October not only rolls out the colored leaves, apple picking, and pumpkin carving, but it is the start of the annual flu season, which runs through March.

The flu, or influenza, is a viral respiratory illness of three types: A, B, and C, causing few (C) to severe symptoms. A genuine case of the flu will not be confused with other respiratory illnesses. High fever, a feeling of exhaustion, severe body and headaches, and an extremely sore throat with runny nose add up to symptoms that make suffering with the flu feel like a dance with death. Unfortunately, between 3,000 and 49,000 people in the United States do die from flu-related illnesses every year, according to the Centers for Disease Control and Prevention (CDC).

Incidences of the flu tend to be spotty through late fall and early winter, but will pick up a full head of steam by the time January and February roll around.

The best way to avoid the flu, say many doctors, is to get the flu vaccine. It is a subject that is not so cut and dried. Every flu season, some people warn against overvaccination of the population and fear life-threatening reactions. Others promote the vaccine, noting that even though the standard vaccination is a scientific guess at the most likely viruses to afflict the population in a season, it saves lives and reduces the incidences of influenza.

Hundreds of researchers in 100 countries test thousands of viruses each year, sending the most likely viruses to five World Health Organization (WHO) Collaborating Centers for Reference and Research on Influenza. The WHO ultimately determines the makeup of the next flu vaccine.

Different types of flu shots, for people of different ages and needs, are available every year, including nasal sprays available for most people between 2 years and 49 years of age, and those that are egg-free. The CDC recommends that anyone over the age of 6 months be vaccinated against the flu, including pregnant women and the elderly. The majority of people who die from the flu are over age 65.

There are people who should not receive the flu shot, as the risks outweigh the benefits. The CDC states, “People with severe, life-threatening allergies to flu vaccine or any ingredient in the vaccine,” including eggs, gelatin, and antibiotics, should not get a flu vaccine, or should defer to his or her doctor’s recommendations. The CDC also suggests that anyone with a history of Guillain-Barré syndrome avoid the flu vaccine. Those with compromised immune systems should also confer with health care givers on whether or not to receive the flu vaccine.

There may be mild side effects to any flu shot, including headache, soreness at the site of the injection, a low fever, and some tiredness. The History of Vaccines report from the College of Physicians in Philadelphia stresses that serious side effects are extremely rare, and that there are more serious risks associated with not getting the vaccine.

People do refuse immunization against influenza for religious reasons, as well as due to personal beliefs.

The argument of natural immunization comes up when weighing the decision to vaccinate or not to vaccinate. The College of Physicians notes that “In some cases, natural immunity is longer-lasting than the immunity gained from vaccination. The risks of natural infection, however, outweigh the risks of immunization for every recommended vaccine.”

For some, there is a fear that side effects can result in long-term health issues.

The use of the mercury-based preservative Thimerosal in vaccines is of concern to some. The CDC states, however, that “Since 2001, no new vaccine licensed by FDA for use in children has contained Thimerosal as a preservative, and all vaccines routinely recommended by CDC for children younger than 6 years of age have been Thimerosal-free, or contain only trace amounts of Thimerosal, except for some formulations of influenza vaccine. The most recent and rigorous scientific research does not support the argument that Thimerosal-containing vaccines are harmful.”

Research also indicates that there is no connection between Thimerosal and autism. Symptoms of autism can appear at approximately the same age that children are immunized.

Less Invasive Options

Dr Shawn Carney is a naturopathic doctor at Northeast Natural Medicine in Newtown. There are less invasive things than getting the flu shot that the general population can do, he said, to prevent the flu.

The job of vaccines, including the flu vaccine, is to provoke the immune system response. His concern is the increase in autoimmune system diseases, one of which is autism, in recent years. People are not tested for, or even asked about, autoimmune system issues prior to getting the flu shot, he said.

“If my goal is good health, introducing things that are dangerous for the body to be exposed to is not wise,” Dr Carney said. Augmenting the body for good health is preferable.

He recommends the use of vitamins C and D, and zinc to support the immune system. The herb astragalus, echinacea, and golden seal are some of the botanicals available to have on hand, as is lauricidin (monolaurin), found in breast milk and coconut milk.

Taking these supplements, especially at the onset of any flulike symptoms, can “knock things back,” Dr Carney said, and put the odds in one’s favor.

Staying on top of hand washing during flu season is important, as well, he said.

Should the flu be contracted, “Consult a doctor,” Dr Carney recommended.

“Now you are actively involved in trying to restore health,” he said. He provides testing to determine the causative agent of the symptoms, he said, and prescribes based on those results.

“My overall approach is: How can we best restore health?” said Dr Carney.

There are vaccines that Dr Carney believes are of great benefit and that make sense for certain populations. Because of what he sees as a low success rate with the flu vaccine and associated injuries,

“The flu vaccine,” he said, “is not one I find myself recommending.”

Have An Open Mind

Other doctors place more value on the flu vaccine. Dr Diane Wenick of The Danbury Medical Group and Dr Greg Dworkin, chief of pediatric pulmonary medicine at Danbury Hospital, recommend the seasonal flu shot to nearly all of their patients.

“If any [patients] ask, ‘Should I have the flu shot?’ I always say, ‘Yes, I think you should.’ If they have a high fever and miss a week of work in February, they would be quite unhappy if they did not get it. I strongly recommend it for my seniors and any patients with lung disease, heart disease, diabetes, or any underlying chronic illness,” said Dr Wenick. “This year, we are giving a high dose vaccine to all of my patients over 65,” she said, due to data showing that it is more protective to that age group.

Severe reactions to the flu shot are very unlikely, she said.

“There is an illness called Guillain-Barré syndrome, which can be very serious and it can be triggered by the vaccine,” she said, “but the flu itself can also cause this illness. It is actually more likely to occur from the flu than the flu vaccine,” Dr Wenick said.

Her practice hospitalizes with the flu patients every year, Dr Wenick said.

“Unfortunately, last year the flu vaccine was not very effective against the illness, but this year looks more promising that the vaccine matches the strain of flu that we are seeing. There is no shortage of vaccine this year,” she said, “so I strongly recommend it.”

The flu shot can trigger allergies, Dr Dworkin said,

“But it doesn’t just happen out of the blue. It is not likely to happen, even,” he said. He recommends the flu shot to all of his patients, from age 2 to 18.

There are special considerations, of course, said Dr Dworkin, and anyone with an illness or allergy about which he or she is concerned should talk to their doctor. He does not suggest the nasal flu vaccine for any of his lung patients between the ages of 2 and 4, especially if the child has asthma.

Other than the nasal flu vaccine, Dr Dworkin said the vaccines do not contain live virus.

“You cannot get the flu from these. It is ‘unpossible,’” he said. Nor should patients fear perceived threats from Thimerosal. “Thimerosal is not in every flu vaccine. Science and the American Academy of Pediatrics do not believe Thimerosal has anything to do with causing autism or other negative responses,” Dr Dworkin added.

“Even if you are totally healthy, if you get the flu, you can get very sick,” he pointed out. “We’d rather prevent [the flu]. When in doubt, talk to your doctor,” and go into the discussion with an open mind, he suggested.

“I can think of no benefits of getting the flu; and the flu vaccine can reduce the chance of getting the flu,” Dr Dworkin said.

Herd protection, in which many in a community are immunized, offers some protection to those who choose not to or cannot be vaccinated, but should not be counted on for avoiding this seasonal illness.

The CDC concludes that “flu vaccination benefits public health, especially when the flu vaccine is well matched to circulating flu viruses.”

Whether or not to get the flu vaccine, and whether to get the jump on the flu season now, by vaccinating against the influenza virus, or wait for National Influenza Vaccination Week (December 6-12), is a decision best made by patients and their doctors.