Immunization, Influenza, and the Immunocompromised

by Keon Collett

Everybody knows they should get a flu shot. But, how many of you actually have? If you’re a Canadian between the ages of 18 and 34 – a demographic that encompasses many in Edmonton – there’s an 83% chance that you haven’t and that you won’t get a flu shot at all this year.

It’s particularly baffling that more people don’t get immunized given how many of the myths that may have discouraged people from getting the vaccinations have been dispelled. We now know that vaccines do not cause autism. We also know that the flu shot cannot “give” you influenza, because the virus it contains has been genetically inactivated or severely weakened. (You can, however, still “catch” the flu even after getting the flu shot. But, of people who receive either the intranasal live attenuated influenza vaccine (LAIV) or more common injected inactivated influenza vaccine (IIV), only 5% report catching the flu after receiving the vaccine.) And if you aren’t phased by the numerous conspiracy theories, but are truly just scared of needles, Alberta Health Services now offers the vaccine in the form of a nasal spray – so you really have no excuse!

When Statistics Canada, asked Canadians who hadn’t gotten a flu shot in 2014 why they hadn’t, 26% said they just “didn’t get around to it” while 56% said they “felt it was unnecessary”. The two responses are probably related: it’s tough to make time for something when you don’t feel it’s particularly important.

For you, that may be the case. You may have an immune system made of steel and, even if you catch the flu, it may not slow you down all that much. But, that isn’t the case for everyone. It certainly wasn’t the case for me when in 2014 (the same year that those Statistics Canada stats are from) I was diagnosed with cancer and began chemotherapy that effectively decimated my immune system.

You may have seen me around campus or had a class with me during that time. I wore a hat, so you probably didn’t notice my baldness (or, if you saw me in class, just thought I had a particular affinity for wearing bandanas). The fact that I was on crutches probably made you assume I had broken my leg. In reality, I was undergoing the start of six months of chemotherapy. Along with a number of terrible side-effects from chemo, I was also affected by a condition called neutropenia – basically an incapacitated immune system and an extremely high risk of infection.

The flu can be transmitted more easily than you might think: viral particles can be found in the normal, exhaled breath of 1 in 3 infected individual. Infected individuals are also able to transmit the virus on average one day prior to presenting with clinical symptoms. Given how stuffy some of the lecture halls on campus are, we’re basically all breathing the same air (and same germs) which is exactly why everyone who can get the flu shot, needs to. Herd immunity does not work if only 17% of young adults who can get the flu shot actually do.

Right now, we are four weeks into the influenza season. In the past four weeks  46 Albertans have been admitted to the hospital due to influenza. These numbers will only grow as the flu season continues. In the 2015/2016 flu season there were a total of 1,698 hospital admittances due to influenza in Alberta.

These numbers are personal for me because I too ended up in the hospital during chemo, crippled by an infection that a non-immunocompromised person could have easily fought off. The repercussions of a hospital stay for people like me are more grim than having to catch up on a few missed classes or re-writing a missed exam. Such hospitalizations often disrupt a patient’s planned course of treatment. There is a reason why chemotherapy drugs are given on specific schedules; it’s because those schedules offer the highest rate of success, which, in this context, means not dying. Deviating from that schedule can result in a less effective treatment, ultimately decreasing chances of survival. After all, cancer is the leading cause of death in Canada.

Even if you think you’re too busy for a flu shot or think you don’t really need one, get vaccinated anyways. Do it for the mostly invisible population of immunocompromised people whose names (and health statuses) you don’t know. We’re here, and the inconvenience of you getting your flu shot just might save our lives.

Read more on Keon’s Blog!

Illustration courtesy of Janelle Holod (janelleholoddesign.com).

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