Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
8 Dec

Dear Mark: Flu Shots

Flu ShotDear Mark,

I’m sure you know it’s gearing up toward flu season again, and the folks at work have started pushing for flu vaccination sign-ups.  I’m always a bit wary of Big Pharm and the “common knowledge” of what’s good for us (more so than ever since I first started reading MDA), so you’ll understand my hesitance in claiming my free shot. What’s your take on this issue?  Is it worth getting stuck, or am I better off left to my own healthy devices?

Thanks to Sarah for the timely question. You’re right that the ads and advice are everywhere this time of year. Some people rush to get their shots as soon as they’re released in early fall. Others swear them off. And then, I think, there’s a large group in the middle who waffle back and forth about the need for them.

Personally, I never get a flu shot, and neither does any member of my family. There are a number of reasons behind my decision. First, most years there is a poor match between the vaccine viruses and those that end up circulating in the general population. Secondly, there’s relatively little risk for healthy people. Though no one likes the flu, serious complications or death from it are rare. About 18,000 people die from the flu each year, and 75% of those people are 70 years of age or over. In many of the older people who succumb, it often comes down to overall health. The less healthy a person is at that age (because of lifestyle and ongoing/recent health conditions), the more likely he/she is to have a lack of “organ reserve,” not enough organ capacity remaining to handle basic metabolic needs plus those demands added by the flu (fever, etc).

Medical research on flu vaccine effectiveness shows very spotty results at best even among the two general population groups most heavily advised to receive the shot, the young and the old. This October a study in The Archives of Pediatrics and Adolescent Medicine didn’t find a decrease in hospitalizations or outpatient flu-related visits in young children receiving the vaccine during either of two studied flu seasons. In the case of older adults, there is less concern about safety issues, but recent research bolsters ongoing skepticism about the flu shot’s effectiveness. A study published in last August’s issue of The Lancet showed that flu shots, after adjusting for existing health conditions, didn’t reduce the risk for the most common flu-related cause of death, pneumonia.

Though public service messages now urge everyone to get the shot, this was not the traditional message. If you’re a healthy individual who is committed to taking care of himself/herself, I don’t think the shot is necessary or will do much if any good. A naturally strong immune system will identify a common flu virus and handle it effectively on its own. Left to its own devices, it does its thing pretty well. Though the situation might be different for those with compromised immune systems or even health care providers who work with sick patients every day, the flu shot likely won’t offer me as a healthy person much benefit for the negatives it imposes with the toxic preservatives used in the shots like aluminum and thimerosal. Sure, there’s a preservative-free flu shot in existence, but it’s in extremely short supply and is only given – when available – to infants and pregnant women. (In many areas there isn’t enough to even offer these groups the shot.) Though a relatively new FluMist vaccine option is available that doesn’t contain these additives, it’s made with a live virus and has additional safety concerns that limit who’s advised to use it.

If you decide to forgo the shot, know that there’s a lot you can do to keep your own natural immune response in great fighting form. Number one: cut out the foods that compromise the immune system the most – sugar and grains. Sure, whole grains don’t send your insulin levels skyrocketing in a nanosecond like sugar, refined flour, etc. do, but they still incite a significant (albeit slower) rise in insulin. When you eat zero-grain and low carb, you see that your immune system easily handles almost everything. It’s when you eat sugar and grain (especially in conjunction with high stress from work or exhaustive exercise routines) that your immune system can’t handle simple everyday viruses.

Unless you’re a sun god, be sure you’re supplementing with vitamin D every day during the winter months. There’s more and more news every day about the essential importance of D for immune function. And forget the current RDA of 400 I.U. I’d recommend 800 I.U.s a day for healthy adults and more for pregnant/nursing women. If a health condition compromises your immune system or if you take medications that interfere with the absorption of vitamin D, you should talk to your doctor about an appropriate daily dose.

Other ideas for boosting your immune function during flu season? I’d recommend what I see as the basic tenets for healthy living: a nutrient-rich, Primal diet; regular (but not exhaustive) exercise; good sleep; wise supplementation; and some kind of stress management routine. Some people (and even certain Northern cultures) swear by practices like saunas and cold water immersion. Finally, skip the hand sanitizers and lotions, and don’t go too crazy washing your hands. When you do wash, use plain old regular instead of anti-bacterial soap. Our skin, as we’ve said in the past, isn’t just a dead outer shell. It has its own chemical balance that provides a layer of protection against infectious agents.

Finally, if you take your chances and end up with the flu, take care of yourself. I know so many people who fight the simple idea of giving their bodies a break for real rest and recovery. They medicate their symptoms with every concoction on the market, keep going with most of their usual routine, and then wonder why they end up sicker. Call in every support, use every trick in the book, but figure out a way to give your body the break it needs.

If you decide to go for the flu shot, I’d suggest that extra antioxidants prior to the shot and in the days after would help your body weather (and release) the added toxins more effectively. Also, if you’re sensitive (or outright allergic) to eggs, you should know that the vaccine (both the shot and the FluMist varieties) is cultured in eggs. The risk of a major reaction would almost assuredly outweigh your risk for the flu (or at least any serious complications from it). I’ve heard from a number of people that occasionally health care providers shrug off the allergy concern and encourage the shot regardless. In these cases, I’d suggest seeking a second opinion – and probably a new provider!

Thanks as always for your questions and comments, and keep ‘em coming!

Further Reading:

Top 10 Ways to Make it Through the Flu Season

9 Natural Cold and Flu Remedies

Natural Alternatives to OTC Painkillers

10 Things You (Likely) Don’t Know About Your Immune System

theIFlife: Make Your Own Flu Shots… or Just Stay Healthy in the First Place.

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. I am 60 years old and to my memory, I have never even had a cold. (I will leave out my time from birth until about 4 years old, because I don’t remember). Maybe I am a little paranoid about the flu shot because I am never sick and I am now in that age group they call the elderly. I do not “wash” my hands at any sign of dirt, I get as close to sick people as I can, and if appropriate even kiss them. My immune system is either very strong because I don’t protect it, therefore it has to protect itself, or I just don’t get sick. Everyday that I have ever missed from work was a mental health day, (got tired of being there), although I had to call off with a lie and say I was sick with a cold, the flu, etc. I wasn’t. I once called off and they made me fill out a sick leave paper and give my diagnosis, and since I had not seen a doctor, I put down cancer. They asked me who told me I had cancer? I said, I did. They said we need a professional diagnosis. I said, ok, so if I said I had the flu you would not ask for a professional diagnosis, even though I know nothing about the flu or cancer? They said yes…I filed a grievance and won. Because once the employer admitted they would take my self diagnosis, the diagnosis was no longer relavent. So, no, I will not get a flu shot. Ok, a lot of crap just to say that huh? Robert

    Robert wrote on December 23rd, 2008
  2. As far as the “folks at work,” I completely understand where you’re coming from. I’m in the military and we were MADE to get our flu vaccinations or face penalty under the Uniform Code of Military Justice. Nice, right? I’ve never had an adverse reaction to the vaccination, though after reading about some of the startling ingredients in this stuff, I believe next year I’ll be standing in front of the “Old Man,” stating my position. Good post!

    Zach wrote on January 15th, 2009
  3. You people are crazy. I cannot believe what i am reading here. I MAKE myself get one every year because it works. And everyone is prone to the flu, does not matter how healthy you are and all that nonsense. Shoppong carts, doors knobs, tables at restaurants,etc. I have been a bartender for around 12 years now, and it has saved me every year. Would not go without it!! I have to touch dirty glasses form the top of the glass almost every nite, and i have been the ONLY one who has NOT been sick where i work, Because of this ridicilous myth that “it gets me sick”. If i hear this one more time i am going to scream.

    augustin wrote on January 24th, 2009
    • Questioning the wisdom of flu vaccines doesn’t make one crazy. In fact lots of very educated people who have looked into the issue choose not to get flu shots. I have had one that I remember, but don’t plan to do it again. If you are happy with your choice to get shots, that’s great. What one eats does, however, have a bearing on the discussion. Having a strong immune system is irreplaceable, and nutrition is a huge determinant of that. Actually allowing your immune system to grapple with disease is in fact important to keeping it functioning. (I am not against all vaccines under all circumstances, but flu is a fast-changing virus and scientists have to guess each year which virus will predominate and make their vaccines to match they one they hope will be dominant.) Beyond nutrition and a healthful lifestyle (rest, exercise, sunlight), common sense hygiene and cleanliness also help prevent the spread of disease. Touching dirty glasses isn’t really a risk unless you then stick your fingers in your eyes, mouth or nose.

      Jeanmarie wrote on August 28th, 2009
  4. This is for Augustin: How do you eat on a regular basis?

    Terrilee wrote on January 24th, 2009
  5. This is for Terrilee. How do i eat every nite? What kind of moronic response is that? Come on. This is not you tube for christs sake!! I USUALLY put whatever i happen to be eating at the time,on a fork, or some sort of eating apparatus, and use that. Does that answer your idiot question?

    augustin wrote on January 24th, 2009
  6. Augustin, I think Terrilee was inquiring about your diet, i.e. *how* you eat. Probably because this is a blog devoted to primal nutrition & health, and we take an interest things like diet’s relation to immunity, and modern medicine pushing “cures” on people that they may not need.

    Glad the flu vaccine has been working for you though. It’s too bad they don’t make a vaccine for having a bad attitude. =(

    Heather wrote on January 25th, 2009
  7. If i made that comment wrong by second guessing, i do apologize. Thought she was being a wiseguy. I am not a person with a bad attitude.So…..I eat rather poorly, but i do get my exercise and walking done.I do not like veggies, or fruit, that much.But i drink alot of milk, and v8 juice, to get my proper stuff.I dont drink or smoke by the way. Very happy about that. Very. Once again, my apologies to all.

    augustin wrote on January 25th, 2009
  8. Thanks Heather, I was asking about his diet.

    Terrilee wrote on January 26th, 2009
  9. Sorry Terrilee. My apologies.

    augustin wrote on January 26th, 2009
  10. Thank you for the apology, Augustin. Sorry for the snarky comment I made, I can be a little defensive about this blog as it’s one of my very favorites. No hard feelings. =)

    Heather wrote on January 30th, 2009
  11. I never understood what all the hype was about the flu shot, I am 48 and the last time I can even recall having a flu was probably around 13 or 14 years old and I never get the shot. I suppose if your older or very young it may be wise. This year because they were so adement about EVERYONE getting a shot my children got it for the first time….and guess what? All three of my children caught something…I,m not sure if it was the flu or just a viral thing going around as it only lasted 3-5 days but there was vomiting, high fever, chills and a nasty dry cough and very sore throat.I am still fine, as is my husband. I also know of two other people that have children that were inocculated and they all ended up sick…so I just don,t know what to say about these shots anymore!

    Karen wrote on March 19th, 2009
  12. I think the other side of this is that if everyone who is healthy gets vaccinated, they won’t get the flu and still be healthy enough despite it to walk around spreading and it and creating epidemics and giving it to people who have chronic illnesses that make the flu more severe and/or disqualify them from being able to receive the vaccine. It’s kind of a public service thing mentality, i guess. That said, I’ve never actually gotten one. Nor have I ever gotten influenza, that i know of.

    Karin wrote on April 2nd, 2009
  13. Dear Mark, I must put in my 2cents about Flu Shots. Last year I was convinced (by GP) because of my age, I needed a shot. One week exactly to the day I had body aches, chills & figured it was a Flu reaction. Wrong!! It was the Shingles. As far as I am concerned, I am putting the two together. Someday, they will figure it out. Flu shots, I think your advice of strengthening the immune is far superior. Thankyou Mark for everything you do & say.

    Elaine Damour wrote on May 18th, 2009
  14. I probably should knock on wood as they say because of what I am about too say. I am 61 years old and I have never even had a cold, much less the flu..I have never had a flu shot, as a matter of fact…I have never had a vaccination other than that the state forced my parents too get me before I was of age..I don’t remember most of them due too the young age…I only know about 10-12 people that have gotten the current types of flu shots, and every one of them 100 percent have gotten ill withing 24 hours…on guy got ill for two weeks after getting the vaccination and then two weeks later he got the flu..hell, I don’t know, but there seems too be a correlation here someplace.

    Robert wrote on May 18th, 2009
  15. For all you people you say you got the flu shot and something bad happened, here is one of the main concepts of epidemiology:

    “Association does not imply causation”.

    Just because something happened after the flu shot doesn’t mean the flu shot caused it. You don’t know if it wouldn’t happened anyway. This is why there are controlled studies.

    The other day, I had a salad for lunch and went to the gym after work. The next day I had a back strain. By your logic, the salad could have caused the sore back just because I did it before the injury.

    I’m not saying everyone should get a flu shot or that Big Pharma is God. I’m just issuing an appeal to logic over knee-jerk reactions against Conventional Wisdom

    J. wrote on May 25th, 2009
    • Thanks, J. I spend a lot of time trying to explain the difference between statistical evidence and anecdotal evidence. I wish our schools would do a better job on this. Someone will say, “My mother smoked and we all turned out fine.” and I want to bang my head on the desk. Low-birth-weight in the babies of mothers who smoke is not 100%. However, the incidence of low-birth-weight babies is DOUBLE in women who smoke vs. women who do not smoke during pregnancy. Vis a vis flu shots: no offense, folks, but your headache or rash is meaningless when discussing the best health practices for a nation of over 300 million souls! Epidemiology isn’t about you as an individual, it’s about gathering statistical evidence on a large population.

      Jean V wrote on August 28th, 2009
  16. I will say it one more time, as I did last year. I took my doctors suggestion that the Flu shot was beneficial. Exactly one week to the day, I came down with the Shingles. NO ONE can definitely say, one had nothing to do with the other. Love you Mark & all the good you do. Now it is up to us to follow.

    mamabear wrote on August 25th, 2009
  17. I do get the flu shot most years, as I am diabetic and I know this impacts my immune system. I think a lot of anecdotal testimonies about reactions to the flu shot are just that – anecdotal. If you look at past pandemics (Google the flu pandemic of 1918) you quickly discover that a STRONG immune system can also be a danger in a flu pandemic. That is, strapping young and healthy folks often drowned in their own body’s immune response (pneumonia or bodily fluids in the lungs.) In many diaries and letters from that time, medical witnesses (nurses, army doctors) described someone young and healthy (e.g. a soldier in his early 20’s, a high school football star, a healthy young policeman) dying of pneumonia within 48 hours of flu symptoms. They drowned, basically. I am willing to do my part to prevent being a vector for the flu within the population, and to keep myself healthy enough to help others when the time comes. It’s not all about me, eh?

    Jean V wrote on August 28th, 2009
  18. I work as a nurse in a hospital. I have had the flu twice in the last 20 years. I have had the flu shot twice in the last twenty years. The same two years. This seems statistically improbable to be only a coincidence. I am definitely afraid to get vaccinated again but it’s being pushed upon us. Soon it will probably be mandatory. I don’t agree with this.

    Dawn wrote on November 13th, 2009
  19. I’ve had the flu twice in my life, once when I was about 9 years old, and the other about 2 days ago!

    It amazes me how some people here have said that 1 week of discomfort from the flu shot is better than being sick with the flu for a month!… Seriously! I’ve been in bed for 2 days with the heater on and a hot water bottle in my bed, keeping warm and healthy is the key, I’ve found that sweating in bed seems to accelerate the killing the bug!

    I’ve been in bed now for 2 days and now it’s just my throat that’s sore, the dizziness, sore head/eyes/nasal passages, and cold shivvers are all gone!

    What have I done to kill off the flu so quickly??? Every 3 hours drink 250mL of Orange juice (vitamin C), I have Vitamin B in the morning and fish oil tablets 3 times a day. Not forgetting by increasing your bodies temperature (sleeping in your bed even when you’re uncomfortably hot)!

    Tomorrow will be day 3 and I expect to be ready to go outside again! Depending on how I feel!

    By fighting the flu myself, I protect my body by building my own immunity and it’s only been a few days (not a month!). And to answer the question, no I have not had the flu shot! :)

    Steve wrote on June 12th, 2010
  20. I’m finding this post very useful, as I am about to begin a new hospital job. I won’t even be working with physically sick patients directly, but they still have a laundry list of REQUIRED vaccinations. I don’t know what to do! I’ve read that it can be very difficult now to get out of taking them. I don’t want to jeopardize my new job, but is it more important than my health?? I imagine a simple “I decline. I’m allergic.” isn’t enough. Any suggestions about avoiding vaccinations/immunizations and the possible long term risks?

    Heather wrote on July 9th, 2010
  21. A randomized, double-blind, placebo controlled trial of school children shows vitamin D prevents the flu.

    An independent analysis of worldwide flu vaccine studies published in the British Medical Journal concluded there is little scientific proof that flu vaccines are safe and effective.

    Most of us are vitamin D deficient – none of us are vaccine deficient.

    Jane wrote on September 25th, 2010
  22. As some of the commentors have already mentioned, mercury is an issue in these shots (also other unhealthy substances like formaldehyde).

    Getting 5000iu of vitamin D a day is the best way to prevent the flu

    Jeff wrote on November 11th, 2010
  23. I had never had the flu until one year my mom had me get the flu shot (I was 11 I think) and guess what, I got the flu! I never got another flu shot after that and I am now 17 and haven’t had the flu since then. So no flu shots for me!

    Emily Drew wrote on December 7th, 2012
  24. Hi Mark: I keep hearing dire warnings about how bad the flu will be this year, and everyone from my husband to my boss is encouraging me to “get the shot”. You’ve posted in the past about getting a flu shot–any updates??

    Trish wrote on January 9th, 2013
  25. Mark,

    this a little late. but can you revisit this topic?

    cause H1N1 is really something else.
    it’s really something else — most victims are YOUNG.

    if you win, i.e., survive, you still loose cause lungs are permanently damaged.

    PHK wrote on January 15th, 2014
  26. The pros and cons of vaccination are completely debatable. As a registered nurse I am an advocate for most vaccines, including the flu shot (not the h1n1 shot, gardisil, and certain others not mentioned). However the comments made by people are based on superficial knowledge about the issue. There is a big different between the type of viral load clients recieve in the flu shot compared to a live virus vaccine, such as the MMR. People who claim they have gotten the flu from the vaccine are either referring to a different illness or became sick soon before or after the shot. To the person who says you are getting a dose of the virus, thats not true. Your immune system is in a nutshell conditioning itself for a response to identifying markers on the ‘envelope’, or membrane of the deactivated virus. So the body createsimmunity without having to fight an infection. My personal experience witht he flu shot specifically: I have given at least 500 seasonal influenza injections to clients and have on rare occasions encountered mild side effects, never have I experienced severe side effects with a deactivated virus vaccine in any of my clients. I advocate for people to make their own choices when it comes to medical interventions, but they should have done their homework.

    Stephanie wrote on July 25th, 2014
    • i have had flu shots on & off for the last 10 years.

      otherwise i would be sick every time i get a flu or cold for ONE MONTH. & i get 2 – 3 /years. —> almost THREE MONTHS/year being sick.

      due to all the vaccine scare in the paleosphere, i stopped having flu shots, + i don’t get sick as often after changing diet + i became a bit smug in my own immune system.

      guess what, last winter i got sick TWICE BACK TO BACK

      pam wrote on July 25th, 2014
  27. sorry it was accidentaly sent.

    2 back to back flu + cold took me out for from Thanksgiving through New Year. SIX WEEKS; i had to cancell all plans for holidays. i had no holidays. (i got pretty pissed for being talked into not having a flu shot + big cold sores break out afterwards that just went on for another 2 weeks) so total of TWO MONTHs not feeling well.

    so right after i got well, i went for a flu shot @ a local clinic which used preservative free vaccines.

    i would really like to say that the paleo/primal diet solve all my health problems. it does help my health but sadly it has not help everything

    (vitamin C does not help at all, neither is echansea & it tastes nasty)

    sorry just had to rant,


    pam wrote on July 25th, 2014
  28. This year marks the first ever flu shot I’ve gotten since adulthood as I am currently on chemotherapy and am immuno-compromised.

    During the two years I ate low-carb (do I ever wish I had not fallen off THAT wagon!) “that thing going around” typically had everyone feeling miserable (but still coming to work anyway) for weeks at a time. “That thing” usually passed by me entirely, or I may have been sick for a day or two, usually far less sick than everybody else as well.

    Eating well DOES work, just that you do need to go against the Conventional Wisdom definition of “eating well”.

    James wrote on July 12th, 2015

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