Monday, January 24, 2022

Get the Facts, Not the Flu


It’s that time of the year again.

As the summer rains begin to subside, the occasional morning dew greets us on our hustle- which now consists of avoiding local school zones, grocery stores, and car haulers. Season is already upon us and the influx of visitors has our ledgers beginning to creep upward, but with it brings some rather unfortunate side effects. For most folks the thought of season provokes visions of the lunch line at the Publix Deli or increased traffic. For me, season is synonymous with the flu!

There have already been documented cases of influenza at our hospital and clinics, all on the heels of the 2017-2018 season classified as a “high severity season across all age groups.” If this is any indication of what Flu Season is going to be like, we are in for a doozy!

Everyone has experience with the flu. Whether it was you, a family member or friend suffering, we all know someone that has had this viral illness. The symptoms and severity of the flu can vary greatly but the two main types of virus that cause the flu are Influenza A and Influenza B.

So you can be in the know, here’s a little information about the flu shot- your best chance at warding off this nasty bugger should you come in contact with it.

Not all flu shots are created equally! To think that all flu vaccines are equal would be the same as saying all cars are created equally. The vaccines differ from the beginning with where they get the original virus. There are currently three production technologies approved to create the flu vaccines

1. Egg Based Vaccines are the most common, a process that starts with the CDC giving the manufacturer the vaccine virus which they predict to be the most prevalent in the upcoming flu season. The manufacturer then injects the virus into a fertilized egg, incubates it for a little, and then harvests it for injection in a dead or weakened state.

2. Cell Based Vaccines take the same virus from the CDC, inoculate it into mammalian cells (instead of eggs), let it replicate, then collect and purify it.

3. Recombinant Vaccines have a different starting point. This is a naturally occurring virus that the manufacturers isolate a protein (a protein responsible for inducing an immune response). They then combine it with another protein that thrives in insect cells and let it replicate to harvest the protein and purify it- the resulting recombinant vaccines do not contain egg (it’s actually the only 100% egg free vaccine on the market!).

With a little understanding about how the flu vaccines are made we can move into what you are getting as the patient. The most common vaccines are the standard and high-dosage Inactivated Vaccine and the Live Attenuated Vaccines (made from live but poor-functioning virus similar to influenza) that are administered intranasally.

Most patients receive the standard or high-dose Inactivated Vaccine. Those over 65 normally get the high dose.

Now, it’s myth-busting time!

This week, I’m going to attempt to debunk a few of the myths surrounding influenza vaccination.

Myth #1: “I got the flu shot last year and right afterwards I got sick with the flu—so I’m not going to get it again this year.”

Arguably one of the most common statements in response to my urging folks to get their flu shot, the reasoning here is invariably flawed.

Yes, you may have contracted Influenza last year despite being vaccinated.

Yes, It may have occurred shortly after getting vaccinated.

But NO, the vaccine had nothing to do with your illness. In fact, therein lies the problem.

Two factors can be at play here—the first being that the vaccine likely had insufficient time to generate immunity (usually 2-3 weeks) before you came in contact with the influenza virus.

Second, there is a possibility that the flu strain you contracted was not covered by vaccine.

The Centers for Disease Control—along with vaccine manufacturers—take on the unenviable annual task of “guessing” which flu strains will be most prevalent in the upcoming season.

They do this with a combination of complex statistical analysis, a Magic 8-Ball, and a Ouija Board.

Shockingly, they sometimes get it wrong and our flu vaccines give us little protection. But hey- something is better than nothing!

Myth #2: “I can’t get the flu shot because I have a cold.”

Also untrue.

While the flu vaccine can occasionally cause some low-grade temperature and a little bit of body ache, there is no documented contraindication to administering the vaccine while having a cold.

Myth #3: “I’m allergic to the vaccine.”

Typically, only individuals who have had an episode of Guillain-Barre Syndrome within six weeks of receiving the vaccine or a documented egg allergy are considered allergic to the vaccine.

With the advent of egg-free formulations, not even an egg allergy is an acceptable cop-out.

Needless to say, the flu shot is a valuable tool in our fight against illness. And if you plan on coming into my office with any of the above excuses, you had better work on a new one.

I’m happy to report that our facility has a generous supply of vaccine that is free for most Medicare and commercially insured patients.

No more excuses, come on by and get your flu shot!

Questions for White Coat Notes? Write me at You can also find me on Facebook by searching “Dr. Carlos Portu, MD.”

Dr. Carlos Portu is an Independent Primary Care Physician practicing in East Naples and Marco Island. He can be reached at 239-235-7908.

Dr. Carlos Portu, MD is an Independent Internal Medicine specialist with offices in Naples and Marco Island and has been practicing for 16 years. He graduated from University of Miami Miller School of Medicine and specializes in Adult Primary Care.

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