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UW Health doctor on the importance of vaccination during flu season

Flu shot vaccines are seen in a refrigerator.
Lindsey Wasson
/
AP
Dr. Jim Conway gives an overview of vaccine accessibility in Wisconsin as we head into the flu season.

October marks the start of the respiratory viral vaccine season in earnest. Illnesses like the flu, COVID and RSV are making the rounds. Fortunately, there are tried and tested tools to help us stay healthy while protecting others: vaccines.

To go over the vaccines available and the importance of getting your annual shots, Lake Effect’s Audrey Nowakowski is joined by Dr. Jim Conway, medical director of the UW Health immunization program.

This interview has been edited for length and clarity.

What factors contribute to flu season and other illnesses peaking starting this time of year and into the winter?

One thing is lower humidity and air temperatures. When temperatures are dry and cold, that seems to be more amenable for viral persistence. There's less sunlight, there's less ultraviolet light from the sun that kills viruses. And so they’re able to persist on surfaces a little bit better.

Then you also get the combination of people touching those things and touching their faces and rubbing their eyes and so on. When you put all these people into enclosed spaces where the windows are closed — in schools and during the holidays — you've got the perfect opportunities for viral transfer.

Let's go over some basics about vaccines before we get into individual types. How do they work and how are vaccines studied and improved over time?

Vaccines are designed to basically trick your immune system into thinking it's previously had a disease that it hasn't. We all generate some immunity after we have a given disease, and so vaccines try to mimic that.

As far as the testing of vaccines, it's interesting because vaccines are held to a very different standard from most pharmaceutical drugs. They're tested in much larger populations. Drugs are often tested in 10,000 or 15,000 people, while vaccine trials generally have 70,000 to 100,000 people in each arm of the trial, as well as monitoring for long- and short-term side effects.

When people ask me why vaccines are so expensive, it's because the amount of work that goes on either in academic settings or by the pharmaceutical industry really demands it. They have to cross every 't' and dot every 'i.'

Which populations are at a higher risk of developing serious illness when they’re either not vaccinated, or when people in their communities are not vaccinated enough?

The groups we worry about are the people whose immune systems aren't quite up to snuff, you know, and that includes obviously people with immune suppressive conditions or immune suppressive drugs, people that have had transplants, people with HIV/AIDS and people that have cancer and are on chemotherapy. At the beginning of life and at the end of life, you also have a pretty diminished immune system.

So, after the CDC’s shift away from broad recommendations, there's been some uncertainty and confusion about whether people can get the COVID vaccine through their insurance. What's your current understanding of access to this vaccine? Is a prescription needed, or can go into your local pharmacy and get it along with a flu shot?

It's been confusing, because there’s been a deluge of information to digest. But to really simplify things, the FDA made an unusual move by saying that the priority should be on these higher risk populations — people over 65 and people with underlying comorbidities or coexisting medical conditions.

In response to that, the major professional medical societies responded with their own recommendations on who should receive vaccines. The Advisory Committee on Immunization Practice couldn't rebut the bulk of data and information that was out there, and so they came out with a recommendation that everybody over six months of age should be entitled to receive COVID vaccines.

Those recommendations were then adopted by the acting CDC director as official polices, which basically means Medicare and Medicaid and all the insurers are covering COVID vaccines this year for everybody six months and above.

Let's move now to the flu shot. What is influenza, and what's the difference between that and the common cold people might experience?

Unlike the common cold, people with flu get a high volume of virus in their bloodstream. It turns on your immune response system, and so you get a release of chemicals called cytokines that give everybody that bad headache, that really achy feeling. That inflammatory response unfortunately leads to pneumonia in some people.

But we're fortunate that we've worked out a way to protect people with vaccines. Similar to COVID vaccines, influenza vaccines have to be updated every year based on what the anticipated circulating strains are. The biggest improvement that's happened in the last 15 years has been the ability to create what are called enhanced influenza vaccines that are really designed for older individuals who have relatively poor immune responses. For people over 65, I really strongly recommend that they make sure they're asking for an enhanced influenza vaccine and not just settle for the standard dose at this point.

With flu season coming up and a number of illnesses people want to fortify themselves against, you might be getting one or maybe multiple vaccinations at your doctor's office or pharmacy. So what are some common side effects from vaccines that people might experience?

You know, I think everybody has some element of hesitancy about getting needles stuck in them. That's kind of the first thing that people complain about. And again, it's sort of simulating a mild version of whatever that illness was. So, I'd say a decent number of people — 10% to 20% — are going to have sort of an achy feeling for a day or two afterwards. But with a little bit of Tylenol or ibuprofen, most people can tamp down those symptoms and manage without too much difficulty.

The other thing to remind people about, and I forgot to mention before, is that for people that are really needle phobic, there are nasal flu vaccines for influenza as well. Those can be obtained at pharmacies and at providers' offices. But currently for RSV and for COVID, the injection is really the only option you have.

Dr. Conway, thank you so much for joining me today to explain more about vaccination and vaccines in general as we are ramping up into flu season.

Thanks for having me, Audrey. The more people that get covered and vaccinated, the more immunity we have within our households and our communities, the smaller the outbreak that we're going to have. Hopefully we can have a relatively mild season, and we can all contribute to that, both by getting vaccinated and hopefully continuing some of the stuff we did during COVID. You know, when you're sick, please try to stay home. Don't be a hero. Don't go to work. Don't go to school. And if you do have to go out, wear a mask when you're out there.

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Audrey is a WUWM host and producer for Lake Effect.
Graham Thomas is a WUWM digital producer.
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