Flu Virus - to vaccinate or not?

So you know by now every year when flu season is about to start,  (roughly a 13 weeks duration spanning from March to July) the influenza vaccine gets promoted through advertisement everywhere! So is this a sales gimmick or is there some real benefit to it?

Well it depends! Who's asking?

Young children (from 12months), pregnant mothers up to 2 weeks post partum, the elderly or the immuno-compromised ( esp HIV/TB), lung/chronic disease and co morbid patients, certainly will benefit from it. The advantage isn't as directly observable as one would think (not catching any virus/not getting sick for the entire season etc). It is more of a "lessening of risk" , or aversion of exacerbation from a viral infection, which is key! After vaccination, the special groups (those mentioned above) patient drastically reduces their risk of landing up in hospital due to severe infection and secondary complications (cardiovascular, pulmonary, etc). The burden of the influenza related hospitalizations depends on the transmission and virulence of the strain each year.

Let's mention the three strains which cause illness. Influenza A - most usual cause of epidemics or yearly outbreaks, Influenza B - less severe outbreaks and illness, mostly burdensome on children and the immuno-compromised individuals. Lastly, Influenza C - which caused minor respiratory illnesses.

However the influenza virus (including all infectious strains) is not the only flu-like virus in the air.
Rhinoviruses which cause the common cold are another huge culprit; the adenovirus, coronavirus and other viruses all thrive during the colder months as indoor ventilation decreases and human clusters (viral harbouring and sharing) increase. So you may still get a cold, or another viral infection or even allergies, which all involve sneezing, rhinorea and sinus congestion among others. NB: the flu has a sudden onset of symptoms, includes fever and body aches, git disturbances in children, sore throat, and running nose as differential.

The question remains, do you vaccinate or not?

Considering the above information. If you fall within this special group, the safe advise to receive is: vaccinate.

If you live or work (especially health care workers) with this special group including newborns/infants, avoid becoming a source of infection to them: vaccinate

If you fall outside of this group, are a healthy individual and have no additional risk: you can skip the vaccine

The trivalent vaccine (TIV) in itself is not a live attenuated strain (it contains three dead/inactivated strains of 2 different A strains & 1 B strain) , therefore the rumors of it causing the flu or other diseases are unfounded/unrelated. However, after vaccination, a mild localized irritation might occur which clears quickly.

Lastly, it is worth mentioning that since the flu vaccine is not long lasting (6 months longevity), it should be re-administered annually at the start of flu season (in SA it's March/April). This also means that if you've had the flu at the beginning of the season, you may still get it again towards the end even if you vaccinate.

Look at this table which shows reduction in severity of disease and morbidity in those who vaccinate vs not:

Heads up, Now you know.

ALWAYS ask your pharmacist for sound pharmacy related advise.

Happy flu aversion

Have pharmacists given up their power?

One of the biggest mistake people make is to give their power away by thinking they don't have any!

This couldn't be more true for most pharmacists it seems. As observed in the retail setting, patients increasingly tend to push their luck and demands towards pharmacists. While entitlement isn't right, times have changed and in this day and age, your professional identity has to marry your personal conviction of who you are in a way you may not have ever experienced before. You have to know who you are and what your strengths and weaknesses might mean to your workplace. Your authority, your jurisdiction, your territory can never be threatened. Don't allow it. On the flip side, you can't rely on your mere title or name tag to suffice in the respect department anymore that's for sure. Patients are notoriously earning their instant online degrees after a few google quick searches and are ready to challenge you - the professionally trained pharmacists with a plethora of misguided, misinformed and misleading statements, questions or comments amongst other atrocities.

The guts!

For such a climate, the winning pharmacists are those who not only know who they are and what their roles, duties, responsibilities and rights are, down to the T! But can equally voice them unafraid. Your pharmacy degrees are no longer enough! You need wit, confidence and a lot of assertiveness to add to the community pharmacy scene. Being nice was often a trait which meant bending rules, doing favours and being "understanding" for many dispensaries. To the point where often, this leniency happens at the expense of the pharmacy's rules, policies and even the law! 

Fast forward to today and community pharmacists are all paying for having given their power away and allowed their dispensaries to become fast-meds pubs on steroids. So what has being "overly nice" got to do with professional power? Everything! If you're familiar with the phrase "familiarity breeds contempt" then you know that when you repeatedly show soft kindness over any other traits such as sternness or even assertiveness, it often is mistaken for weakness...

What do opportunists do when they perceive weakness? Take advantage of course! 

*Wait an hour at the doctors, but if you spend more than 5 minutes at the pharmacy... someone has to apologize! 

*Ask how they know how to read a prescription but never understand nor value the scrutiny involved in cross checking each item for safety. 

*Worry about asking your doctor if you can switch to a generic, while you ignore the one who actually studied your medication's various formulations  kinetics and dynamics.

*The list is very long...

Patients keep asking the wrong questions while pharmacists keep giving their power away... 

Before they ask, tell them. Before they stray, restrain them. Before they run off to their prescriber, educate them. Unfortunately the damage is done and the only way to fix it now is to overcompensate.  Over explain. Have readily available guidelines policies or laws, provide overflowing therapy information, do superfluous continuous self study, and be astoundingly resourceful. You cannot be caught slipping, or not knowing.

In short, always add and verbalize value to your patients (and other health care professionals whom we haven't touched on in this particular blog) during usual services. They will start understanding and respecting your work better. 

Become aware of such gaps. Fill them.

Go the extra mile in your supervision and training. 

Be excellent.

Just a thought.