Thursday, October 17, 2019

Get a Flu Shot

The Journal of Clinical Oncology just published an article that looked at the effectiveness of the flu vaccine on patients with cancer. On the surface, the results don't look all that great. But the researchers' conclusion is very clear:

Cancer patients should get a flu shot.

The timing of the publication is great, because this is the time when cases of the flu start to ramp up. (I just saw an article yesterday that the first flu case in my sate was reported a couple of days ago.)

The study looked at 26,463 cancer patients in Ontario, Canada, between 2010-2011 and 2015-2016 (the flu season overs fall into early spring, so one season takes place over parts of two years). They used records of patients who who were tested for having the flu, and checked those against records of patients who had been diagnosed with cancer. About 16% of the group tested positive for the flu, and about 45% had received a flu shot.

For cancer patients, the flu vaccine was less effective than it was for the general population. It was effective for about 21% of cancer patients overall. For patients with a solid tumor, the effectiveness was about 25% effective.

But for patients with blood cancer, it was much less effective -- about 8%.

The reason for this lower effectiveness isn't clear, though researchers think it could be because so many blood cancer patients go through treatments that cause myelosuppression -- less activity in the bone marrow. And that's where blood cells are created.

It makes sense -- our treatments work to harm the blood cells that are cancerous, but those same cells are the ones that help our immune systems do their job. Fight the cancer -- lower our immunity -- make us more vulnerable to the flu.

Some treatments for solid cancers also target the bone marrow, but not all, so they may be a ittle less likely to have problems with myelosuppression.

So the question is, with only an 8% effectiveness, is it even worth it for blood cancer patients to get a flu vaccine?

The answer is a very loud YES.

“Overall, our results support current clinical practice guidelines recommending influenza vaccination for patients with cancer and survivors...This recommendation acknowledges the safety of vaccination and the potential severity of influenza infections among strongly immunocompromised patients with hematologic cancers.”
In other words,  even an 8% increase is worth it. For someone with a weakened immune system, the flu can be devastating. Anything you can do to protect yourself is important.

I've been following the conversation about this article on Twitter. I follow a lot of oncologists, and they all same the same thing -- get the flu vaccine.

And just as important -- encourage the people you send time with to also get the flu shot. You want to do everything you can to keep that nasty bug far away from you.


Have I gotten my flu shot yet?

No. But I will very soon. My wife and I usually go together. We go right to the drugstore down the street, which has a walk-in flu clinic. We pick a day when we can both take some time off. We get the shot, and then we go to lunch, and then eat something with bacon in it and complain about our shoulders hurting. It's a weird date, but I get to have bacon. And we get to protect ourselves. 

So please protect yourself, too. Get a flu shot.

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