The Flu: Inconvenience or Danger?
During this pandemic, many of us are paying special attention to the topics of disease, disease-prevention, and remedies. How do we know what is actually helpful? What are the risks of vaccines vs remedies? Are natural remedies better or safer?
In light of the devastation COVID-19 has wrought, it seems almost trivial to talk about the flu. To most of us, the flu seems like more of an inconvenience than a threat to our lives. However, the COVID-19 pandemic has repeatedly been compared to the 1918 H1N1 flu pandemic. It is estimated that 1918 H1N1 strain of influenza killed approximately 650,000 people in the United States.
Even when we're not talking about the 1918 H1N1 strain, various other flu strains (and there are many strains) kill thousands of Americans each year. Within the last ten years, the CDC has actual annual flu death counts as high as 15,620. The CDC also estimates that tens of thousands more than they are able to actually count may die from the flu or "flu-like" diseases each year. It's also important to recognize that - just like COVID-19 - there is no known cure. Some potential complications of influenza, such as pneumonia, are themselves deadly. In 2017, the CDC noted that approximately 55,000 people died of "influenza and pneumonia." Older adults are more at risk of dying from the flu or its complications.
The flu can be, and has been, deadly.
Flu Vaccine Effectiveness
Each year to reduce the occurrences of the most dangerous flu viruses and prevent larger outbreaks of influenza, a variety of organizations, including the CDC, try to predict which types and sub-types of influenza viruses will be most prominent in any given year. Based on those predictions, plans are made for a "combination" vaccine which will work on the predicted types and sub-types. Vaccine manufacturers then begin making those vaccines.
The predictions about which types and subtypes are never perfectly accurate and some years its hard to say they are very accurate at all. Every year, some sub-types (or their mutated strains) make it into the U.S. which weren't expected. So, though the vaccine will likely work against sub-types and strains which were predicted, it will not likely work against some unexpected sub-types. This is partially what results in what seems like a very low effectiveness rate for seasonal flu vaccines - often less than 50%.
Alternatives to Vaccination
What if you miss the seasonal flu vaccine or decide not to get it? What else can you do? Well, if you are lucky (or are in quarantine), you will simply not get any strain. Most of us, however, will encounter a bout of some type or subtype of influenza. There are several remedies that are out there, some available over the counter. There are also remedies that are not pills or medicines, but are foods or actions you may take.
You may have heard of a homeopathic remedy called Oscillococcinum. The website for Oscillococcinum claims that "it has been shown in clinical studies to help reduce both the duration and severity of flu-like symptoms, such as body aches, headache, fever, chills, and fatigue." You may also have heard any of the following natural remedies: eat more garlic, have chicken soup, drink lots of water, use a neti pot, drink tea with lemon and honey, get more rest, etc...
Some of these work better than others. Thought Oscillococcinum claims that clinical studies have shown it works, there are also clinical studies that have shown it doesn't. More studies need to be done. A neti pot will definitely clear up clogged sinuses. Evidence suggests that garlic does improve your immune system, though how much is not clear. Honey is a surprisingly effective antibacterial (though the flu is not a bacteria) and often soothes sore throats. Staying hydrated when you have a flu is very, very important (some of the flu-related deaths are due to dehydration).
Almost all of these remedies, however, only try to lessen flu symptoms or their duration once you already have the disease. None of them are a cure.
Risks of vaccination and alternatives
There are risks to getting the flu vaccine and those risks should be weighed against those of natural remedies. Also, they should be weighed against the risks of not having that vaccine.
The most common risk of the flu vaccine is a low-grade fever in about 1 - 2 % of people getting the flu vaccine. Also, if you have ever fainted from getting a shot or having blood drawn, the risk is the same here. There is also the risk of a type of injury which can occur with any vaccine administered in your shoulder called a Shoulder Injury Related to Vaccine Administration (SIRVA). Precise numbers for this this injury as it relates to the flu vaccine are not available, but it is less common than the low grade fever.
An allergic reaction to the vaccine or a component of the vaccine is another more serious risk. An allergic reaction can be deadly by a specific reaction called anaphylaxis. If you already have any known reactions (particularly to eggs) you should discuss the vaccine with your doctor. In general, however, there are about 10 "hypersensitivity" reactions (most of which do not involve anaphylaxis) in every one million vaccines. That's a rate of approximately .001%.
One study has also suggested there may be a connection between the flu vaccine and a debilitating condition called Guillain-Barre Syndrome or GBS. The study found 1 case of GBS in every million vaccinations. That's a rate of .0001%. Another study, however, found no such connection. So, it is very possible that there is no connection whatsoever between GBS and the flu vaccine.
Oscillococcinum has been in use for a very long time and though some evidence suggests that it may not work, there is no evidence which suggests it has harmful side effects. Eating garlic has been studied and quite a number of health benefits have been associated with it, but no risks have been noted. Chicken soup, with its different recipes reveals different things in different studies, but most of it suggests that various ingredients (like garlic and ginger) are associated with various health benefits and few risks (other than a possible increased sodium intake).
However, if you do not get a flu vaccine, you are at an increased risk of getting one of the various flu subtypes the vaccine was designed to prevent. Per the CDC, there are approximately 2 deaths for every 100,000 people in the United States (vaccinated or not) which is a rate of approximately .002%. Since those numbers include both vaccinated and unvaccinated, and vaccinations have had a success rate about 50% every year, those who are vaccinated are much less likely to get the flu.
The risk of suffering some kind of allergic reaction (whether that includes anaphylaxis or not) to the vaccine is approximately .001%. The risk of suffering from GBS may be as much as .0001% (if there is any actual risk at all). So far, the evidence suggests that getting the seasonal flu vaccine is much safer than going without.
Because it seems there are no serious health risks to eating lots of garlic and having some chicken soup when we are ill (as long as we keep our sodium intake low enough), eat that garlic! Enjoy that chicken soup! But, don't forget to get the seasonal flu vaccine, too.