Should I get the Flu vaccine?

Should I Get the Flu Shot?

 

It's going to be a bad flu season this year, so.... YES, get the flu vaccine.

(...Unless you have an egg allergy or other component of the vaccine, or had a bad reaction to a previous flu vaccine in the past, or don't believe in vaccines for philosophical reasons...If you belong to any of these groups of people, this article is not for you.)

 

But I hear the flu vaccine is not very effective, so it doesn't work!

That's partially true.

Flu vaccines are generally around 30-40% effective for reducing influenza like illnesses, based on previous year's research. This is in stark contrast to most other vaccines that are much more effective (compare with 90% effective for Gardasil9, or 99% for polio vaccines). Any reports or experts that you hear predicting this year's effectiveness is basically an science-based estimate, an educated guess. (It ain't over until its over, and when its over, then we'll know, but it will be too late.)

Just because something is not 100% effective, does not mean it is a waste of time to protect yourself. For example, seatbelts reduce risk of serious injury and death by about 50%. Well if it only protects me half the time, then maybe I shouldn't wear seatbelts? No, it is still better to have the protection of wearing seatbelts, than zero protection of not wearing seatbelts. Similarly, the flu vaccine may not be perfectly effective, but 40% protection is still better than zero percent protection.

 

I hear this year's effectiveness is only 10% effective! So it basically doesn't work at all!

Again, this is only actually maybe true, but not fully true yet.

The actual effectiveness of this year's flu vaccine is not actually not known until the end of comparing two groups of people (those that received this year's vaccine, and those that didn't receive the vaccine, and waiting to see how many got influenza this year). As you can see, you can't really know the answer of this fully, while we are still experiencing the current flu season. You have to wait until enough people get sick this year, and then compare.

The 10% you may hear in the news, is actually based on the vaccine effectivness for last year's flu season in the opposite side of the world (in Australia, the Southern Hemisphere). What happens in the other side of the world, in another time, does not always correlate to what happens on our side of the world, and in this season. So basically, the experts are predicting something for this year, based on something that happened somewhere else, in another part of the world, where the flu seasons is often different.

So why are the experts so worried? Well, although the flu strains on the opposite side of the world are often different, and behave differently, this year's predominant North American flu strain (H3N2) is turning out to be the same as last year's Australian flu strain. (Remember, winter in Australia, is summer in Canada) Last year's Australian flu was bad, and the vaccine was only 10% effective for the predominant H3N2 flu strain. However, the CDC has tested this year's predominent H3N2 flu strain to what's in this year's vaccine, and the found that it matched very well. So why is there a difference between genetic matching and actual vaccine effectiveness? This is because what is done in a laboratory does not always correlate to the real world data (how many actual people don't get the flu with the vaccine, compared to how many that do without the vaccine). There are also other flu strains circulating (some of which is not included in the flu shot). The flu virus is notoriously unpredictable.

Is Australia 2017, like Canada 2018? Well, you guess is as good as mine. Expert still advise people to get the flu shot, because the flu virus is notoriously unpredictable (they mutate). Predicting the future is not an exact science. Just look at weather predictions, they're pretty good, but not perfect.

30-40% protection from the horrible flu (fever, sore throat, coughing, muscle aches, runny nose, wipe-out fatigue for weeks) is still better than zero protection. Even if you still end up getting the flu, the body will be better prepared to fight it off, and you will have a milder form, or shorter duration of the flu. You will also protect those around you from getting the flu from you (ie. your baby, your senior parents or grandparents).

 

References:

http://exchange.aaa.com/safety/driving-advice/safety-belts/

https://arstechnica.com/science/2017/12/this-years-flu-season-is-upon-us-and-it-looks-bad-heres-what-you-should-know/

https://www.canada.ca/en/public-health/services/publications/diseases-conditions/fluwatch/2017-2018/weeks51-52-december-17-30-2017.html

https://www.cdc.gov/flu/about/season/flu-season-2017-2018.htm

https://www.cdc.gov/flu/weekly/index.htm

http://www.nejm.org/doi/full/10.1056/NEJMp1714916

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No more annual physicals?

Why does my doctor not include Annual Physicals anymore?

 

There is evidence that annual complete physical checkups in healthy individual (with no symptoms) do not significantly improve their risk of disease or death. Since 2012, the Ontario government revamped the coverage for Annual Physicals by changing the definition to targeted screening of age-specific risks (now called a Periodic Health Visit), and reducing the payment to doctors by 30% for the visit. The time allowed for this visit has also been reduced since there is less amount of history, physical exam, and testing.

We also know that excessive medically unnecessary checking or testing can lead to false positive findings, incidental benign findings, anxiety, and  unneccessary further invasive investigation and treatment.

Therefore, OHIP does not cover an Annual Complete Physical Exam for healthy individuals anymore. Complete Physical Exams for academic, employment, travel, or volunteering are not OHIP covered.

So if your doctor says she doesn't do Complete Physicals or Annual Exams, but a short Periodic Health Visit, then you will now know why.

https://www.theglobeandmail.com/life/health-and-fitness/health-advisor/annual-health-check-ups-physicals-becoming-a-thing-of-the-past/article27996873/

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Rapid Weight Loss vs Slow and Steady

Is your New Year's resolution to get back in shape and lose weight?

If you feel guilty about your holiday feast indulgences, you may be tempted to jump on to the latest diet craze, head to the gym, or hop on the treadmill to lose some weight. However, be warned that rapid weight loss may actually do more harm to you in the long run! A recent study of the contestants in the reality TV show "The Biggest Loser", showed that most contestants who lost weight would eventually start regaining weight again. This was partly due to the slowing down of their metabolism that happened when they tried to lost weight rapidly on the show. There was a pattern in the study that showed those who lost the most weight rapidly, would have the slowest metabolism, meaning they had to eat even less than they ever did, just to maintain their lower weight!

At Get Well Clinic, we recommend a weight loss program that is slow and steady, approximately 1 lbs a week. In this manner, we hope to reduce the decrease in metabolism which can make it even harder to keep the weight off. If you would like a customized weight management program that fits with your situation, please ask your doctor to refer you to our Spring Health Weight Loss Program. We offer a whole person approach to your issues: integrating nutrition advice with lifestyle habit changes, psychology and medications.

http://www.nytimes.com/2016/05/02/health/biggest-loser-weight-loss.html?_r=1

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Prevent Cancer of Cervix and Anus

How to Prevent Getting Cancer

Newer HPV Vaccine prevents 90% of cervical cancers, anal cancers, and genital warts!

Gardasil-9 is better than original Gardasil.

 

 

Cancer is a scary word. We all know someone, a friend, family member, or co-worker who developed cancer. They go through difficult treatments like surgery, chemotherapy and radiation. Sometimes they die. We all fear getting cancer some day in our life. When you feel a little sensation in your body, do you often wonder if you might have cancer? Many people always end up going to family doctors and asking if they have cancer. It is a top reason why people request unnecessary imaging and tests, just to reassure themselves that they don't have cancer. We also always get asked questions about what kind of foods, or supplements to take to prevent getting cancer. Why wait until you have cancer to treat it, when you can prevent getting cancer in the first place?

 

What if we told you that there was a vaccine that prevents 90% of cervical cancers, anal cancers, and genital warts? Would you want to prevent getting cancer and avoid going through all that stress and anxiety in the first place? Gardasil-9 is an HPV vaccine that does just that! 90% on anything, even a school exam, is worth it!

 

Gardasil-9 has been shown to prevent approximately 90% of cervical cancers in women. It also prevents anal cancers in men. It also prevents ugly genital warts in men and women. Research has shown that it is HPV (human papilloma virus) infects human skin and mucosa and causes cellular changes which lead to cancer. Gardasil 9 trains the body's immune system to recognize and kill the top 9 strains of HPV (human papilloma virus 6, 11, 16, 18, 31, 33, 45, 52 and 58) that cause cervical cancer and genital warts. If your body can fight off the infection and kill the virus, then your body heals and doesn't develop cancer. Gardasil 9 is available at your family doctor's office, such as Get Well Clinic (416-508-5691).

What if you wanted to take your chances with cancer, how likely could you get HPV infection? 7 out of 10 people (who are sexually active) will get an HPV infection in their lifetime (75%). What if you are not "sexually active?" Think again, you don't need to be "sexually active" to get infected with HPV. (https://www.ncbi.nlm.nih.gov/pubmed/2256864)

What if you didn't have a cervix? Well, you can still be protected against 90% of anal cancers and genital warts! The HPV vaccine is also for boys and men, especially if you love your current or future partner!

There is another older version of HPV vaccine, called Gardasil that is available in Ontario, and given to all Gr 7 and 8 students in the schools. As you can tell from the number, it only covers 4 strains of HPV (2 strains which cause cervical cancer, and 2 strains that cause genital warts). It only prevents 70% of cervical cancers. Would you 70% or 90% on a school exam? In order to boost your protection up to 90%, we recommend students be re-immunized with the newer Gardasil-9 at Get Well Clinic. Grade 7 boys in Ontario only started getting Gardasil in 2015 (but this was the original 4-strain version only).

Other countries are starting to recongize the importance of preventing cancer with vaccines. Hong Kong had introduced Gardasil 9 in 2016, and many Chinese students were travelling to the territory for this vaccine. Mainland China recently approved Cervarix and original Gardasil (another HPV vaccine) in 2016/2017. However, Cervarix and original Gardasil only covers 2 strains of HPV (16, 18), and therefore is only offers 70% protection for cervical cancer, but no protection against the other strains that cause genital warts.

Gardasil-9 is better than original Gardasil.

Get 90% Protected from cervical cancer and genital warts!

 

Even if you get the HPV vaccine, women should still see their family doctor regularly for PAP test's (Women's Health Exam) to check for early signs of cervical abnormalities that may develop in to cancer. Getting the vaccine does NOT mean you can skip the PAP tests.

 

Gardasil-9 is a vaccine that is injected in to the shoulder muscle. There are 2 or 3 shots needed over a span of 6 months, depending of your age. Gardasil 9 is officially indicated for girls/women from 9 yr old to 45 yrs old, and for boys/men from 9 yrs old to 26 yrs old. It has been recommended by the Canadian NACI guidelines for any age and any gender. It is safe for older men and women, however, the research studies only studied the vaccine in the indicated age groups. Your doctor may still recommend it for you depending on your specific situation.

It is better to get it earlier than later. Getting the HPV vaccine earlier means you get protected sooner and more effectively, before you are exposed to all the strains of HPV in your lifetime.

If you got original Gardasil or Cervarix, you can still get Gardasil-9 safely and boost your immunity to 90%.

 

Get your HPV vaccine today at Get Well Clinic! Contact us to make an appointment. 416.508.5691.

 

References:

http://www.arhp.org/publications-and-resources/clinical-proceedings/Managing-HPV/Impact

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC145302/

https://www.ncbi.nlm.nih.gov/pubmed/2256864

http://www.gardasil.ca/what-is-gardasil.html

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Pneumonia Vaccine

Have you every had pneumonia? Did you know of someone who died of pneumonia?

We now have a newer, more powerful vaccine to protect adults from pneumonia! Its called Prevnar13 and is the safe enough for babies, but strong enough for seniors. The older Pneumovax vaccine was developed in the 1980's and was routinely given to seniors for free in Ontario, however, it never actually prevented people from getting pneumonia. On the other hand, Prevnar13 prevents ~50% of vaccine-type pneumonias overall! We've been giving Prevnar13 to babies, as part of their routine childhood immunizations, for over a decade in Ontario (those lucky kids get it for free). Communities that got the vaccine actually saw lower rates of pneumonia in the rest of the population, even for those people who didn't get the vaccine (herd effect). Studies also show that you get better protection if you receive Prevnar13 first, before you get the free Pneumovax.

Contact us now (416-508-5691) to get your Prevnar13 pneumonia vaccine and protect yourself and your loved ones around you!

http://www.uptodate.com/contents/pneumococcal-vaccination-in-adults

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