True or false? Five commonly held beliefs about the flu vaccine

U of A infectious disease specialist sets the record straight.

Getting the flu shot is an effective, safe way to reduce your risk of developing or passing on a truly unpleasant and sometimes deadly illness, according to a University of Alberta infectious disease specialist.

"You can protect yourself, you can protect others and it's a safe vaccine," said Lynora Saxinger, who is also medical lead of Antimicrobial Stewardship for Northern Alberta with Alberta Health Services.

"I actually see very little downside to it."

Alberta's influenza vaccine program started last week, offering free shots to all Albertans over the age of six months.

Last year, there were 7,698 lab-confirmed flu cases and 52 deaths in Alberta, down from 9,609 cases and 92 deaths in 2017-18.

Saxinger addressed some of the top reasons people say they won't get the shot:

Getting the shot doesn't guarantee you won't get the flu

True.

"The vaccine doesn't make you bulletproof," said Saxinger. "People who have the vaccine can still get the disease, but it tends to be milder and patients are less likely to require hospitalization or die."

This year's vaccine is designed to target four strains identified by the World Health Organization as the most likely to be active in Canada this year-including different influenza A strains of H1N1 and H3N2 than in last year's vaccine, as well as the Yamagata and Victoria strains of influenza B.

The vaccine works by injecting parts of the outer coat of the purified influenza virus to induce an immune response that can then neutralize the virus when you are exposed to it.

"Rather than having to start from scratch, when you're exposed to the real thing, you have a primed response and you can gain control of it immunologically more quickly," Saxinger explained.

Depending on how well matched the vaccine is to the way the virus behaves, it can be between 30 and 70 per cent effective at preventing the flu. Those statistics don't count those who still get the flu but have partial protection and milder symptoms.

Saxinger said measures such as seatbelts and helmets are similarly effective at reducing risk.

"We don't say, 'Well, that's imperfect protection so I'm not going to bother with a seatbelt,'" she said. "You should do everything you can to reduce your own risk-and there's also personal culpability if you decide not to bother and you put the vulnerable people around you at risk.

"Don't give the flu to your grandma or your baby niece."

The vaccine isn't safe

False.

Saxinger said myths about the vaccine's safety persist thanks to outdated or incomplete information, or outright misinformation. For example, she said there is zero risk of catching influenza from the injected vaccine because it contains no live virus. The vaccine takes up to two weeks to be protective, so you could be infected or catch another virus that is circulating at the same time.

Similarly, Saxinger noted the risk of developing Guillain-Barré syndrome-an immune disorder that can occur after infections and causes paralysis-is much lower after getting the flu vaccine than after getting the flu.

Some people worry about the non-medicinal ingredients in vaccines, such as formaldehyde and aluminum, which are used to keep the vaccine stable or boost the immune response. Saxinger said they may sound frightening, but only miniscule amounts are used and most occur naturally in the body in higher amounts.

Vaccines have among the highest levels of testing, safety and monitoring of all modern medical interventions, she said.

"If people don't trust the safety of vaccines, I actually don't see how they could trust any medical intervention or treatment," she added.

There's a long list of people who shouldn't get the flu shot

False.

Saxinger said it's a very short list. People with a severe egg allergy can get the vaccine, but those with a previous severe influenza vaccine reaction should be reviewed by Public Health and likely should not have a further dose.

Those you might think of as medically vulnerable-seniors, pregnant women and people with chronic conditions or illnesses such as diabetes or cancer-are encouraged to get the vaccine because influenza can be so harmful for them.

Unless everyone gets immunized we can't stop a flu outbreak anyway

True.

Alberta has purchased enough doses to immunize 35 per cent of the population, up from 31 per cent last year and 29 per cent the year before.

"We won't get rid of influenza completely because the virus is too intelligent and the vaccine isn't perfect," Saxinger said, "but we can reduce the spread within our community and have a really low-impact influenza year."

I'm healthy, so even if I do get the flu, it's not that big a deal

False.

Saxinger estimated that up to 10 per cent of the total population will come down with the flu in a typical year, but in some closed environments such as a workplace or school, almost everyone can get sick.

Symptoms include a cough, fever and aches. H1N1 tends to strike hardest for otherwise healthy adults, including pregnant women, whereas H3N2 usually affects the very young and the elderly more.

Saxinger has had both strains-she always gets the shot but gets intensive exposure working in hospitals-and reports they are clinically indistinguishable.

"Most people cannot function with influenza; it's quite different from a cold," she said. "They're home for at least a couple of days, and on average it's five days of being down for the count and 10 days of illness.

"There's a loss of productivity, there are child-care issues-all unnecessary if you reduce your risk to a reasonable degree by getting vaccinated," she said.

"Some people feel the flu doesn't impact them and it's not necessary to get vaccinated. But I would argue this might be the year where it would impact you, so why not stop by and get the shot?"

Learn more about how to get a free influenza vaccine on the U of A's north campus.