Advice: Should You Have a Flu Vaccination?

DrMareeTodd

Geriatrician Dr Maree Todd encourages older people, those with chronic conditions, family carers, and health workers to have an annual flu injection.

Influenza vaccinations are free for those over 65 or who have a chronic medical illness which makes them more vulnerable to the effects of flu. Influenza can cause severe illness, robs people of their independence, and can be fatal in older people.

The cold months are a riskier time to catch influenza and other viral illnesses. Cold wet weather means it is hard to get about outdoors (be careful of the hazards of wet, slippery paths). Some people do not get the exercise they need because of the cold.

Is it a good idea for older people to take advantage of the free flu jab?

Yes, yes, and yes!

I get it every year for three reasons. One, I do not want to pass on influenza to any of my frail patients, as it may kill them. Two, I do not want to add to my colleagues’ burden by getting sick myself or passing it on to them; we are busy enough over winter without dealing with staff illness due to influenza. And third, I have the jab for my own personal protection. A new vaccination is required every year, as the flu virus is cunning and changes from year to year.

You cannot catch influenza from the vaccine. And it will not stop you getting other respiratory viruses like the common cold.

So, be smart, get the jab! You can do this by making an appointment with your doctor or practice nurse.

Government flu programme

Influenza can be an especially serious illness. For this reason, influenza immunisation is provided free if you are pregnant; regularly use an asthma preventer; have diabetes, cancer, heart disease, or kidney problems; have a serious medical condition; or are 65 years or over.

A small number of people should not be vaccinated without first consulting a doctor, such as those who have had a severe reaction to an influenza vaccine previously, or who have a severe allergy (anaphylaxis) to chicken eggs.

The vaccine is usually available from late February/early March to the end of July every year.

Looking after yourself if you get sick

If you do get sick, seek advice from your doctor or nurse early, before symptoms worsen. See advice by telephone first as you don’t what to spread your bugs around the GP’s waiting room. If you get the flu or other respiratory viruses, then antibiotics do not work.

Drink plenty, take paracetemol up to four times a day for headaches and muscle pain, and eat something regularly (little and often is best). Try soup, Complan, or those prepared meals you put away for days when you aren’t feeling up to cooking.

Seek sympathy and do not be too proud to ask for help!

Only the super fit can sustain full bed rest; try to keep moving regularly so you do not lose too much strength.

Older people who have existing illnesses such as lung, heart or kidney disease should seek advice from their doctor, as the background illness may become unstable. Some might be candidates for specific flu treatment, i.e. Tamiflu. People with dementia might become more confused – explain, reassure.

While most fit people who get influenza can manage this at home without medical attention, seek help if the illness is severe, you get very short of breath, you start coughing up a lot of spit (especially after you thought you were getting better), you cannot care for yourself or walk, or if you start falling.

Remember, wash your hands, cover your mouth when coughing, and avoid going out in public, to meetings, to hospitals, or anywhere where you might pass on the infection.

Maree’s tips to stay well over winter

  • Keep warm, dress well, eat well, keep fit, get your flu jab, and consider outdoor hazards – keep paths clear and use outdoor grab rails and non-slip surfaces. Tell the family and visitors to stay away if they’re sick.
  • Shopping malls are good places for exercise: warm and dry, with plenty of space for walking.
  • Most older people do not need to take extra vitamins if they are eating well, with the exception of Vitamin D. This is made in the skin and requires sunlight. Many older people are low in Vitamin D even when tanned, so we now recommend that all older people take a Vitamin D supplement. Talk to your doctor about this. Vitamin D is very important for bone health, muscle strength, falls prevention, and may have a role in preventing infection, heart disease and some forms of cancer.
  • It is very important to eat well and this includes fruit and vegetables – 5 plus a day. While fresh is good, frozen or tinned fruit and vegetables are perfectly fine. Colourful fruits and vegetables are especially good and will keep your Vitamin C levels high. Eat a wide variety of foods.
  • Keeping warm is critical. Older people can have difficulty regulating their temperature, older houses can have poor heating, and the risk of hypothermia is very real. This is associated with decreased resistance to infection, and many adverse effects on a range of bodily functions. Consider wearing thermal underwear, hats and gloves as well as good nutrition.
  • I have three tips for carers who need to conserve energy. First, make sure you get your own health checked. Second, make time for some exercise or physical activity; if you are fitter you will feel more energetic, you won’t waste as much energy doing simple tasks, and it will help your mental health. Lastly, make use of others. Accept help and, for carers, get someone else to do the tasks you don’t like doing, and prioritise the important tasks. As Quentin Crisp said, “There is no need to do any housework at all. After the first four years the dirt doesn’t get any worse.”

Dr Maree Todd is a geriatrician advisor for Bupa and for the Auckland District Heath Board.

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