Some people have to get the flu before they'll get a flu shot.
They'll miss a week or more of work or school, suffer through high fevers, body aches, headaches, a sore throat and coughing before they vow to do everything possible to prevent or lower their chances of getting the flu again. The flu, they feel, is that bad.
Gabe Echazabal of Tampa can tell you all about it. He never wanted to get the shot after hearing the stories of people who got the bug despite getting the vaccine. He also heard that the vaccine itself might make him sick.
People can, in fact, get the flu after being vaccinated, but the illness tends to be less severe. And medical experts say it's impossible for the vaccine itself to make you sick.
Still, Echazabal never opted to roll up his sleeve for an injection of protection.
Last month, he developed a severe headache. "I don't get sick often, and regular Tylenol would usually take care of something like that, quickly. But not this time," said the 49-year-old senior human resource analyst with the Clerk of the Circuit Court in Hillsborough County. "This headache wouldn't stop and I was getting worried."
After a few days of unrelenting head pain, Echazabal developed extreme fatigue, back aches and fever. He woke feeling so bad one morning that he went to a walk-in clinic. That's where he learned he had influenza B.
"I kept thinking it was just something minor, but I couldn't function. I knew something was seriously wrong," he said.
Influenza symptoms can range from mild to severe. They almost always include a fever, cough and sore throat. And, in certain people — primarily the very young and older adults — they can be life-threatening.
"People often downplay the severity of the flu and they shouldn't. It is a silent killer," said Dr. Sally Alrabaa, a University of South Florida infectious disease specialist at Tampa General Hospital.
Of the two most common types of influenza circulating now — viruses A and B — Alrabaa said type A is particularly aggressive this season and is most likely to cause serious complications in infants and toddlers, older adults and those with chronic health conditions or who are on medication that weakens the immune system. According to the Florida Department of Health, the state has seen widespread influenza activity in recent weeks, mostly type A.
The flu usually comes on suddenly. It's described as feeling like you've been hit by a bus. Most people recover in a week or two but fatigue from the illness can persist for another week. Flu patients usually miss several days of work or school, and the most seriously ill patients may spend weeks or months in the hospital.
Should you see a doctor if you suspect the flu? It's probably worth at least a phone call to your doctor, if not an office visit. Doctors can prescribe a medication known as Tamiflu or its generic equivalent, oseltamivir phosphate, which may make you better sooner. The medication also may be prescribed to prevent the flu in high-risk people — diabetics, cancer patients, pregnant women, people with chronic respiratory or cardiac conditions — and their caregivers who have come in contact with someone who has the flu.
"The sooner you see the doctor and start taking Tamiflu, the sooner you'll start to get better," said Dr. Amber Stephens, a family medicine specialist at BayCare Urgent Care in Largo. "It makes you less infectious to others, the symptoms aren't as severe and it shortens the time you're sick to about five to seven days instead of seven to 10 days."
But Tamiflu may carry a hefty price tag. Stephens said patients without insurance coverage may pay as much as $150 for 10 capsules, enough for the typical five-day course of treatment. Even with insurance, copays can be high, around $50 to $60. "But some pharmacies offer discounts, particularly to those without insurance," said Stephens. So, it's worth it to shop around.
During the last flu season in 2015-16, 25 million Americans got the illness, according to the Centers for Disease Control and Prevention. Of those, 310,000 had to be hospitalized and more than 12,000 people died from the flu. Most of the deaths and hospitalizations involved people 65 and older.
The CDC estimates that the flu vaccine prevented more than 5 million cases of flu last season, 71,000 hospitalizations and 3,000 deaths. Still, most people eligible for the vaccine don't get it. According to the CDC, working-age adults between 18 and 64 are the least likely to get a flu shot.
Keanna Serrette was among that group when she decided not to get a flu shot in 2015, figuring she was too young and healthy to get the illness. But she did, over the winter break from school, forcing her to miss out on family Christmas celebrations.
"I had high fevers, headaches. It was awful, but I felt better almost immediately after taking Tamiflu," said Serrette, who is now 20 and majoring in chemistry at the University of South Florida. "So last November I made sure I got my flu shot. I did not want to get the flu again."
Current guidelines recommend the flu vaccine for everyone age 6 months and older. The flu season generally runs from October to March, peaks between December and February and can hang around well into May. Because of the long flu season, if you haven't been vaccinated yet, it still makes sense to get the vaccine now.
And bear in mind that the vaccine isn't 100 percent protective.
"Such a vaccine just doesn't exist," said Stephens, the BayCare doctor, noting that this year's vaccine is about 43 percent effective at preventing influenza type A and 72 percent effective at preventing influenza type B. The effectiveness of the vaccine also depends on your other medical conditions, the medications you take and the people around you.
"School-aged kids bring home lots of germs," Stephens said.
If you get a flu shot and still manage to get the flu, chances are good that you'll have a milder illness than someone who wasn't vaccinated. "Also, vaccinated people are less likely to pass the virus on to a new baby in the house or an elderly or sick family member," said Alrabaa, the doctor at Tampa General.
Gabe Echazabal felt better two days after starting Tamiflu and only missed about three days of work. He has had a major change of heart about the flu vaccine.
"After what I've been through," he said, "next year I'm more apt to give it a shot."
Contact Irene Maher at [email protected]