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Trump’s Flu Shot Reticence

President Donald Trump cast doubt on the value of influenza vaccines, saying he has never had the seasonal flu and only got a flu shot because he was required to as president. “I don’t know if I should have. Who knows?”

We don’t know what prompted the president’s reluctance to get a flu shot or why he questioned whether it’s a good idea, but the Centers for Disease Control and Prevention says each year it saves thousands of lives and prevents tens of thousands of hospitalizations.

The president’s hesitance about the need for a flu shot comes as medical professionals say those influenza vaccinations will be particularly important this year to lessen public confusion between seasonal flu and COVID-19, and to prevent unnecessary medical evaluations for the new coronavirus.

Trump’s comment about flu shots came during an interview with the Washington Examiner on May 14.

Trump, May 14: I never lost anybody to the flu. Look, I’ve had people having the flu. I said, “Hey, how are you doing with the flu?” They had the flu. I never had the flu. You know, the first thing they did, they want to give me a flu shot. I never had the flu. And I come to the White House, “Sir, we have to give you a flu shot.” I said, “Why?” And I took it. I don’t know if I should have. Who knows? Three times now. I’ve taken three flu shots, but anyway. …

It’s not the first time the president has expressed reticence about getting a flu shot.

“All my life I see — I was lucky; I never had the flu,” Trump said during a Fox News virtual town hall on May 3. “Then I came here; they want to give a flu shot. And I said, ‘I don’t want a flu shot,’ but they have to give it.”

The CDC says flu shots carry very little risk and have important benefits. According to the CDC, the vaccine “can reduce flu illnesses, doctors’ visits, and missed work and school due to flu, as well as prevent flu-related hospitalizations.” The CDC points to studies that indicate “flu vaccination reduces the risk of flu illness by between 40% and 60% among the overall population during seasons when most circulating flu viruses are well-matched to the flu vaccine.”

Although Trump said he has never known anyone who has died from the flu, seasonal influenza kills thousands of Americans each year, and infects millions.

For the 2019-2020 flu season, which ended in April, 39 million to 56 million people had flu illnesses in the U.S., according to preliminary estimates from the CDC. The CDC estimates last season’s flu had caused between 24,000 and 62,000 deaths. Since 2010, influenza in the U.S. has caused between 9 million and 45 million illnesses annually, the CDC says, with 12,000 to 61,000 of those resulting in death.

According to the CDC, flu vaccinations — which target the three or four influenza viruses that researchers expect will be most common that season — prevent tens of thousands of hospitalizations each year. About 49% of Americans got a flu shot during the 2018-2019 flu season, and according to the CDC, that prevented: “4.4 million flu illnesses, more than the population of Los Angeles; 58,000 flu hospitalizations, about the number of students at Ohio State University; 3,500 flu deaths, equivalent to saving about 10 lives per day over the course of a year.”

Risks from getting a flu shot are low, the CDC says. “Common side effects from a flu shot include soreness, redness, and/or swelling where the shot was given, headache (low grade), fever, nausea, muscle aches, and fatigue,” according to a CDC webpage about seasonal flu shots.

“Life-threatening allergic reactions to influenza shots are very rare” the CDC  says. “There is a small possibility that influenza vaccine could be associated with Guillain-Barré syndrome, generally no more than 1 or 2 cases per million people vaccinated. This is much lower than the risk of severe complications from influenza, which can be prevented by influenza vaccine.”

A webpage produced by the Kaiser Permanente Washington Health Research Institute in Seattle seeks to debunk “10 flu shot myths,” including misconceptions such as that the flu shot can cause the flu, that flu shots don’t work or contain harmful ingredients, and that flu shot side effects are worse than the flu itself. The final entry speaks directly to Trump’s comments.

Kaiser Permanente Washington Health Research Institute : Myth #10: I never get the flu so I don’t need to be vaccinated. Just because you’ve been fortunate in the past doesn’t mean you’ll be so this year. As health author Tara Haelle puts it, “Millions of people have never gotten into car accidents. They still wear seat belts and carry insurance.”

Health experts say flu shots are particularly important this year to “prevent influenza and possible unnecessary evaluation for COVID-19.”

CDC Director Robert Redfield made this point when he clarified comments he made to the Washington Post on April 21. Redfield told the Post: “There’s a possibility that the assault of the virus on our nation next winter will actually be even more difficult than the one we just went through. … We’re going to have the flu epidemic and the coronavirus epidemic at the same time.”

At a press conference the following day, Redfield said he did not mean that the COVID-19 pandemic was going to be worse next winter, but rather that it would be “more difficult and potentially complicated because we’ll have flu and coronavirus circulating at the same time.”

“The key to my comments and the reason that I really wanted to stress them was to appeal to the American public to embrace the flu vaccine with confidence,” Redfield said. “One of the greatest tools we have as we go through the fall-winter season that we’re into is to get the American public to embrace the influenza vaccine and thereby minimize the impact of flu to be the co-respiratory disease that we confront.”

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