What You Didn’t Know About the Flu
November 7, 2018

The Flu: Potentially Fatal

Latasha Haynes was 34 when she almost died of the flu last year. What started as a little coughing and fatigue ended with two blood transfusions and a diagnosis of congestive heart failure weeks later. Flu had caused damage to her heart muscles and the saclike tissue around it. She survived, but just barely, and it took her months to recover.

Haynes, who has a photography business in Tacoma, Wash., and came down with the flu in January 2017, was one of the estimated 30.9 million people who got the flu during the 2016-2017 season. She was one of the 14.5 million who saw a doctor because of the virus, and among the estimated 600,000 people hospitalized because of the flu — 50,000 of whom, like Haynes, were adults under 50.

The last flu season was even deadlier than the 2016 to 2017 season. In a recent report, the Centers for Disease Control and Prevention said flu killed about 80,000 Americans in the 2017-2018 season, the most in decades. In other recent years death estimates have ranged from 12,000 to 56,000, according to the CDC. That compares with about 40,000 annual deaths from motor vehicle crashes .

Yet while 9 in 10 people in the United States use seat belts, fewer than half get the flu vaccine — the most important way for everyone older than 6 months to protect against serious cases of the ailment, according to the CDC.

One of the biggest reasons people give for not getting the flu vaccine is that they don’t think it’s necessary. A Rand Corp. study of unvaccinated adults reported that roughly 1 in 4 of those surveyed said they didn’t get the flu shot because they didn’t think they needed it.

That was the case for Haynes. Before getting sick, she had never received a flu vaccine.

Flu strains are pulled from a freezer at the National Institutes of Health in Bethesda, Md. Less than half of Americans get the flu vaccine — the most important way to protect against the virus. (Carolyn Kaster/AP)
“It just wasn’t at the top of the list,” Haynes said. “ ‘I’m healthy. I’m young. Why would I need a flu shot? If I got the flu, I’d be able to fight it. It’s not that big of a deal.’ That was my attitude about it.”

This type of thinking, however, doesn’t take into account how deadly flu can be to healthy people, said Flor Munoz, a pediatric infectious disease expert at Texas Children’s Hospital in Houston.

“People who are healthy can get severe consequences from influenza,” said Munoz, citing a 2018 study in the journal Pediatrics that found that half of children who die of the flu have no underlying medical conditions.

Another reason people don’t get vaccinated is because they are more concerned about the vaccine than they are of the flu itself. Kari O’Driscoll, a mother of two in Washington state, said she doesn’t get the flu shot because she and her kids are healthy, and she doesn’t think they would suffer dramatic health effects if they got sick.

“I weighed that [risk from flu] against the thought of injecting them with something every single year that may or may not afford them immunity . . . and it didn’t seem worth it,” O’Driscoll wrote in an email.

Science, however, supports the safety and necessity of vaccinations.

“We are more afraid of risks when they’re human-made than when they’re natural,” said David Ropeik, a consultant in risk perception and risk communication. “[But] these are natural substances. They are. They’re made in a lab, so what? . . . Water’s put in a bottle in a factory; it’s still a natural thing.”

For those concerned about safety or side effects, Munoz assures them flu vaccines are tested extensively for safety and produced under “very high standards.” And for those worried that flu shots will give them the flu, they don’t, according to the CDC. They’re made of inactivated, or dead, virus and proteins — not live virus — making it impossible to get the flu from the shot.

In terms of effectiveness, Munoz concedes that the flu vaccine isn’t perfect. Last year’s flu vaccine received a lot of press over what many saw as a disappointingly low effectiveness rate. According to estimates by the CDC, the vaccine was about 40 percent effective at preventing the flu, about the same as the season before it.

Focusing on just that one number, however, is shortsighted because it lumps all strains and all ages together, Munoz said. The flu vaccine protects against some flu viruses more than others, and it works better in certain groups of people.

“The ability to respond well to the vaccine and develop good immunity and be protected from it is better in healthy people because everything is working properly,” she said. But because we vaccinate a greater proportion of those in the extremes — the very old, very young and very sick — the vaccine effectiveness rate number that makes headlines disproportionately represents those groups.

A better number to focus on, according to Munoz, would be how well the vaccine protects against not just getting sick but also hospitalization and death. If a vaccinated person gets the flu, they’re less likely to have a serious case that leads to pneumonia, brain swelling, multiorgan failure or other serious complications as a result of the virus.

Influenza may also trigger a heart attack, and studies have shown that getting a flu shot can help prevent heart attacks and strokes as effectively as taking blood pressure and cholesterol medication.

That 40 percent vaccine effectiveness rate in 2016-2017 didn’t just avert an estimated 5.3 million cases of the flu, according to the CDC, it also prevented about 2.6 million medical visits and 84,700 hospitalizations.

An estimated 80 percent of children who die of the flu are unvaccinated, the CDC says, and vaccination can help reduce an infected child’s risk of dying by 65 percent. That’s why the American Academy of Pediatrics urged parents in early September to get their children the flu shot “as soon as it is available.”

Even with last season’s record-setting 180 deaths in children due to the flu, it’s unclear whether parents will heed the organization’s advice. Less than 60 percent of children — and about only a third of adults under 50 — were vaccinated against the flu during the 2016-2017 season.

But this year, Haynes will be among the vaccinated. She’s 20 weeks pregnant, and her life isn’t the only one she wants to protect.

“I feel like a flu shot is an insurance,” she said. “It’s not a guarantee that you’re not going to get the flu, but I see it as it’s that one extra layer of protection. That if I do get sick, I know that I’ve done my part to put something in place to help me fight.”

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