Welcome to my blog, a place to explore and learn about the experience of running a psychiatric practice. I post about things that I find useful to know or think about. So, enjoy, and let me know what you think.

Tuesday, September 10, 2013

Flu Season

It's that time of year, again. Time to get a flu vaccine. Well, time to decide whether or not to get a flu vaccine.

I never do. Why?

1. You can get vaccinated and still get the flu, it's specific for certain strains.
2. I'm always already sick by the time I think of getting vaccinated.
3. I know the chance of getting Guillian-Barré is, literally, one in a million. But I happen to know someone who was that one. That doesn't change the odds, but it makes it feel like it does, and I'd rather have the flu.
4. I don't work in a hospital setting, so I'm not at a higher risk than most "healthy adults".
5. I don't treat geriatric patients, so I'm not putting my patients at higher risk.

However, I decided to be a little more responsible this year, so I looked it up in The Cochrane Reviews. They have this really nice section called, PEARLS - Practical Evidence About Real Life Situations (it's at the lower half of the linked page).

Here's the conclusion:

Bottom line: 
There is insufficient evidence to decide whether routine vaccination to prevent influenza in healthy adults is effective. Influenza vaccination did not affect the number of people needing to go to hospital or to take time off work (the follow up period was up to 3 months post vaccine).
Vaccination against influenza avoided 80% of cases at best (in those confirmed by laboratory tests, and using vaccines directed against circulating strains), but only 50% when the vaccine did not match, and 30% against influenza-like illness. Some vaccines cause pain and redness at the injection site (NNH* 1), muscle ache (NNH 27), and other very rare serious harms such as transient paralysis. *NNH = number needed to treat to cause harm in one individual.

Incidentally, The Cochrane Reviews Site is awesome. Check it early and often. The Cochrane Collaboration was established in 1993, and is named after the British epidemiologist and medical researcher, Archie Cochrane (1909-1988).

Archie Cochrane

I'm always disappointed that it isn't named after Doc Cochran from Deadwood, SD-apparently there were several doctors in the camp, but the name is fictional.

Brad Dourif as Doc Cochran

I guess this is a peculiar post for a psych blog, but I'm a doctor, and I treat patients in my office, and flu vaccination is an important question. And who says lifelong learning has to be restricted to psychiatry?

No comments:

Post a Comment