The Flu, the Shot and The Takeaway: A Special Report and Q+A with Veteran Pediatrician, Dr. Nancy Zimble

With so many uncertainties swirling on the internet about the flu this year, I wanted to know the facts.  

I interviewed my children’s’ pediatrician, Dr. Nancy Zimble, to get the real deal on this years’ flu and flu shot.  With 40 years in pediatrics and a guestimated 100-200K office visits, “Dr. Nancy”, as we call her, reminds us to stay rooted in science and to work with our trusted pediatricians to meet our kids’ needs when they’re ill.

Here’s what you need to know about the flu and the flu shot. 

“By some estimates about three quarters of influenza is in unvaccinated patients. So yes, some vaccinated kids still get the flu, but probably fewer complications too.  ”

— Dr. Nancy Zimble, Pediatrician

Polite As Fudge:  Is the flu really worse this year?

Dr. Nancy:  Yes, this year is worse.  The strains in the vaccine can mutate by the time we have it available, or even during the season.  This year, it did.

In our office, we give a vaccine that protects against four strains (some doctors use only three) and the protection against one of the strains was not good.  Usually, the vaccine is about 60 percent effective.  This year it is more like 30 percent.  There are more cases this year and the H3N2 strain is particularly nasty so the patients are sicker.

The definition of “worse” does depend on what you are looking at.  I would say we are seeing more kids with flu this year but that is somewhat because the media has the parents so scared that they are coming in right away.  Sometimes parents just treat a fever and give fluids and come in only if things aren’t getting better or if something gets worse.

Polite As Fudge:  So that’s where the big question comes in.  If it isn’t going to cover the right strain of the flu, is it still worth it to get it?  

Dr. Nancy:  Definitely.  It still works more than 30 percent of the time and vaccinated patients may have fewer complications.

Polite As Fudge:  What are your thoughts on the media coverage of the flu?  

Dr. Nancy:  The media keeps stressing the pediatric deaths – there have been about 30 this year and the season isn’t over – but there were 100 last year and it was a really quiet year for flu.

Polite As Fudge:  I’ve seen a lot of back and forth on the news, internet etc., from both pro-vaccination people and non-vaccination people regarding the flu shot and “how much it’s actually working”.  What are the cold hard facts, and what’s your take on vaccinating kids this year (and any year) for the flu?

Dr. Nancy:  I think parents worrying about side effects of vaccine would do better to read up on the seriousness of the diseases we are protecting from.  We have done such a good job at preventing many childhood illnesses that parents are now more worried about shots then disease!

By some estimates about three-quarters of influenza is in unvaccinated patients – so yes, some vaccinated kids still get the flu but probably fewer complications too.

The hardest, scariest thing about medicine is that you can see a kid with mild infection one day who can develop complications by the next.  I hear parents say, “she said nothing was wrong” when what I did say was” it is a virus and I can’t fix it” – there is still something wrong and it might get worse before it gets better.  I always try to tell parents what to watch for – and it isn’t just the degree on the thermometer.  Also, we need to be respectful of each other and diligent in keeping sick kids home to try to manage the spread of disease.  Parents know their own kids best – if they aren’t getting better or if the symptoms are getting worse, do not hesitate to have them seen again.

We are all used to getting things fixed with the click of an app:  you could have a new bed delivered to your door tomorrow and groceries in an hour!  We have no magic wand to fix most viruses and though for most they are mild self-limited illnesses, for some they can cause terrible complications.

Even the uneventful flu is probably a one-week illness.  Children are probably contagious the day before you know they are sick and for three to four days after acute symptoms improve.  There is so much pressure for parents to get back to work and kids to school.  But what our kids need most are rest, fluids, and comfort.  We need to wash our hands often, cover our mouths and throw out our dirty tissues.

Polite As Fudge:  Do you get a flu shot yourself?  Did you always have your kids’ vaccinated for the flu when they were little? 

Dr. Nancy:  I do get the flu shot.  It would be irresponsible of me to work with babies if I got sick and I am exposed frequently.  Luckily this constant exposure builds great immunity!

My kids got flu shots also.

Polite As Fudge:  What are the important takeaways for concerned parents? 

Dr. Nancy:  Most young healthy children sail through this, but they are the ones that get the rest of us sick.  Very young and very old are more likely to have complications as well as patients with underlying illnesses (asthma, cancer, etc.)

Polite As Fudge:  Anything else we should know? 

Dr. Nancy:  I think parents deserve to have physicians they can trust and should then use their advice.  Another good source of advice (for many pediatric issues) is a site from the American Academy of Pediatrics:  Parents shouldn’t be getting advice from nonmedical friends.  That’s NOT science.  I have spent almost 40 years trying to help parents raise healthy happy kids.  That’s anywhere from 100-200,000 office visits.  I am trained to figure out how sick your child is, but we need to be partners in this.  If things aren’t going well you need to come back and let me check again because the complications are the problem and they don’t always show up right away.

Some high-risk patients need to take Tamiflu, an antiviral drug. It needs to be started in the first 48 hours of illness.   Tamiflu is not a great drug – the liquid tastes terrible and is hard to get kids to take.  It may only shorten the course by one day.  Many kids have vomiting as a side effect and that will make it harder to prevent dehydration.

Growing up in Massachusetts,

Growing up in Massachusetts, Dr. Zimble knew she wanted to be a doctor since she was a young girl.   She attended Vassar College and Tufts University School of Medicine, and came to California in 1978 to do her residency at the LA Children’s Hospital.  She has had a private practice in the San Fernando Valley since 1982. She loves helping families raise healthy children and especially enjoys advising them through the normal hiccups of the journey. She has two young adult daughters, and in her spare time she enjoys yoga, reading, the beach, and sushi.

Please note:  readers should always consult with their child’s pediatrician regarding medical decisions.  This is just a little ole’ blog, not intended to give medical advice or otherwise.  Polite As Fudge and it’s guests give their opinions, never to be replaced by one-on-one medical care.  Had to say it.  <3