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Should cancer patients get a flu shot? Yes, and caregivers, too

Flu shot
It’s the height of flu season, and medical professionals are advising cancer patients, and those who spend time with them, to get the flu vaccine. Find out why.

We’re at the height of flu season, but that doesn’t mean it’s too late to get a flu vaccine. In fact, though influenza viruses are typically most active during fall and winter, the dreaded season has been known to stretch to May, according to the U.S. Centers for Disease Control and Prevention (CDC). The agency estimates that between Oct. 1 and Dec. 7, between 2.6 million and 3.7 million people in the United States had the flu, and up to 3,300 of those patients died as a result.

The CDC defines the flu, short for influenza, as a “contagious respiratory illness caused by influenza viruses that infect the nose, throat, and sometimes the lungs. It can cause mild to severe illness, and at times can lead to death.” Because cancer patients may be more susceptible to the virus, medical professionals strongly advise them, and those who spend time around them, to get the flu vaccine.

“Cancer patients are particularly vulnerable because they’re immunocompromised when they get chemotherapy or radiation,” says Mashiul Chowdhury, MD, Infectious Disease Program Director at Cancer Treatment Centers of America® (CTCA). “If they get the flu, it can lead to pneumonia or overwhelming sepsis. A person who is not immunocompromised may get the flu and eventually recover, but for cancer patients, the flu may result in very serious complications. We need to make sure they get their flu shot.”

Despite some claims to the contrary, Dr. Chowdhury stresses that the flu vaccine is not a live virus and cannot give you the flu. There’s also no truth, he says, to misconceptions that the vaccine’s effectiveness won’t last the entire flu season. “The vaccine provides protection for up to one year, and there’s a mistaken notion that if you get vaccinated early, the effectiveness will wear out,” he says. “Even if you get vaccinated in August or September, the effectiveness will run through the season.”

Who should get vaccinated?

With few exceptions, the CDC and the American medical community recommend everyone aged 6 months and older get vaccinated. Those aged 65 or older, as well as infants, young children and immunocompromised individuals, like cancer patients, are especially susceptible to the virus, he says. Other high-risk groups include pregnant women and people with a chronic illness (like diabetes or asthma, for example).

“These are the ones who get complications and whose influenza may be very severe because their immune systems are not as strong,” Dr. Chowdhury explains.

Equally as important is that caregivers, medical personnel and others who spend time around cancer patients, babies or people 65 or older, receive the vaccination.

Alaska Natives and American Indians are also at an increased risk and are advised to get vaccinated. Statistically, the two groups are more likely than other races and ethnicities to get seriously ill from the flu, and possibly die as a result, according to the U.S. Indian Health Service. The reason isn’t clear, but experts suspect that “social and economic factors that often result in reduced access to health care and crowded living conditions” play a role.

Who shouldn’t get it?

According to the CDC, the only people who should avoid the flu shot are those who have had a severe allergic reaction to it in the past.

Much discussion often revolves around the vaccine’s effectiveness for a given year. Last year’s efficacy, for example, was poor, at about 29 percent, because one of the flu strains was not covered, according to Dr. Chowdhury, who notes that the effectiveness is typically more in the range of 50 percent to 60 percent. But he cautioned against letting those numbers persuade you to skip the vaccine.

“There’s no other effective, preventive technology that comes close, other than personal hygiene,” he says. “It’s just not there at this time. Not even close. It’s a risk-benefit equation. Should I get something that’s 50 percent effective or nothing at all? I’ll take 50 percent.”

In addition to the flu vaccine, the pneumococcal vaccine is recommended every five to six years for individuals aged 65 and older, patients with certain health conditions and all cancer patients. A high-dose flu vaccine  may be recommended for certain populations when the response to the regular flu vaccine is not as robust, Dr. Chowdhury added. A high-dose flu shot, according to the CDC, contains up to four times the amount of antigen, or the inactive virus that promotes the immune system’s protective response, as a regular flu shot.

Dr. Chowdhury cautions that cancer patients, and their caregivers and loved ones, should do their due diligence during flu season. “Cancer patients should be educated about flu etiquette,” he says. “Avoid crowded places. Avoid people who are sneezing or coughing. And do a lot of handwashing. Hand hygiene is important. It can be done with soap and water or with alcohol. What matters is that it’s done properly.”

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