Why Get a Flu Shot?

Reprinted from PN/Paraplegia News January 2015

We’re deep into flu season again and if you haven’t already gotten a flu shot, there’s still plenty of time to protect yourself.

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Many people who get the flu will have a mild illness, won’t need medical care and will recover without any complications in a week or two.

Even so, influenza is a very dangerous disease that can lead to serious complications, including death. In fact, influenza causes on average 200,000 hospitalizations and 36,000 deaths every year in the United States alone.

While people can develop a serious illness when they’re infected with the influenza virus, certain individuals are at especially high risk.

These include adults 65 years of age and older, children younger than 5, pregnant women, Native Americans and Alaskan natives.

Those at even greater risk are people with ongoing medical conditions such as heart disease, pulmonary conditions such as asthma, liver and kidney disease, diabetes and those with spinal-cord injury or disease (SCI/D).

Increased Risk

People with SCI/D are at increased risk because of pulmonary complications from less effective clearance of secretions, weak respiratory muscles, autonomic changes and decreased overall mobility.

Also, those with a complete cervical SCI are known to have decreased immune function to fight off infections. In fact, it’s been reported that individuals with SCI/D who got the flu were 37 times more likely to die from influenza than comparable individuals who don’t have SCI/D.

Compounding the risk is the fact many people with SCI/D have other medical conditions such as diabetes, asthma and heart disease.

Those reasons are why the Centers for Disease Control and Prevention (CDC) have added SCI/D to its list of high-risk conditions and recommends a yearly flu shot.

Simple Prevention

Despite these obvious risks, influenza immunization rates for individuals below the age of 65 are very low.

It’s thought this is because of complacency on the part of the health care providers who tend to these individuals. The providers are often specialists who are less likely to recommend vaccination than primary care physicians.

This isn’t the case with the Department of Veterans Affairs (VA). The VA has been proactive in making sure that veterans with SCI/D receive their yearly influenza vaccination.

The rate of influenza vaccination in veterans with SCI/D who are cared for in the VA system went from 28% in 2000 to 67% in 2005. While this is heartening, there remain a large number of SCI/D individuals who aren’t getting vaccinated.

The flu vaccination is such a simple, preventative procedure with such great value; it’s hard to comprehend why the yearly vaccination rates aren’t even higher.

It’s Never Too Late

The vaccination itself is administered as an injection for all age groups. Those ages 2 through 49 also have the option of getting vaccinated through a nasal spray.

Formulated on a yearly basis before the start of the flu season, the vaccine is based on which flu viruses the manufacturers predict will be present that year. Since the flu viruses change on a yearly basis, it’s important to get vaccinated every year before the season starts in September or October.

Although that’s the optimal time to get your flu shot, it’s never too late. The shot will start providing protection against the flu within two weeks of administration.


There are currently six formulations of the flu vaccine.

Four of them are trivalent vaccines that protect against two influenza A viruses and one influenza B virus. They include:

-A high-dose trivalent shot approved for people 65 and over.

-A trivalent shot containing a virus grown in cell culture.

-The standard-dose trivalent shot. The most common, it’s made using the virus grown in eggs.

-An intradermal trivalent shot that’s injected into the skin instead of the muscle and uses a smaller needle.

The remaining two formulations are quadrivalent vaccines that protect against two influenza A viruses and two influenza B viruses. They include:

-A quadrivalent flu shot.

-A quadrivalent nasal spray vaccine that is approved only for those ages 2 to 49.

The CDC has not issued any recommendations for which shot to get, but they do recommend using the nasal spray flu vaccine for healthy children ages 2 to 8.

The bottom line is that everyone should get a flu shot, particularly those who are at high risk.

Lana McKenzie is associate executive director for medical services-health policy at Paralyzed Veterans of America.


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