Flu Bites

Here at East Portland Pediatric Clinic, we firmly believe in vaccines. All of us here are in this field of work because we love to see kids thrive. We’re also the place to go when children are not thriving. Vaccines are our most effective tool to keep children healthy and living their best lives. When vaccination rates are up, less of our children get sick or illness-injured. Vaccinating our kids against terrifying diseases like lockjaw are obvious–most of us remember the harrowing case of the 6-year-old boy who spent nearly two months hospitalized at OHSU. All our parent-hearts hurt to think of any child having to suffer through such an ordeal. The flu vaccine, however, is often overlooked and considered unnecessary by many people. I want to take a moment to break down why the doctors here at EPPC so strongly encourage getting the flu shot every year.

First, lets talk about what flu looks like. Flu attacks the nose, throat and lungs causing inflammation and increased mucus production. The typical presentation has cough, sore throat, mucus production, fever, body aches, and malaise and lasts between several days to two weeks. Some people get sick for longer. Vulnerable individuals are at higher risk for severe complications, but with a longer duration of increased mucus anybody with flu is at risk for secondary infections including sinus infection, ear infection, or pneumonia. In children, the flu is especially taxing; the fever burns through energy stores and their airways are smaller and more easily blocked leading to increased work of breathing and higher susceptibility to secondary infections.

Watching a child laying like a sack of potatoes throwing all their energy into breathing is terrible. It’s scary for you but it’s scary for us too and we worry right along with you. We would much rather be placing splints on arms and stitching knees. Which brings us to our number one reason for recommending the flu vaccine: IT WORKS. Yes, the efficacy of the vaccine varies from year to year, but the research is increasingly showing that vaccinated folks recover more easily from the flu than unvaccinated folks. So if in a year we have an efficacy rate of preventing flu infections at 40% (which is on the low side), we might have a reduced hospitalization rate of 70%. Often times people will talk about this in terms of hospital usage, but I prefer to think about it in terms of human suffering. People are hospitalized because they are fighting to breathe. That’s a lot of people not having to fight to breathe. And by the way, a 2018 study showed flu vaccine reduced hospitalizations by 82%. As Dr. Matthieu is fond of saying, “Flu vaccine may not be perfect, but it is the single most important thing you can do to prevent flu and complications!”

The second reason we support vaccination is because as providers, we look at the health of individuals AND their community. A community in which there is less illness circulating around is a healthier community to live in. Some people talk about how they “never get the flu.” Well, actually, people can contract and spread the flu without showing symptoms. This is why, as a healthcare worker, I get the flu shot every year. Because I work with children, a vulnerable population where some are unable to get vaccinated, I consider it my moral prerogative to ensure I do everything I can to ensure I am protecting the people I care for. If there are fewer people in the community where the virus can take hold, then there are fewer people getting sick. All of us working together to make a healthier community is also an effort in equity, protecting our most vulnerable groups for whom flu illness has compounding effects–houseless families, financially and food insecure families, families with compromising health conditions.

Finally, Tamiflu isn’t great. The side effects of the flu vaccine are mild and short lived. The most common side effect of Tamiflu is nausea and vomiting. So you have a child who is already miserable with the flu and you’re going to add nausea and vomiting on top of that. Fun, right? Exactly what you want to be doing for your suffering child. Given how risky the flu can be for children, it might be worth it. And I say “might” because Tamiflu isn’t always that effective. However, once a child is sick with influenza and we’re worried that it could send them to the hospital, it’s what we’ve got to help. Our preference however is for that child to not get sick in the first place.

Being a parent means having episodes of fearing for your kids, it’s part of the deal. We want to do everything we can to reduce the number of those episodes. We love to see our families, watch them grow, share in the excitements, offer our knowledge and expertise; and it is our honor to be there with you in the moments of fear. But maybe we can see less of each other during flu season.

Some extra information:

– This year’s vaccine has two strains of A type and two strains of B type.

– In Oregon so far this year, the B type has been more prevalent but the A type is more responsible for hospitalizations.

– Reported cases in Oregon are already increasing and are higher than the previous three years’ data at this point in time.

– Vaccination rates in Oregon are lower than last season.

– Follow along with Oregon’s flu surveillance here.

– Follow along with the nation’s flu surveillance here.

– Learn more about how flu vaccine effectiveness is measured here.

– Learn more about the benefits of flu vaccination here.

Trivia Tidbit: The influenza epidemic of 1918 killed more people that the total number who died in the World War I. Learn more here.