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October 2018 When it comes to flu shots, most of my patients are eager to sign up, but some people are afraid because they believe the vaccine will make them sicker rather than healthier. Flu shots protect people from getting influenza, a contagious respiratory illness that comes with fever, body aches, coughing, sneezing, headache and fatigue. Once a person is immunized, not only are they less likely to get the flu, they are also less likely to spread it to those who are too vulnerable to fight it: the young, the old, and people who have compromised immune systems—like those with chronic diseases. The flu affects up to 20 percent of the U.S. population each year and it can be serious or even deadly for some—an average of 200,000 people are hospitalized annually, and tens of thousands die from flu-related illnesses. Because the stakes are so high and the vaccine is so effective, the Centers for Disease Control and Prevention recommends annual influenza vaccination for everyone six months and older. People who don’t get the shot aren’t just being obstinate. They are often scared or uninformed. They say, for example, “When I get the flu shot, I always get sick. When I don’t get the shot, I’m fine.” First, let me explain how flu shots work. Then, I’ll explain the difference between causality and correlation. The flu vaccine is made up of little bits of inactive (dead) flu virus that allow your immune system to build up the specific defense needed against this year’s flu. After the shot, some people experience mild, flu-like symptoms while their bodies build up the immunity. I assure you, this is far better than getting the flu. The flu vaccine will likely save you from a week or two of feeling like you were hit by a truck. If you’re relatively healthy and you get the flu, you may miss work, get behind on the laundry, and even have to cancel that nice anniversary dinner you had planned with your sweetheart. But you’ll recover. However, your getting the flu could have catastrophic consequences for people you love—your toddler or your mother-in-law who’s undergoing treatment for cancer. When everyone receives the flu vaccine, we all benefit from what they call “herd immunity.” The incidence of flu drops and everyone is less likely to get sick. This is especially important for those with diabetes, chronic obstructive pulmonary disease (COPD), asthma and other chronic diseases that affect the respiratory and/or immune system. To prevent the flu, it is important to wash your hands frequently. The flu is most commonly spread by sneezing and coughing, but it can also stick around on hard surfaces for 24 hours where you can come into contact with it. This brings me to causality versus correlation. People sometimes connect unrelated events. Just because two things happen around the same time doesn’t mean they are related. You may get the flu after you get the flu shot. The vaccine does not guarantee you will not get the flu, although it reduces the chances significantly. If you do get the flu after getting the flu shot, it is likely to be far milder than it would have been without the vaccine. It seems like some people make decisions about vaccines based on rumor or hearsay, even though we have hard science to prove vaccines are safe and effective. I encourage people to make decisions about their health based on facts rather than Facebook posts—on information rather than fear. If you are concerned about the dangers of vaccines, talk to your healthcare provider. They can give you accurate information about the risks and benefits associated with vaccines. I assure you the risks are tiny compared to the benefits.   Justin Ebert, PA, is the Medical Director of MCHC Health Centers, a local, non-profit, federally qualified health center offering medical, dental and behavioral healthcare to people in Lake and Mendocino Counties.