Respiratory infections are nearly impossible to avoid. We will breathe in viruses, bacteria and other disease causing bugs. However, there are things we can do to lessen the impact it has on our health as well as lessen the disruptions in life that infections cause for us and those around us.
Staying away from people that are sick is only partially effective. People breath out pathogen loaded droplets before they are displaying obvious signs or the person recognizes that they are getting sick. There are differences in the degree to how much this happens with each pathogen. For example people can transmit the measles virus for at least 4 days before the rash appears – in contrast to influenza which a person probably only transmits for a day or so before symptoms start. The symptoms of influenza also have a more abrupt onset than infections such as COVID-19 or bacterial pneumonias causing the infected person to self isolate earlier.
Masking and other strategies may improve your odds of not getting enough of a dose of a pathogen to infect you but your risk will not be zero. Wearing a well fitted “N95 mask” gives you good protection – not a bad idea to wear one for example if you will be traveling by mass transit or being in a congested area. However, always wearing an N95 mask is not a very practical strategy.
Being in overall good health through getting a good night’s sleep, choosing nutritious foods and getting regular physical activity is a start but not the end of what you can do to avoid getting really sick. We can give our bodies a head start against the most problematic invaders by showing our body what it will be challenged with. We can “load the dice” when it comes to what will happen when we breathe in certain viruses and bacteria. We improve our odds by teaching our immune systems through getting vaccinated.
Every year I get asked many similar questions and hear many of the same concerns about vaccines. Patients will ask “so how well does the flu shot work this year” or “every time I get the flu shot I get the flu”. More recently the questions and comments are about the COVID vaccines. People will ask if they really need to get the updated vaccine or will tell me that they are not getting anymore vaccines because they got COVID-19 even though they were vaccinated.
Regarding the effectiveness of each year’s vaccine; the reality is that we will not know how well this year’s vaccine works until after the end of the season. Each year the data is a little different; but what we do know is that in every year in the recent past, influenza and COVID vaccines have provided significant protection against severe disease.
There are lots of studies that have analyzed different aspects of the vaccines. I certainly have not read each and every one of these studies but I have seen enough information to know what I should expect this year based on previous years. It is not practical to detail all of the studies and other pieces of relevant medical literature. So for this article I will tell you what I expect the vaccines to do for me and my family.
A little over 30 years ago I did not get the influenza vaccine – just did not get around to getting the shot. I remember rather vividly. We were living in a duplex with a 75 gallon fish tank. A pump on the tank malfunctioned. When the pump failed the tube acted like a siphon emptying out half the tank. We had a mess to clean up, a carpet to clean, and a fish tank to move and refill – fortunately no fish died. Just before this happened – I started getting sick – but we had to work quickly to get everything cleaned up.
We got the fish out of the tank and into buckets and ran a carpet cleaner over the carpet. That activity completely exhausted me. I remember laying on the wet carpet – absolutely wiped out telling my wife I did not know if I could keep going – the fish still in buckets and the tank still needing to be set back up.
In the 30 some years since, I have each and every year been vaccinated against influenza. Working in health care most of the last 30 years it is very likely I have had multiple exposures to the influenza virus every year – but I have not developed any significant symptoms of influenza since then.
I will get my influenza vaccine this week. I expect that it will keep me from getting significantly sick when I breathe in the influenza virus droplets this fall and winter. It is still possible that I will still get influenza – but I expect not to get very sick.
A few weeks ago my wife and I got our updated COVID-19 vaccine. Just like the influenza shot – we will not know how much protection this year’s vaccination gives us until all the data is analyzed in several months. We can look back at how well the vaccines worked in previous years.
Here are my expectations for the COVD-19 vaccine. I expect that first and foremost it will keep us from getting significantly ill. We are in our mid 50’s without serious chronic health problems and we have always been up to date on previous COVID-19 vaccinations. Therefore our risk of ending up dead or in the hospital from COVID-19 is probably already very low – but not likely zero – getting vaccinated again this year moves that needle a bit more towards zero risk.
Expecting to not end up in the hospital or dead is a rather low bar. I set the bar higher for myself and my family. I also don’t want to transmit the virus to others if I do get sick. I have seen more than adequate evidence that primary vaccination and the updated vaccines reduce transmission – and it makes sense that the vaccines should reduce transmission. There is also adequate evidence that there is less risk of suffering from the longer term consequences of being infected with the virus if you are up to date on your vaccination.
My hope is that getting vaccinated will keep me from getting COVID-19 at all. That would be a very high bar if that was my realistic expectation – I know there is still a fair chance I will get COVID-19. My wife and I have both had COVID-19 once – at different times. Neither of us got very sick and were feeling just fine within a couple days. As an interesting side note – in the day or so we were getting sick (before testing) we had close contact with each other but did not make the other person sick. On each of these occasions we were both current on our vaccinations – so maybe that kept us from making the other person sick.
My wife and I only have only a moderate risk for being seriously ill from COVID-19 even if we had not already gotten the most recent vaccine – probably. I say probably because we really don’t know until all of the data is analyzed – we need to do what makes sense for us today.
We are not all at the same risk for having serious consequences of being infected with the virus and therefore the vaccines will have different absolute amounts of risk reduction. My mother who just turned 82 is at much higher risk than my 18 year old son. They both however should benefit from getting vaccinated this year against influenza and COVID-19.
My son is already at very low risk. He somehow has been able to avoid significant infections – having gone from kindergarten through high school graduation missing only one and a half days of school due to illness. His luck is that he has good genes – but he has been fully vaccinated against COVID-19 gets vaccinated against influenza every year AND he is physically active.
My son is in his first year of college. He will be sitting in crowded classrooms, eating in cafeterias, and sharing living space with his dorm roommates. It is guaranteed he will be breathing large amounts of lots of viruses. Getting COVID-19 or influenza could be a serious disruption in his learning and college experience. It is a no brainer – he is a smart kid – he will get both vaccinations.
Influenza and COVID-19 vaccines are widely available at most pharmacies and medical clinics. The vaccines are covered by Medicare, Medicaid, and most insurance companies.
In the next article in this series; “Staying in the Game”, I will discuss RSV and vaccines.
I will also be continuing my series of articles on nutrition and fitness. Here are the last 2 articles; Problems with Protein Digestion & Absorption, Training 4 Life: 9 Adaptations
If you missed it check out my article on Winning and Integrity.
Russ
Any opinions stated here are solely of myself and do not necessarily reflect those of any organization I am a member of or of my employer.
