there is a link between MRSA and influenza. I am not sure of how much has been published on this topic at the moment..But, having been an ID physician in OR in past flu seasons (I have now moved away...), there were a few cases of influenza complicated by MRSA pneumonia reported in our weekly meeting of ID physicians. These cases were in 20-30 something old individuals, interestingly otherwise healthy. Nothing to my knowledge in the pediatric population.

Of note, it is true that the flu vaccine is made on a "best guess" of what this years current strain will likely be. It is not a "shot in the dark" though...the bird/fowl and pig populations in China (from whence the influenza virus comes) are monitored.

It is interesting to note, that if ever the dreaded H5N1 avian flu manages to acquire an ability to spread from human to human (which it has not yet done..it has only been spread from bird to human in SE Asia), the flu vaccines that are offered every year HAVE been shown to provide some protection.

Finally, reccomendations from the CDC are for vaccination in children between 6 months and 5 years.

As a member of the healthcare community and having had influenza (one of the worst illnesses I have ever had), I choose to get vaccinated myself. Working with sick individuals, I am the most likely person to spread it to my children (9 months and 2.5 years)...therefore I protect THEM by protecting MYSELF.

A quick link concerning the link between influenza and MRSA.

http://firstwatch.jwatch.org/cgi/content/short/2007/413/2?rss=1

And one last comment....I am sorry.

No matter what anyone says, you do NOT get influenza from the vaccine! It is an inactivated virus.

I stand corrected on MRSA! I ended up - sort of by accident - reading a very long piece about its role in hospital infection, but that was a couple of years ago.

(And I didn't think you sounded patronizing in the least.)

Do you have any information on why/how a disease that used to be primarily hospital-transmitted has made the jump to the larger community?

It actually does not appear that the MRSA jumped from the hospital to the community.

The CA-MRSA (community acquired) has a different genetic make up than the HA-MRSA (hospital acquired), with a different antibiotic suspectibility pattern, and actually a different spectrum of clinical disease. One can actually tell which you have based upon these two things.

Reason for the emergence of CA-MRSA? Probably the same old story...overuse of antibiotics. Bug has simply just gotten wise...it has evolved to be resistant to the mostly commonly used antibiotics for staph infections.

Good news is that it retains susceptibility to a couple of oral agents still...but they will no doubt fail also with time.

These days we are always in a race so to say to control infections with drugs we have while we develop new ones as the organisms evolve against our defenses. That is why overuse of antibiotics should be avoided.

Believe it or not, best recommendation I can give anyone to keep themselves protected against most any infection circulating arond...WASH YOUR HANDS. And that antibacterial stuff is NOT needed...good old soap and water. Prevent having to use antibiotics in the first place.

I'm not sure if this link will work, but here is a timely story. I think I read this in The Oregonian early this week, but here it is in the New York Times.

http://www.nytimes.com/2007/10/19/us/19staph.html?em&ex=1192939200&en=ec7d4526efc04472&ei=5087%0A

does anyone know a place (other than kaiser) that is offering the thimerosal-free version of the vaccine?

my ob/gyn didn't receive the thimerosal-free version.

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