Flu and pneumonia jabs.

[arthwollipot]

Originally Posted by Capsid

Influenza is different each year due to the way the virus can reassort its 7 segmented genes rather than due to mutation. Once inside its host it can mix its genes with other flu strains so a pig flu can mix with a bird flu etc. Mutations do occur but they are usually small changes and not the reason for the seasonal variation.

Each year the seed strains are selected based on what is circulating around the globe (this is monitored); for northern hemisphere vaccine, the strains arriving from the southern hemisphere are identified (and vice versa I think). A committee sits to decide what each strain should be included in that year's vaccine. A new vaccine is made and licensed every year.

I've had the vaccine every year for the last 20 years.

Originally Posted by Skeptic Ginger

It's not correct.

Flu virus is continually being sampled around the world. Based on the RNA analysis the WHO recommends which strains to include in the vaccine twice a year, one for the northern hemisphere and 6 months later for the summer hemisphere and so on.

It is true that the vaccine production starts 6-9 months before the influenza season. Because of that, the strains that actually do circulate can differ from the vaccine strains.

On average, flu virus strains have about an 18 month cycle, but the range is wide and ever under new influences. With no other variables, a strain will infect a susceptible population. By the second season go round, fewer people are susceptible, and newer strains have more potential hosts. By the next season new strains will dominate and the strain from 18 months ago will fade out.

Then there are all the variables: recombinant strains, new strains emerging from animal hosts, vaccine effectiveness can affect a strain's chances of being dominant that year, world travel, population migration and so on.

So there is no guarantee we'll get it right every time. But the idea it's a guess or simply last year's strains is not correct.

Thanks both for the clarification.

My arm was sore for a bit over 24 hours. I got no other side effects, not even the mild flu-like symptoms that they said I might get.

[Skeptic Ginger]

Originally Posted by arthwollipot

...I got no other side effects, not even the mild flu-like symptoms that they said I might get.

At least one placebo controlled study found flu vaccinations in adults caused no more 'flu-like' symptoms than placebo. In children it is more common, and though it probably does occur rarely in adults, the belief flu vaccinations cause 'flu-like' symptoms is mostly myth.

We give flu vaccinations during peak upper respiratory infection season. The vast majority of the time, people erroneously blame the cold they got near the time of their flu shot on the vaccine.

A mild sore arm is a tad more common.

[arthwollipot]

Originally Posted by Skeptic Ginger

At least one placebo controlled study found flu vaccinations in adults caused no more 'flu-like' symptoms than placebo. In children it is more common, and though it probably does occur rarely in adults, the belief flu vaccinations cause 'flu-like' symptoms is mostly myth.

We give flu vaccinations during peak upper respiratory infection season. The vast majority of the time, people erroneously blame the cold they got near the time of their flu shot on the vaccine.

A mild sore arm is a tad more common.

That makes sense. The pharmacist told me that it might happen anyway.

My arm was quite sore for that 24 hours, but it was the good kind of sore - the kind of sore you get after a good workout. A wholesome kind of sore that you know is well-earned, and for good reason.

[Planigale]

Originally Posted by arthwollipot

Especially since the virus strain is different every year. Even if you had been exposed to one strain last year, it doesn't mean that you won't be exposed to, and infected by, a different strain this year.

Perhaps Skeptic Ginger can confirm or deny this tidbit of information that I heard somewhere:

Because the influenza virus mutates so quickly, no-one knows exactly what strain will be prevalent in any given year. So they hedge their bets by vaccinating against last year's strain. This is one reason why the flu vaccine is less effective than some other vaccines that protect against less-quickly-mutating viruses.

The development of the flu vaccine every year is an amazing process. Each year the 'world' meets to decide what to put in the flu vaccine, (actually twice a year once for winter in each hemisphere), they review emerging strains from global spotter sites; China is a likely source of new flu strains. They also look at what happened over winter in the Southern hemisphere (or vice versa). Then each country will put in an order for flu vaccines; each vaccine is usually against two flu A and one flu B strain. The companies then have a matter of months to develop test and manufacture millions of doses of flu vaccine. The vaccine is not just against last years strains but against what is predicted to be circulating, as people become immune to circulating strains they become less prevalent.

As said the immune response is strain specific so new strains evoke a poor immune response in general there is a drift due to small mutations so there is some underlying immunity. What is looked out for is a jump in the flu genetics due to recombination of strains that produce a flu to which there is no immunity these are the pandemic strains (actually they may be old strains that circulated a generation ago that no one now alive is immune to).

[Planigale]

Originally Posted by Modified

Unless they are throwing up due to coughing fits, it's not the flu.

If you have what feels like a cold, but with body aches and significant fatigue, it's probably flu. I always know when I get sore from a workout that shouldn't have made me sore, then later that day my adenoids will become inflamed - it always starts there. I've had it three times in the last 20 years (twice confirmed).

This is not true. Throwing up due to coughing fits is most likely to be adult whooping cough. Cough is not a big feature of flu.

The rest of what you posted fits with flu.
Flu causes an abrupt onset (going from well to feeling really unwell in hours) illness. With high fever (> 38C) shivers and sweats, there is usually profound muscle ache and fatigue. Cough is usually a minor part, there may be GI upset but this is rare. It may progress to pneumonia with breathlessness and death within days (but hopefully not).

Runny noses, coughs, sore throat are usually rhinovirus, coronavirus, adenovirus all the things that cause colds.

[Skeptic Ginger]

Originally Posted by Planigale

... Cough is not a big feature of flu... Cough is usually a minor part, there may be GI upset but this is rare.....

Where did you get this idea?

In humans, influenza viruses replicate in the ciliated epithelium of conducting airways (15), which consists of several distinct cell types with different functions (16).

Cough is a common feature in flu.

Sudden onset, high fever, muscle aches and headache, anorexia which can include nausea and vomiting, and cough are classic flu symptoms.

It's a respiratory infection, more often centered in the trachea rather than just the pharynx.

[Agatha]

So-called "gastric flu" is not influenza, it's a stomach bug/something you've eaten.

You can be sure you have real flu if there is a briefcase with a million pounds/dollars just out of reach, and you feel too ill to get to it. Anything less is a bad cold.

I am immunosuppressed because of the drugs I am prescribed to control my Crohn's disease, so I get the flu jab every year and have had the pneumonia jab too, which gave me a sore arm for a few days.

[Dr. Keith]

Originally Posted by lionking

Meanwhile the swelling has almost gone. Still a little tender, but not so bad.

That really kills the momentum of the thread. Maybe tomorrow you could say you were posting from the hospital with only one hand. I trust you to fill in the gaps creatively, just not too many ducks or whales. I can never keep those two straight.

[Modified]

Originally Posted by Skeptic Ginger

Cough is a common feature in flu.

I get the worst coughs during recovery, when the throat seems to be itchy from healing.

Quote:

Sudden onset, high fever

That's where I'm weird. I haven't had a measured temperature over 99 F in 30 years, despite flu, strep, etc. The last time was during a severe strep infection where I had fevers that reached 106 F for a few hours each day, for four or five days in a row. I think that broke my fever mechanism somehow.

[Planigale]

Originally Posted by Skeptic Ginger

Where did you get this idea?

In humans, influenza viruses replicate in the ciliated epithelium of conducting airways (15), which consists of several distinct cell types with different functions (16).

Cough is a common feature in flu.

Sudden onset, high fever, muscle aches and headache, anorexia which can include nausea and vomiting, and cough are classic flu symptoms.

It's a respiratory infection, more often centered in the trachea rather than just the pharynx.

I was responding to a post that said it was not flu unless you get a severe spasmodic cough that made you retch. I did not say you do not get cough, but that it was not the dominating symptom. The dominating feature in flu is abrupt onset fever fatigue muscle aches and head ache in contrast to the common cold where runny nose and cough and feeling a bit miserable are the dominating symptoms. Yes you do cough and sneeze. Yes it is a respiratory virus. It certainly effects the airways into the lungs (indeed this is the crucial event in transfer from birds to mammals - in birds flu is a intestinal illness, the flu virus has to develop a mutation allowing it to bind to mammal airways to jump from birds to mammals where it becomes a respiratory infection.

[Skeptic Ginger]

Originally Posted by Dr. Keith

That really kills the momentum of the thread. Maybe tomorrow you could say you were posting from the hospital with only one hand. I trust you to fill in the gaps creatively, just not too many ducks or whales. I can never keep those two straight.

[Modified]

Originally Posted by Planigale

I was responding to a post that said it was not flu unless you get a severe spasmodic cough that made you retch.

Except that what I said was: if you are vomiting, then it probably isn't the flu unless the vomiting is due to coughing fits. Though apparently flu can directly cause nausea and vomiting, which is news to me.

[Skeptic Ginger]

Originally Posted by Modified

Except that what I said was: if you are vomiting, then it probably isn't the flu unless the vomiting is due to coughing fits. Though apparently flu can directly cause nausea and vomiting, which is news to me.

Influenza causes GI upset, anorexia accompanied by nausea and vomiting. The problem arises when people refer to GI infections, most often caused by noro viruses, as the stomach flu, which is unrelated to influenza virus.

[Modified]

Originally Posted by Skeptic Ginger

Influenza causes GI upset, anorexia accompanied by nausea and vomiting.

It never has for me, except for loss of appetite. Then again, almost nothing makes me nauseated.

[lionking]

For those who are saying they never get the flu, don't be too smug. That described me into my 40s. In recent years I get it about once a year.

[arthwollipot]

You get influenza yearly? That's harsh.

[psionl0]

Originally Posted by lionking

For those who are saying they never get the flu, don't be too smug. That described me into my 40s. In recent years I get it about once a year.

Thanks for making me feel like a young whippersnapper.

If have already said that I will start taking injections if my status warrants it in the future.

In the mean time, here is a question for the (internet) experts: Can I be a carrier of the influenza virus and pass it on to others even if I don't have the flu? Is this changed if I have the inoculations?

[lionking]

Originally Posted by arthwollipot

You get influenza yearly? That's harsh.

It seems that way. I don't keep a diary of it. I know I had it last year, and it was suspected of being pneumonia. I know I had it in 2014. Maybe once every two years.

[Dr. Keith]

Originally Posted by lionking

It seems that way. I don't keep a diary of it. I know I had it last year, and it was suspected of being pneumonia. I know I had it in 2014. Maybe once every two years.

It's admirable that you continue posting with one arm from the hospital after all you have been through. How's the autism coming along?

[lionking]

Originally Posted by Dr. Keith

It's admirable that you continue posting with one arm from the hospital after all you have been through. How's the autism coming along?

Is it a problem that I have just lost my eyebrows?

[casebro]

In defense of my thought processes as quibbled over above:

1) the OP subject IS about the flu jab.

2) I use deaths in most of my comparisons because they are absolute data. No "I think I had the flu", no muddling by what is bad enough for hospitalization. You can take my comparison and extrapolate to any level you want.

3) Comparative risk is much more valuable to an individual than relative risk. Relative risk says the flu vaccine is good for the world, but LK is the one that suffers the side effects. He needs to take comparative risk into consideration. Of course his consideration must include his own personal susceptibility to pneumonia, which was not mentioned until way later in this thread.

I've muddled bout in genes enough to know that we are all unique. We can't each assume that what is good for the over all population is good for ourselves. SG, how many times have you said to a patient, or thought to your self "lets try this, and see how it works for you"? You must be familiar with CYP2D6 enzyme, and how it's variations cause variations in the function of about 25% of medications.

My own health as the example on which I base my logic- I do have a genetic metabolic problem, AMPD1 deficiency. It makes my muscle sore ALL THE TIME. So on the one hand I make sure to get the flu vaccine, I don't need more soreness. On the other hand, I can't take statins. They seem to give muscle soreness to about 20% of people, and just kill me.

[Dr. Keith]

Originally Posted by lionking

Is it a problem that I have just lost my eyebrows?

No, this could work. Go on . . .

[casebro]

Originally Posted by lionking

Is it a problem that I have just lost my eyebrows?

Probably not. But talk to the Doc if one testicle is bigger than the other two.

[Skeptic Ginger]

Originally Posted by casebro

In defense of my thought processes as quibbled over above:....

3) Comparative risk is much more valuable to an individual than relative risk. Relative risk says the flu vaccine is good for the world, but LK is the one that suffers the side effects. He needs to take comparative risk into consideration. Of course his consideration must include his own personal susceptibility to pneumonia, which was not mentioned until way later in this thread.

I've muddled bout in genes enough to know that we are all unique. We can't each assume that what is good for the over all population is good for ourselves.

With the exception of people with conditions the flu vaccine is contraindicated for, very large population studies tend to turn up risks that can be applied to the population at large.

When it comes to risk/cost of vaccinating vs benefit/risk of not vaccinating, the calculation applies to individuals as well as to the population as a whole. We are not all that unique.

Originally Posted by casebro

...SG, how many times have you said to a patient, or thought to your self "lets try this, and see how it works for you"? You must be familiar with CYP2D6 enzyme, and how it's variations cause variations in the function of about 25% of medications.

My own health as the example on which I base my logic- I do have a genetic metabolic problem, AMPD1 deficiency. It makes my muscle sore ALL THE TIME. So on the one hand I make sure to get the flu vaccine, I don't need more soreness. On the other hand, I can't take statins. They seem to give muscle soreness to about 20% of people, and just kill me.

I don't find this relevant. There are people for whom the flu vaccine is contraindicated.

[lionking]

Originally Posted by casebro

In defense of my thought processes as quibbled over above:

1) the OP subject IS about the flu jab.

2) I use deaths in most of my comparisons because they are absolute data. No "I think I had the flu", no muddling by what is bad enough for hospitalization. You can take my comparison and extrapolate to any level you want.

3) Comparative risk is much more valuable to an individual than relative risk. Relative risk says the flu vaccine is good for the world, but LK is the one that suffers the side effects. He needs to take comparative risk into consideration. Of course his consideration must include his own personal susceptibility to pneumonia, which was not mentioned until way later in this thread.

I've muddled bout in genes enough to know that we are all unique. We can't each assume that what is good for the over all population is good for ourselves. SG, how many times have you said to a patient, or thought to your self "lets try this, and see how it works for you"? You must be familiar with CYP2D6 enzyme, and how it's variations cause variations in the function of about 25% of medications.

My own health as the example on which I base my logic- I do have a genetic metabolic problem, AMPD1 deficiency. It makes my muscle sore ALL THE TIME. So on the one hand I make sure to get the flu vaccine, I don't need more soreness. On the other hand, I can't take statins. They seem to give muscle soreness to about 20% of people, and just kill me.

Did you actually read the OP? The side effects had nothing to do with the flu jab.

[novaphile]

Hah! Just had my annual flu vaccine (thanks work)

However, weirdly for me, 24 hours have passed and I have had no response at all. (Usually I get the sore arm).

There was one year, where my response was terrible, so I phoned up CSL (the manufacturer here) and asked if I should report my symptoms.

They were very keen, and put me on to a person who went through a series of questions.

Once they were finished they said something like: "There were seven strains in this year's vaccine, and we are getting a lot more calls."

[Skeptic Ginger]

Originally Posted by novaphile

Hah! Just had my annual flu vaccine (thanks work)

However, weirdly for me, 24 hours have passed and I have had no response at all. (Usually I get the sore arm).

There was one year, where my response was terrible, so I phoned up CSL (the manufacturer here) and asked if I should report my symptoms.

They were very keen, and put me on to a person who went through a series of questions.

Once they were finished they said something like: "There were seven strains in this year's vaccine, and we are getting a lot more calls."

Where are you where they put seven strains in a dose? The max they use here is 4 and that only went up from 3 a couple years ago.

BTW, I've not seen any difference in side effects with 4 strains. I give ~600 doses or more a year.

[novaphile]

Adelaide, South Australia.

I could easily be mis-remembering the number, it was a long time ago.

I can think of one reason it could happen, we get a lot of visitors from Asia and Europe. I'll see if I can find anything about it online.

[arthwollipot]

Yeah, the one I got I think had three strains.

[novaphile]

Interesting, at least the last two years, mine has been marked as quadravalent...

[Skeptic Ginger]

Originally Posted by novaphile

Interesting, at least the last two years, mine has been marked as quadravalent...

Three strains was the standard formula until ~3-4 years ago. This year the drug manufacturers in the US for the most part switched to 4 strains in all formulations. There is also a high dose version for people 65 and older. Kid's 6mo to 3 years get 1/2 dose.

[stargazer0519]

Originally Posted by lionking

I had flu and pneumonia jabs the other day on different arms. I think it is pneumonia one that is causing me the most trouble. My arm is very sore and even causing numbness in my fingers. Is this a normal reaction?

I had an anatomy professor once who said that vaccines constituted sort of a mild challenge to the immune system.

She said she thought it was best to have vaccinations on different days. When her children were babies, she wouldn't let the pediatrician give her babies more than once vaccine per day. She'd split up the shots and go to a Monday/Wednesday/Friday schedule for, say, three different vaccines that were supposed to be given within the same month.

It was more trouble and expense, but she felt better about it.

Maybe, next year, do your flu and pneumonia shots on different days and you won't feel so bad.

[Skeptic Ginger]

Originally Posted by stargazer0519

I had an anatomy professor once who said that vaccines constituted sort of a mild challenge to the immune system.

She said she thought it was best to have vaccinations on different days. When her children were babies, she wouldn't let the pediatrician give her babies more than once vaccine per day. She'd split up the shots and go to a Monday/Wednesday/Friday schedule for, say, three different vaccines that were supposed to be given within the same month.

It was more trouble and expense, but she felt better about it.

Maybe, next year, do your flu and pneumonia shots on different days and you won't feel so bad.

The 'spread the vaccines out' hypothesis has been debunked.

[luchog]

Originally Posted by arthwollipot

You're confusing possession of a functional immune system with actual literal immunity. The fact that you have a working immune system does not confer 100% guaranteed immunity to any damn thing. A person can get chicken pox twice in their life, and I know people that has happened to.

Including me. I've had it twice in my life, a mild case when I was about seven years old, and a severe case when I was twenty-five. In the latter, I really should have been hospitalized for it, but wasn't thanks to the fact that I was still living at home with my religious fanatic parents. That was quite possibly the worst week of my life.

Originally Posted by Skeptic Ginger

So there is no guarantee we'll get it right every time. But the idea it's a guess or simply last year's strains is not correct.

And even if they get it wrong, oftentimes the strains are similar enough that the vaccine provides at least partial protection, reducing the severity of symptoms or giving the immune response a slight "head start".

Originally Posted by Skeptic Ginger

Three strains was the standard formula until ~3-4 years ago. This year the drug manufacturers in the US for the most part switched to 4 strains in all formulations.

I've had the quadrivalent every year for the last five, as soon as it started to become available to people outside the high-risk groups.

I've had influenza several times in my life, one time when it progressed to full-blown pneumonia. That was the same year I had chicken pox, about 5 months after, so it's possible my immune system had not fully recovered.

[novaphile]

Originally Posted by luchog

I've had influenza several times in my life, one time when it progressed to full-blown pneumonia. That was the same year I had chicken pox, about 5 months after, so it's possible my immune system had not fully recovered.

You certainly have my sympathy.

The last time I had it, I ended up with Bell's Palsy about two weeks after recovering.

Half of my face was non-responsive for about 18 months, and I still have reduced functionality (and crossed wires*) now. At least I only had to tape my eye closed for the first week.

Yay for brain plasticity! But I really, really don't want to get the flu again.

*my right eye closes when I eat or drink.

[casebro]

Originally Posted by novaphile

You certainly have my sympathy.

The last time I had it, I ended up with Bell's Palsy about two weeks after recovering.

Half of my face was non-responsive for about 18 months, and I still have reduced functionality (and crossed wires*) now. At least I only had to tape my eye closed for the first week.

Yay for brain plasticity! But I really, really don't want to get the flu again.

*my right eye closes when I eat or drink.

So flu can get into particular nerves and cause problems? Like shingles? I've gotten a lazy eye the last few years, I wonder if it started with the flu back when? Or is it latent prob from a head injury to that side? It was my worst concussion, I needed an anti nausea shot that time.

[MuDPhuD]

Originally Posted by Skeptic Ginger

With the exception of people with conditions the flu vaccine is contraindicated for, very large population studies tend to turn up risks that can be applied to the population at large.

When it comes to risk/cost of vaccinating vs benefit/risk of not vaccinating, the calculation applies to individuals as well as to the population as a whole. We are not all that unique.

I don't find this relevant. There are people for whom the flu vaccine is contraindicated.

And that is the best argument for everyone else getting the vaccine. Yes, the individual benefit is quite small, (One might even calculate it is barely worth the sore arm) but when the population is largely immune, epidemics will be much less likely, and therefore the most vulnerable will be protected.

[Skeptic Ginger]

Originally Posted by MuDPhuD

And that is the best argument for everyone else getting the vaccine. Yes, the individual benefit is quite small, (One might even calculate it is barely worth the sore arm) but when the population is largely immune, epidemics will be much less likely, and therefore the most vulnerable will be protected.

Preacher > meet choir.

Did you think I was objecting to herd immunity?

[novaphile]

Originally Posted by casebro

So flu can get into particular nerves and cause problems? Like shingles? I've gotten a lazy eye the last few years, I wonder if it started with the flu back when? Or is it latent prob from a head injury to that side? It was my worst concussion, I needed an anti nausea shot that time.

The best I can reply to this, is I don't think anyone knows...

The advice that I was given at the time was that Bell's palsy may be caused by a virus (where it is not caused by a physical injury), and that a number of viruses are implicated.

These include influenza and several kinds of herpes. So, in my case, could have been influenza (timing) or the cold-sore virus (herpes simplex type 1) getting away from the immune system because of the influenza.

I was immediately given steroids and some kind of anti-viral medication, but the Drs explained, that there was little evidence to support either assisting.

Still makes me very, very keen to get my flu shot every year.

[Skeptic Ginger]

Originally Posted by casebro

So flu can get into particular nerves and cause problems? Like shingles? I've gotten a lazy eye the last few years, I wonder if it started with the flu back when? Or is it latent prob from a head injury to that side? It was my worst concussion, I needed an anti nausea shot that time.

The current thought on many of these post-infection reactions is that they are some kind of immune over-response. Bell's Palsy is an inflammatory disease. But novaphile is right in that the syndromes are not yet fully understood.