As another flu (influenza) season approaches, it’s time for dental health-care professionals to consider getting their annual vaccination against the flu. According to the Centers for Disease Control and Prevention (CDC), 5 to 20 percent of the population gets the flu. More than 200,000 people are hospitalized each year due to flu complications, and approximately 36,000 people die each year from the flu. Young children, the elderly, and people with chronic health conditions are most susceptible to serious complications from flu, but health-care workers can also be susceptible to influenza since they work in such close contact with patients who are potential carriers.
When I speak to groups about vaccinations for dental health-care professionals, I often hear objections to getting flu vaccines. Many times the objections are due to stories that individuals have heard about the vaccine’s side effects, its ineffectiveness, or a false sense of security about their vulnerability to getting the flu. So my purpose this month is to help us all be better informed about influenza and the benefits of vaccination.
What are flu symptoms? Flu symptoms include fever, headache, extreme fatigue, dry cough, sore throat, runny or stuffy nose, muscle aches, and gastrointestinal symptoms (nausea, vomiting, and diarrhea). Flu can cause serious complications such as: ear and sinus infections, bacterial pneumonia, dehydration, and worsening of chronic medical conditions. These chronic medical conditions include congestive heart failure, asthma, and diabetes. Dehydration that may result from severe diarrhea can be life-threatening.
How does the flu spread? The flu virus is most commonly spread from person to person, by exposure to people with the flu who are coughing and sneezing. Touching objects that have flu virus on them and then touching the nose or mouth can also spread the flu. People who are infected with influenza may be infectious to others a day before symptoms appear and for up to five days after they become sick. As we approach the holiday season, when large numbers of people are out shopping and traveling, the potential for exposure to the flu increases our vulnerability beyond our everyday exposure to patients we treat. If you have young children, you also have the risk of exposure from your children’s school companions and activities.
How can the flu be prevented? The CDC states that the single best way to prevent the flu is through vaccination each fall. There are currently two types of influenza vaccine: the injectible vaccine - known as the “flu shot” - and a nasal-spray vaccine. The flu shot or injectible vaccine is appropriate for use in children six months or older, for healthy people, and for people with chronic medical conditions. This vaccine is an inactivated vaccine that contains killed virus.
The nasal-spray (FluMist®) is approved for children age 5 or older and for adults up to age 49 who are not pregnant. This intranasal vaccine is made with attenuated viruses - live, weakened flu viruses that do not cause the flu.
It takes up to two weeks for antibodies to develop after vaccination for protection against the influenza virus. This is the chief reason why vaccinations are administered in the fall, prior to the holiday season and winter flu season, when risk of exposure is greater. It is important to note that flu vaccines are not 100 percent effective. In other words, they are not a guarantee that one won’t get the flu. But the vaccine does contain three strains of influenza to increase effectiveness. If one does get the flu in spite of receiving a flu vaccine, symptoms may not be as severe. It is also important to note that flu vaccines do not prevent flu-like illnesses, often mistaken for the flu, which are caused by noninfluenza viruses. This may explain a common belief on the part of some people who say that they got their flu shot but still got the flu. In many cases, these individuals decide not to get vaccinated after such an occurrence, believing that the vaccine is ineffective.
Does the flu vaccine have any side effects? Any vaccine, including the influenza vaccine, can have side effects. Common side effects from flu vaccines include soreness, redness, and/or swelling at the injection site; a low-grade fever; and aches. These symptoms are sometimes mistaken for the flu, fueling a common belief that the flu shot causes the flu.
Severe side effects, such as allergic reactions, can occur, but they are rare. In some cases, these allergic reactions can be life-threatening. Signs of severe allergic (anaphylactic) reactions include: breathing problems, wheezing, hives, tachycardia, and dizziness. These signs of allergy will occur within a few minutes or hours after the injection. These allergic reactions can be due to an allergy to eggs, since the viruses used in the vaccines are grown in chicken eggs, or to another component in the vaccine, such as the preservative thimerisol.
Another possible severe side effect of influenza vaccines is Guillain-Barré syndrome. This illness was associated with the swine flu vaccine in 1976. Symptoms caused by the body’s immune system attacking the peripheral nerve system, causing fever, nerve weakness, nerve damage, and paralysis. More information about potential side effects of the influenza vaccine can be found on the CDC Web site at www.cdc.gov.
Is the flu vaccine safe for everyone? As with any vaccine, you should always consult your physician to determine if it is appropriate for you. There are some individuals who should not receive the flu vaccine. This includes those with severe allergy to chicken eggs, those who have had a severe reaction to a past influenza vaccination, those who developed Guillain-Barré syndrome within six weeks of getting a flu vaccine, children younger than six months, and anyone currently experiencing an illness with a fever. In the latter case, the vaccine can be administered when symptoms of the illness subside.
Is there going to be a vaccine against the avian or bird flu? Researchers are currently working on vaccines against this type of flu, but none is ready for distribution as of this writing. The CDC recommends, however, that health-care providers receive the current influenza vaccines to provide protection against the more common forms of influenza. There is no evidence yet that avian flu can be readily spread by person-to-person contact. It is theorized, however, that this flu strain may be able to piggyback onto the more common influenza viruses, which would enable it to spread from person to person. Having vaccine protection against the more common influenza viruses may provide some level of indirect protection against the avian flu.
Stay healthy! Talk to your physician and determine whether a flu vaccine is appropriate for you. If so, plan to get it now rather than later. Also, remember that one of our best infection prevention tools is hand washing. While we are usually very conscientious about hand washing at work, we may not be as diligent outside the work setting. Wash your hands after being in public places. Use liquid, rather than bar soap, since bar soaps can become reservoirs for microbes. Carry alcohol hand sanitizers with you - but not on airplanes. Here’s hoping that this year’s flu season is uneventful for you. RDH
Mary Govoni, CDA, RDH, MBA, is the owner of Clinical Dynamics, a consulting company based in Michigan. She is a member of the Organization for Safety and Asepsis Procedures and is a featured speaker on the ADA Seminar Series. She also writes a column for Dental Equipment & Materials magazine. She can be contacted at [email protected].