“Oh, I never get the flu shot. It makes me sick,” a woman tells me at a dinner party, with the sort of shattering confidence that only ignorance can provide.
I am, for a moment, taken aback — and living in Northern California, where ill-informed comments about vaccines are very much the norm, I should be used to it by now. With flu season rapidly approaching, I’m among those lining up for my flu vaccine, but all around me, I hear people saying they don’t plan to vaccinate because “I just get sick anyway” or “I heard it doesn’t work” or “I’m not supposed to get to get it.”
When I asked Dr. Anthony Fauci, the Director of the National Institutes of Allergy and Infectious Disease (NIAID), whether the flu vaccine makes patients ill, he was swift to respond.
“No, it doesn’t,” he said.
Fauci oversees $5.3 billion in U.S. funds dedicated to researching a broad spectrum of topics related to allergies and infectious disease. He’s served under five presidents and made incredible contributions to the field of immunology: In other words, if you’re gonna talk to a guy about the influenza virus, he’s a good place to start.
Dr. Sharon Frey, the clinical director at the St. Louis University Center for Vaccine Development, explains that while there are a lot of influenza viruses out there, influenza A and influenza B are our greatest concerns in humans, as they’re the most likely to cause disease. From year to year, though, these viruses mutate extremely quickly, in a phenomenon known as drift. Sometimes, those changes are dramatic, potentially creating an influenza virus that could trigger a pandemic like that seen in 1918: This is called shift. These phenomena make flu a challenging virus to vaccinate for.
“Even on a good year, it’s only about 60 percent effective,” thanks to the fact that it doesn’t cover every single flu strain, says Fauci, but 60 percent is vastly better than zero percent. And researchers are working on a universal vaccine that targets a part of the virus that remains stable over time, a task that’s proving challenging, though Fauci says their work is showing promise. This work could allow people to get a shot that would protect against a larger number of flu strains.
But for now, “I just get sick anyway” is a common comment, and one Frey says is misleading. During cold and flu season, a large number of viruses are circulating, including a veritable smorgasbord of viruses that cause respiratory infections as well as flu strains that weren’t included in the annual vaccine. So it’s possible to get a flu vaccine and then get sick later with a different seasonal illness, she explains.
Another issue depends on the timing of the vaccine. People carry and shed the influenza virus without realizing they’re sick for a few days, and if you’re exposed before you get vaccinated, you’ll develop influenza whether or not you got the vaccine. Similarly, it can take a few weeks for your body to develop an immune response, explains Fauci, so immediate post-vaccine exposure could also make you sick. That’s why it’s important to get vaccinated as early as possible, says Frey, but also, “it’s never too late to vaccinate.”
And an infection can be serious business. Influenza isn’t much fun to have. “It’s a systemic disease,” explains Fauci. While you may have heard people refer to congestion and the sniffles as “the flu,” that’s imprecise: These symptoms are more commonly associated with a different kind of respiratory infection. Infection with influenza can include the sniffles, but also significant body aches and pains, fatigue, headache, intestinal upset, and sometimes fever, according to the CDC. In some populations, say both Fauci and Frey, influenza infection can be very dangerous: People at both extremes of the age spectrum, for example, along with immunocompromised individuals and people with lung, heart, or kidney conditions.
“Obviously, I don’t want to get the flu or any other secondary infection (viral or bacterial) that one can pick up during a bout of flu. It’s not just about not getting sick, it’s also about the recovery. I’ve reached a place where my body takes longer to get over things: a cold lasts a day or two longer than most people, a sinus infection usually ends up including bronchitis (and, often an extra round of antibiotic treatment),” says John N., a writer who was diagnosed with HIV in 1988. “My immune system is not as strong as it once was,” he comments, and a day of feeling a little tired and achy after a flu shot is worth it for him.
If you don’t get your flu shot, you’re not the only one at risk. People like John N. and Shayla Maas, a podcaster and writer, has difficulty forming immunities via vaccination, and can also get very sick if she contracts the flu. “My immune system is nonfunctional in a specific way,” she says wryly, noting that her partner gets the flu shot every year. “I don’t want anybody around me who doesn’t have their vaccines,” because it’s just too risky — and during flu season, she makes big lifestyle changes to avoid exposure to unvaccinated people, like going to the grocery store late at night and avoiding crowded spaces.
“You not having a vaccine puts me at risk of death,” says Maas, bluntly.
John N. remembers the swine flu vaccine scare of 1976 and the subsequent fear of vaccines among many Americans, which may have helped feed distrust of the flu shot today. He spent years avoiding the flu shot. Now? He gets one every year, and so does his husband.