Dr Michelle - Flu Shots

Dear Dr Michelle,

In Reality Check's regular column, Melbourne GP who just happens to have diabetes, Michelle answers some questions they didn't cover in her textbooks.

This month she answers this question just in:

The campaigns about flu vaccines say that people with diabetes are strongly advised to have it, and eligible for free vaccines as well? I'm young and healthy
- presumably they mean old Type 2s?

Or should I be getting the jab?
And if so, how do I get it (for free if possible!)?

Let's start with what the flu is all about ....

Flu vaccines are vaccines to prevent you gettng sick from the flu or
'influenza'. The world has not had a disastrous epidemic of influenza for
ages. One of the worst was about the time of the First World War and it killed more people than the fighting.

Influenza is a virus, or actually a family of viruses, that infect humans and other animals - for instance bird flu infects birds.

A virus is a tiny particle that cannot be seen by the naked eye. It is a
very basic thing that gets into your body and lives there and uses your
cells to grow and replicate. In trying to grow, be happy and bring up its
kids and grandkids in your body, the virus makes your body sick.

Different viruses can cause other diseases, e.g. the common cold, warts, cold sores, glandular fever, HIV. Viruses are different to bacteria, which are bigger but still make you sick.

Influenza virus is transmitted from person to person mainly by 'droplet
spread' which is when someone sneezes, coughs or talks to you and accidently sends tiny drops of their saliva or snot (that contain the small influenza virus particles) over to your body and then you breath them in to your lungs. Then the virus likes its new home -you- and starts to grow. You get very sick.

How does a flu vaccine work?

The flu vaccine is made from tiny bits of the influenza virus (not the
whole thing). These little bits are what the immune system cells see as foreign things, and when the vaccine is injected into you, your immune system fights them off.

Then when the flu virus hits your town and someone who has it sneezes on you and the influenza virus gets into your lungs, your immune system cells see these parts of the virus, they realise they have seen it before and they fight it off pretty quickly.

But won't I get sick from the virus in the vaccine?

Because the flu vaccine is only made of bits of the influenza virus, and not the whole working thing, it can not actually infect your body with
influenza.

So when people say they had the flu vaccine and then got the flu a week or 2 later - it is usually crap. They probably just have a bad common cold, not actual influenza, which is just coincidental, or bad timing. Most of us will get a cold a few weeks after having the flu injection in April or May as its that time of year anyway for all sorts of colds.

Apart from NOT causing the flu, the flu vaccine may have a few small side effects. Most people get nothing other than a sore arm for a day or so. But common side effects are a slight fever or headache. As with any medication/vaccine or food there is a very, very, very low risk of an allergic reaction.

OK, so I can't really be bothered with yet another injection.

What's the big deal?

When you get sick with Influenza you get the worst cold you have ever had in your life. You'll feel 'fluey' with headaches, fever, cough, muscle and bony aches and you probably won't be able to get out of bed for a week or two. So that means no school, no work, no exams, no holiday to Fiji, no looking after kids or anyone else. Is that something you want to risk?

Iif you are really unlucky, the flu might develop into pneumonia (really sick lungs causing difficulty breathing) and you'll need to go to hospital.

Inluenza can kill people this way. People who have crappy lungs to start with (ie. asthma, smokers) or not such strong bodies (babies, oldies) are more at risk of a serious case of flu and pneumonia.

And what's Diabetes got to do with it?

People with Type 1 and 2 diabetes are also in this higher risk category as our bodies just don't work perfectly, so when the immune system needs to be working at its absolute best to fight off the infection, it can't. This is why the flu vaccine is advised for us.

So, the vaccine's free?

The flu vaccine is only free in Australia for people over 65 years of age, or Aboriginals and Torres Strait Islanders over 55.

It is often free through children's hospitals for patients of that hospital who have chronic illnesses such as asthma, cystic fibrosis or Type 1 diabetes. So if you or your kids fall in this category, contact the immunisation department or nurse, or your Paediatrician at the hospital.

For the rest of us, it is recommended but not funded by the federal
government.

There are three main ways for adults to get the vaccine:

1. Freebies at work. Check with your workplace if they provide annual flu vaccines to all the staff - if so, it is usually free or at discount prices. Many employers realise that it is more cost effective to immunise workers than risk everyone off work, or even having to shut if everyone gets Influenza.

2. Get lucky with a GP or health centre that does a big trade in flu vaccines. Some GPs and health centre may have flu vaccine stocked in bulk and you can buy it directly from them for $15-20. If so, they can give you the injection then and there too.

3. How it works at your average downtown GP surgery. GPs who don't do so many flu vaccines may not be quite as well set up. You'll need to go to the GP to get a prescription for the vaccine, go and buy the vaccine from a nearby chemist and then go back to the GP to have the injection. They may let you pick the prescription up from the front desk (without first seeing the doctor).

Note: You need to keep the vaccine cool between chemist and the doctor's - the chemist will usually give it to you in a cool, foil bag. If it gets hot it won't work as well - if it gets too cold or frozen it also won't work, so pick it up just before you go to the doctor's for the jab - don't get side- tracked and go shopping all afternoon or put it in your fridge
overnight - it may freeze!

You may have to actually see the doctor for the prescription (usually so they can discuss it with you and remind you to get your HBA1C done, blood pressure checked and see if you neeed any insulin scripts too) and then they or their nurse will give the injection when you go back after picking up the vaccine.

Ask the doctor's receptionist about the price when you arrive or when you ring up for your appointment. If you are a Health Care Card holder it will cost the usual cost of a script (less than $5).

Of course the visit to your doctor is mostly covered by Medicare, but may also cost a bit depending on how your GP works.

What's the verdict?

Even though you might have to pay between $5 and $50 dollars for the vaccine and the whole process, it will be worth it when the infection hits - and it will one day. You will be spending a lot more money on tissues, panadol, missed work and all the rest if you do catch it.

So don't buy that carton of Winnie Blues, that bottle of Tequila or that present for mum on Mother's Day - go and get a flu injection instead.

Tell mum it's her Mother's Day present - you are saving her the trouble of having to look after you in bed for a week!

All the best,

Michelle

Published 12 May 2006

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