Separating fact from fiction about the flu vaccine – 2015

Editor’s Note: This article – separating fact from fiction about the flu vaccine – separating fact from fiction – has been reblogged with permission from Tara Haelle’s Red Wine and Applesauce blog. Many thanks to Tara and a host of other people for creating this list.

Note from Tara Haell: This post is co-published with NPR’s health blog Shots. Check out the story for updated information about this year’s flu shot from a CDC medical officer.

Once again, flu season is upon us — and so are all the misconceptions, excuses and worries that have kept so many people away from getting their flu vaccines. Plenty of people are fully informed about the flu vaccine’s safety and effectiveness and simply choose not to get the vaccine, as is their right (as long as they don’t work in healthcare settings where it’s required). But many others may have skipped the shot because they’ve bought into one of the many myths about the vaccine that always circulating with the influenza virus itself. Or perhaps they’ve read something unsettling about the vaccine that has a kernel of truth in it, but which has been blown out of proportion or misrepresented.

Of all the vaccines out there, the flu vaccine is unique in several ways: it’s the only one the CDC recommends for the entire (eligible) population every year, it has the most variability (and nearly always the lowest percentages) in effectiveness, and it has more tall tales told about it than Paul Bunyan. Much of the debunking and explaining you’ll find here is essentially the same as in past years’ posts, but a couple misconceptions have been rearranged, and I spent a bit more time discussing the evidence about potentially lower effectiveness of the flu vaccine in people who had gotten it the previous year.

Finally, I called these items “concerns” instead of “myths” because several of the issues discussed here are not outright “myths.” That is, some of these concerns originated from factual situations, but the details got gnarled and twisted along the way, or else the fact itself doesn’t have the implications people may expect it does. “Concerns” therefore better captures that each of these items is a legitimate concern for many people but is something that simply requires explanation, whether that’s an outright debunking or simply context and clarification.

One thing that needs a bit of clarification is last year’s vaccine’s effectiveness, as I discuss in the NPR Shots blog post that accompanies this one. The overall flu vaccine effectiveness last year was an uninspiring 23%, low enough to legitimately make you wonder why you bothered if you got the vaccine. But as I explain at NPR based on an interview with CDC influenza medical officer Lisa Grohskopf, the overall effectiveness doesn’t capture the effectiveness of each strain within the vaccine.

A poor match with the H3N2 strain — which caused the most illness and the most serious cases — was responsible for the lion’s share of that low number. Meanwhile, the match between the vaccine strains and the virus strains for B viruses, which circulated the most toward the end of the season, was good enough that the vaccine was closer to 60% effectiveness for those strains. This year, changes to the H3N2 strain for the vaccine should boost the effectiveness and offer a better showing than last year’s lousy run, according to Grohskopf.

With that info out of the way, let’s get to the flu vaccine concerns, with two important notes. First, for those who prefer to do their own research, I’ve provided all my sources in the hyperlinks. More than half of these go directly to peer-reviewed research articles, and a fair number go to the Centers for Disease Control and Prevention or the World Health Organization.

Second, but very important: I am a science journalist but not a medical doctor or other health care professional. I’ve compiled research here to debunk common misconceptions and clarify common concerns about the flu vaccine. This post does not constitute a recommendation from me personally to each reader to get a flu vaccine. You should always consult a reliable, trusted medical professional with questions that pertain specifically to you. For the CDC recommendations on the 2015-2016 flu vaccines (including information on which vaccines pregnant women, the elderly and children under 2 should *not* get), please consult the CDC flu vaccine recommendations directly. There are indeed people who should *not* get the flu vaccine.

To make it easier to navigate, I’ve listed all 31 concerns at the top followed by the factual information below it. They hyperlinked facts will jump to that explanation. I use “flu shot” and “flu vaccine” interchangeably to refer to any type of flu vaccine, including the nasal vaccine.

Concern #1: Can getting the flu vaccine give you the flu or may you sick?
Fact: The flu shot can’t give you the flu.

Concern #2: Do I really need to get the flu vaccine this year if I got it last year?
Fact: For now, a new flu shot each year is still recommended.

Concern #3: Could getting the flu vaccine make it easier for me to catch viruses, pneumonia or other infectious diseases?
Fact: Flu vaccines reduce the risk of pneumonia and other illnesses.

Concern #4: Isn’t the flu shot just a “one size fits all” approach that doesn’t make sense for everyone?
Fact: You have many flu vaccine options, including egg-free, virus-free, preservative-free, low-dose, high-dose and no-needle choices.

Concern #5: Can the flu shot cause death?
Fact: There have been no confirmed deaths from the flu shot.

Concern #6: Aren’t deaths from the flu exaggerated?
Fact: Deaths from influenza range from the lower thousands to tens of thousands each U.S. flu season.

Concern #7: Aren’t the side effects of the flu shot worse than the flu?
Fact: Influenza is nearly always far worse than flu vaccine side effects.

Concern #8: Don’t flu vaccines contain dangerous ingredients such as mercury, formaldehyde and antifreeze?
Fact: Flu shot ingredients do not pose a risk to most people.

Concern #9: Shouldn’t pregnant women avoid the flu shot or only get the preservative-free shot? Could the flu vaccine cause miscarriages?
Fact: Pregnant women are a high risk group particularly recommended to get the flu shot. Fact: The flu shot reduces miscarriage risk. Fact: Pregnant women can get any inactivated flu vaccine.

Concern #10: Can flu vaccines cause Alzheimer’s disease?
Fact: There is no link between Alzheimer’s disease and the flu vaccine; flu vaccines protect older adults.

Concern #11: Don’t pharmaceutical companies make a massive profit off flu vaccines?
Fact: Vaccines comprise a tiny proportion of pharma profits. That makes it possible for them to continue making them in the event of a pandemic.

Concern #12: Flu vaccines don’t really work, do they?
Fact: Flu vaccines reduce the risk of flu.

Concern #13: But flu shots don’t work in children, do they?
Fact: Flu vaccines reduce children’s risk of flu.

Concern #14: Can flu vaccines cause vascular or cardiovascular disorders?
Fact: Flu shots reduce the risk of heart attacks and stroke.

Concern #15: Can vaccines can break through the blood-brain barrier of young children and hinder their development?
Fact: Flu vaccines have been found safe for children 6 months and older.

Concern #16: Will the flu vaccine cause narcolepsy?
Fact: The US seasonal flu vaccine does not cause narcolepsy.

Concern #17: Can the flu vaccine weaken your body’s immune response?
Fact: The flu vaccine prepares your immune system to fight influenza.

Concern #18: Can’t the flu vaccine cause nerve disorders such as Guillain-Barré syndrome?
Fact: Influenza is more likely than the flu shot to cause Guillain-Barré syndrome.

Concern #19: Can the flu vaccine make you walk backwards or cause other neurological disorders like Bell’s palsy?
Fact: Neurological side effects linked to flu vaccination are extremely rare (see Concern #18), but influenza can cause neurological complications. Fact: The flu shot has not been shown to cause Bell’s palsy.

Concern #20: Don’t people recover quickly from flu since it’s not really that bad?
Fact: Influenza knocks most people down *hard*.

Concern #21: Can people die from the flu even if they don’t have another underlying condition?
Fact: Otherwise healthy people DO die from the flu.

Concern #22: Can people with egg allergies get the flu shot?
Fact: People with egg allergies can get a flu shot.

Concern #23: Can’t I just take antibiotics if I get the flu?
Fact: Antibiotics can’t treat a viral infection.

Concern #24: Since I got the flu last time I got a flu shot, that means it doesn’t really work for me personally, right?
Fact: The flu shot cannot guarantee you won’t get the flu, but it reduces everyone’s risk.

Concern #25: But I don’t need the shot since I never get the flu, right?
Fact: You can’t predict whether you’ll get the flu.

Concern #26: Can’t I protect myself from the flu by simply eating right and washing my hands regularly?
Fact: A good diet and good hygiene alone cannot prevent the flu.

Concern #27: Won’t getting the flu simply make my immune system stronger?
Fact: The flu weakens your immune system while your body is fighting it and puts others at risk.

Concern #28: If I get the flu, why won’t just staying home prevent me from infecting others?
Fact: You can transmit the flu without showing symptoms.

Concern #29: Can having a new vaccine each year make influenza strains stronger?
Fact: There’s no evidence flu vaccines have a major effect on virus mutations.

Concern #30: Isn’t the “stomach flu” the same thing as the flu?
Fact: The “stomach flu” is a generic term for gastrointestinal illnesses unrelated to influenza.

Concern #31: Is there any point in getting a flu shot if I haven’t gotten one by now?
Fact: Getting the flu shot at any time during flu season will reduce your risk of getting the flu.

Please ask questions, provide new information, etc. in the comments. However, any comments which include inaccurate information posing as “warnings” or “countering” accurate info will be deleted. I encourage debate but not the dispersal of misinformation.

If you’ve read the alarmist “Should I Get the Flu Shot?” post from “Food Babe,” here’s a great, in-depth debunking of that piece.

Special thanks to the extensive research for this post goes to Kathy McGrath, Nathan Boonstra, Jessica Atwell, Rene Najera, Amber Bickford Cox, Karen Ernst and Emily Willingham.

The Original Skeptical Raptor
Chief Executive Officer at SkepticalRaptor
Lifetime lover of science, especially biomedical research. Spent years in academics, business development, research, and traveling the world shilling for Big Pharma. I love sports, mostly college basketball and football, hockey, and baseball. I enjoy great food and intelligent conversation. And a delicious morning coffee!