CAMDEN — BY MICHAEL ROIZEN, M.D., AND MEHMET OZ, M.D.
Q: I heard that the flu vaccine worked only 20 to 25 percent of the time last year. Is it even worth getting it this year? -- Lolly G., Stamford, Connecticut
A: It’s always worth getting the flu shot, and that 20 to 25 percent effectiveness number was simply an early estimate. The Centers for Disease Control and Prevention states that the effectiveness rate ended up around 36 percent across several different flu strains, but primarily against H3N2. However, even a 20 percent effectiveness rate -- as was the case in 2014-2015 -- prevents an estimated 144,000 flu-related hospitalizations and 4,000 deaths. This year, the vaccine almost doubled that prevention/death rate! That’s avoiding a lot of misery!
So, yes, get your flu shot as soon as it’s available this fall. Don’t forget, there’s also a cumulative benefit. We can’t put an exact number on it, but we do know that people who receive the vaccination year after year, and who still end up getting sick, tend to have less severe symptoms for a shorter period of time than unvaccinated folks. And getting the flu shot 10 years in a row from age 50 to 60 decreases all causes of death, including from stroke and heart attack, by more than 25 percent.
Plus, there’s the benefit, especially for 30- to 50-year-olds, that comes from creating “herd immunity.” When you’re inoculated against the flu, you’re not putting vulnerable young kids and seniors who may not have been inoculated at risk of coming down with it and suffering serious complications.
Clearly, there’s no downside to getting the flu shot. (Compared with the odds of preventing serious illness and death, the chance of a serious side effect is 1 in 40,000.) As Health and Human Services Secretary Alex Azar put it, it’s “the same kind of sensible precaution as buckling your seatbelt.”
So protect yourself and your family by getting vaccinated when the time is right; there’s a schedule for all of your vaccinations at www.cdc.gov/vaccines/schedules.
Q: My dad is 91, and living in an assisted care facility. He’s recently started taking an anticholinergic medication for a bladder problem and depression. It seems to be dulling him down, and I read that anticholinergic meds are linked with dementia. Should we get him off these pronto? -- Quentin, H., Sacramento, California
A: First off, these are a powerful class of drugs; never, ever stop taking a medication without a doctor’s supervision. Even aspirin or a statin requires careful consideration before stopping. They need to be stopped slowly. Second, there are alternatives to anticholinergics that may make sense, depending on how your dad handles the side effects. The Golden Rule is that a medication’s benefits need to clearly outweigh any harm it may cause. So let’s take a look at the study you mentioned.
Published in the BMJ, the study looked at the records of more than 40,000 patients with dementia and more than 280,000 without dementia, and analyzed over 27 million prescriptions. The researchers didn’t find a direct relationship between the prescriptions and dementia, and there was no link between people taking inhaled anticholinergics for lung problems and dementia. But they did find that folks who took the most oral anticholinergic meds had higher rates of dementia.
Now, we’re not sure which came first, the dementia or the meds, but as far as your dad is concerned there are a couple of takeaways.
We do know that some anticholinergic drugs can cause temporary, short-term cognitive impairment to attention and reaction time. That’s why current guidelines say that frail older people should avoid anticholinergic drugs. If you talk to his doctor about alternative medications, remember that he may have to switch to two medications, which can be a concern, but they may have less serious side effects.
On the positive side, the side effects you think he is experiencing may be temporary, but under any circumstance, the smart move is to let his doc know your concerns.
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(Mehmet Oz, M.D. is host of "The Dr. Oz Show," and Mike Roizen, M.D. is chief wellness officer and chair of Wellness Institute at Cleveland Clinic. Email your questions to Dr. Oz and Dr. Roizen at youdocsdaily(at sign)sharecare.com. Distributed by King Features Syndicate, Inc.)