6 Flu Comments Every Pharmacist Will Hear

MARCH 28, 2016
It’s March, and it’s the “end” of another flu season.

Embedded within communities, pharmacists have long been leading patient education, vaccination, and treatment efforts.
 
Seasonal influenza is a highly contagious respiratory illness that spreads via droplet transmission and can be contracted even when an infected person is not experiencing symptoms.
 
This virus can cause severe illness and life-threatening complications. These include dehydration, ear/sinus infections, bacterial pneumonia, and worsening of chronic medical conditions. Children are also at risk for Reye’s syndrome, an encephalopathy characterized by stages of symptoms.
 
Populations at especially high risk for complications include those under the age of 5 years and over the age of 65 years; those with chronic lung disorders, heart disease, diabetes, and weakened immune systems; and pregnant women, according to the US Centers for Disease Control and Prevention (CDC).
 
As of February 26, 2016, approximately 146.4 million doses of the influenza vaccine have been distributed. While that is a high number, there are still a number of patients who are unfamiliar with the flu or not quite convinced about the importance of getting vaccinated.
 
Below are 6 flu situations you may experience in the community.
 
1. “I think I have the flu.”
 
While both colds and the flu are respiratory illnesses that can have similar symptoms, colds are milder and last for a shorter amount of time.
A cold can present as a combination of runny nose, nasal congestion, sore throat, and headache, but the patient has preserved daily functioning. 
 
The flu is a more debilitating set of symptoms. Patients generally experience chills and sweats, high fevers, backaches, myalgia, and general malaise. These symptoms, along with an unproductive cough and extreme fatigue, impair daily functioning for the patient. Vomiting and diarrhea present more commonly in children. 
 
2. “I need antibiotics.”
 
Antibiotics are ineffective against viruses.
Although there are 3 antivirals (Tamiflu, Relenza, and Rapivab) recommended to treat influenza in the 2015-2016 season, they should be reserved for select patient populations.
Patients who are hospitalized, have severe flu illness, or are at higher risk for complications should receive therapy as soon as possible without waiting for confirmation via testing.
 
For others, OTC options are best, along with nonpharmacological treatments, including hydration, humidification, nasal irrigation, and rest.
 
3. “The flu shot will give me the flu.”
 
Assure your patient that the flu shot will not give him or her the flu. The vaccine will contain either attenuated viruses that are inactivated or recombinant DNA, which is not a virus at all. Neither of these can cause the flu.
After receiving the vaccine, the patient may experience some discomfort at the site of injection or a low-grade fever. If the symptoms include greater uneasiness, they should abate after 1-2 days and are much less severe than flu symptoms.
 
The body takes around 2 weeks to develop the necessary antibodies, so there is a chance that patients might actually contract the flu from other sources around the time they got vaccinated.
 
4. “But it doesn’t work!”
 
The CDC released a preliminary overall influenza vaccine effectiveness of nearly 60% for the 2015-2016 season.
 
If the patient experiences flu-like symptoms, there are a few explanations:

·     Regardless of whether they received the trivalent or quadrivalent vaccine, patients are only protected against the strains included in those cocktails. Additional circulating strains of the virus can still infect them. That is not to discount, however, the fact that the vaccine can also provide protection against these additional strains.

·     The patient contracted a virus that causes similar symptoms. Rhinovirus and coronavirus comprise of 40%-65% of the estimated annual proportion of cases.

·     The patient did not respond effectively to the vaccine. Because responses to the vaccine can vary, there are cases where patients’ bodies do not create an adequate immune response to the virus.
 
5. “I never get the flu, so I won’t this year.”
 
They’re right—they may not get the flu. However, with the convenience of walk-in flu shots at most corner pharmacies, avoiding the vaccine is not worth the risk of the illness’ symptoms, complications, or chances for hospitalization. 
 
6. “What’s the point?”
 
There are 200,000 influenza-associated hospitalizations yearly. Getting vaccinated serves to protect not only the patient, but also those in the patient’s vicinity. The flu vaccine is contraindicated in infants younger than 6 months, those with allergies to vaccine ingredients, and select other patients. These populations rely on those around them to do their part and get vaccinated.
 
Educating patients and easing fears surrounding the flu vaccine are critical so that patients get vaccinated for the upcoming season. This is essential for lowering direct and indirect medical costs, eliminating the necessity for taking sick days, and reducing the prevalence of an illness with dangers of such severe complications. 

Jola Mehmeti, PharmD, MBA
Jola Mehmeti, PharmD, MBA
Jola Mehmeti is a 2018 PharmD graduate from the UConn School of Pharmacy. She is a CITI-certified researcher with investigative and work experience at a large tertiary care center in Hartford, Connecticut. Connect with her on LinkedIn or send a message to contact@jolamehmeti.com.
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