Caregivers, Healthcare Workers, and Patients Up in Arms Against the Flu

Coauthored by Sean Fischer, MD

While Labor Day signals the ceremonial end of summer, the autumnal equinox, which falls on Sept. 22, is considered to be the first day of fall for countries in the Northern Hemisphere. Along with days getting shorter and leaves turning colors, the first days of fall are also often heralded by announcements from the Center for Disease Control (CDC) to get your flu shots.

Photo courtesy of Whitney “Honey” Wasden. Special thanks to Connie Reeves-Campbell, Founder of the San Diego Brain Tumor Foundation

Family caregivers, care partners, community volunteers, and healthcare providers from the 2018 San Diego Brain Tumor Foundation Walk who have received or pledged to receive flu shots to protect cancer survivors. Cancer survivors are in the middle of the picture wearing their gray (for brain cancer) survivor shirts.

According to the CDC,¹ people diagnosed with cancer are more likely to get serious flu-related complications if they get sick with flu. The table below presents the groups of people at high risk for developing flu-related complications. The other group of people who should receive flu vaccination are “persons who live with or care for persons at higher risk for influenza-related complications,”² in other words, the caregivers.

For many of us who care for people who are at risk for serious complications from the flu, getting the flu shot means doing our part to protect them from harm. While some patients stay home to avoid unnecessary crowds and public spaces, there is a chance that we, who are out and about, may spread the virus from being around other sick people.

In the United States, the flu season typically occurs in the fall and winter seasons with the peak often reported between December and February. The 2017-2018 season which started early in November, was the first season to be classified as high severity across all age groups. A total of 180 pediatric deaths had been reported to CDC during that time; and approximately 80% of these deaths occurred in children who had not received a flu vaccination for the season.³ The CDC recommends receiving the flu shot by the end of October. It takes about 2 weeks after receiving the shot for the antibodies to develop; these antibodies provide protection against the influenza virus.

It is also important to mention that the flu vaccine cannot cause flu illness. Flu shots are made with inactivated (killed) viruses, recombinant vaccines (proteins from the virus instead of the flu vaccine virus), or attenuated (weakened) viruses that cannot cause flu illness. Some people complain of getting sick after getting the flu shot--which may most likely be from other respiratory viruses. We are as likely to get the common cold when we receive the flu shot as we would be if we had not received the flu shot. The flu vaccine only protects against influenza. We may remember getting the flu shot when we catch a cold a few days later, and we tend to connect the two events in our minds. The fact is that study after study show less than minimal risk from the flu shot.

The holidays and the cold weather associated with fall and winter seasons can be stressful. No one wants to be sick during the holidays. So get your flu shot soon to spend less time worrying about being sick during the flu season and more time celebrating the holiday season.

At the 2018 San Diego Brain Tumor Foundation Walk, president and executive director of the San Diego Brain Tumor Foundation Connie Reeves Campbell discussed the importance of getting the flu shot with a group of family caregivers, care partners, community volunteers, and healthcare providers. Many have already received the seasonal flu shot and those who have yet to receive pledged that they will get it, to protect the family members who may are receiving cancer treatment or are cancer survivors. This is a great example of patient and family-centered care and community-academic partnerships working to improve outcomes.

Table: People at High Risk of Developing Flu-Related Complications

--Children younger than 5, but especially children younger than 2 years old

--Adults 65 years of age and older

--Pregnant women (and women up to two weeks postpartum)

--Residents of nursing homes and other long-term care facilities

--American Indians and Alaska Natives seem to be at higher risk of flu complications

--People who have medical conditions including:

• Asthma
• Neurological and neurodevelopmental conditions (including disorders of the brain, spinal cord, peripheral nerve, and muscle such as cerebral palsy, epilepsy [seizure disorders], stroke, intellectual disability, moderate to severe developmental delay, muscular dystrophy, or spinal cord injury)
• Chronic lung disease (such as chronic obstructive pulmonary disease [COPD] and cystic fibrosis)
• Heart disease (such as congenital heart disease, congestive heart failure and coronary artery disease)
• Blood disorders (such as sickle cell disease)
• Endocrine disorders (such as diabetes)
• Kidney disorders
• Liver disorders
• Metabolic disorders (such as inherited metabolic disorders and mitochondrial disorders)
• Weakened immune system due to disease or medication (such as people with HIV or AIDS, or cancer, or those on chronic steroids)
• People younger than 19 years of age who are receiving long-term aspirin therapy
• People with extreme obesity (body mass index [BMI] of 40 or more

Centers for Disease Control and Prevention (CDC), National Center for Immunization and Respiratory Diseases (NCIRD) website. cdc.gov/flu/about/disease/high_risk.htm. People at High Risk of Developing Serious Flu-Related Complications. Updated August 27, 2018. Accessed September 18, 2018.

About the Co-author

Sean A. Fischer, MD, completed his hematology and medical oncology fellowship at Georgetown University Hospital in Washington, DC, where he was the chief fellow. Fischer is an active member of the American Society of Clinical Oncology and the American Society of Hematology, as well as other professional societies, and has been listed in Best Doctors in America and Los Angeles Super Doctors.

References

• Centers for Disease Control and Prevention (CDC), National Center for Immunization and Respiratory Diseases (NCIRD) webpage cdc.gov/flu/about/disease/high_risk.htm. People at High Risk of Developing Serious Flu-Related Complications. Updated August 27, 2018. Accessed September 18, 2018.
• Grohskopf LA, Sokolow LZ, Broder KR, Walter EB, Fry AM, Jernigan DB. Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2018—19 Influenza Season. MMWR Recomm Rep 2018;67(No. RR-3):1–20. DOI: dx.doi.org/10.15585/mmwr.rr6703a1
• Centers for Disease Control and Prevention (CDC), National Center for Immunization and Respiratory Diseases (NCIRD) webpage cdc.gov/flu/about/season/flu-season-2017-2018.htm. Summary of the 2017-2018 Influenza Season. Updated August 31, 2018. Accessed September 18, 2018.