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A podcast by millennials, for millennials, covering health challenges unique to Gen Y. Get expert insights, practical patient advice, and inspiring survivor stories to help you make informed healthcare choices. Empower your journey with YMyHealth!
Julie Woon (00:44)
Hi everyone. Thanks for joining the Why My Health podcast. Today's guest is Alexandria Yarborough, a pharmacist and children's book author based in South Carolina. Yarborough received her doctorate in pharmacy from the Presbyterian College School of Pharmacy and her book, Our Best Shot, is designed to educate children about getting their flu shot. Today, Dr. Yarborough is on the show to speak with us about the 2024-2025 flu season. So welcome to the podcast, Alex.
Dr. Alexandria Yarborough (01:07)
Thank you so much for having me.
Julie Woon (01:09)
Yeah, we're really excited. I think this has been an interesting flu season. so maybe we can just start there about how this year's season has differed compared to previous seasons regarding timing and severity. seems like this year was a little bit earlier.
Dr. Alexandria Yarborough (01:24)
Yeah, you're exactly right. So this year it started earlier. Usually we see kind of peaks around December and into January, but this year was actually October and it's also more severe than the past couple years. So more severe and starting earlier. So two not so great things when it comes to talking about the flu.
Julie Woon (01:43)
And what are the dominant flu strains that we've seen? Is there any more that are more prominent than the others?
Dr. Alexandria Yarborough (01:48)
So right now what we're seeing is a lot of H3N2. So usually it's a combination of H1N1, which is also known as influenza A. But this is a more severe strain. And so that's also kind of coming into play with why it's starting earlier and why we're having all these issues with such an early season.
Julie Woon (02:08)
Interesting. Does that have to do with the severity as well?
Dr. Alexandria Yarborough (02:11)
It does. Yes. It's a lot more intense. Sometimes people, when they get the flu, they're not too worried, which is something I'm sure we'll dive into. But this is one to definitely not take or make light of. It can be very, very severe. The flu is fatal. I think a lot of people do not realize that.
that it is very, very severe and especially with this circulating strain.
Julie Woon (02:31)
Yeah. Is there any data out yet that tells us about the severity, you know, regards to hospitalizations or deaths?
Dr. Alexandria Yarborough (02:38)
There is. So the main source I use for data when I'm educating my patients is the CDC. And so they've said so far since October 1st, they've had about 1.2 to up to 2 million illnesses.
Unfortunately, it's a little bit hard to get the data so early. The actual data projections, like the numbers don't usually come out until December, but the estimates tend to be pretty spot on. So of those, you know, one to two million illnesses, there's been about 33,000 hospitalizations and about 3,000 deaths so far, which is a lot. It's way too many, including two pediatric deaths, which are, I think, one of the saddest metrics that we have.
Julie Woon (03:22)
So, you know, we know that vaccines are obviously the most prevalent way for prevention. How does the vaccine address the specific strands that we're seeing this year?
Dr. Alexandria Yarborough (03:30)
So one of the cool things about the vaccine this year is that it is a trivalent. So in the past, it used to be a quadrivalent vaccine, which meant there were two strands of A and two of B, but one of the B strands hasn't been seen in over four years. So they were able to drop that strand. So there's not any unnecessary vaccine components.
So it's just a trivalent that addresses specifically the H3N2, the H1N1, and then also an influenza B strain.
Julie Woon (03:57)
Got it. And are there any specific populations that should prioritize getting the flu vaccine?
Dr. Alexandria Yarborough (04:02)
Well, I personally believe everyone, but absolutely young children. That's a big one. And then also older folks as well, or anybody with a comorbid condition.
Because, for most healthy people, hopefully if you get your flu shot and you were to get the flu, you should be able to bounce back. But if you've got some type of comorbid condition, such as COPD, diabetes, or anything else that's chronic, it can really, really affect you.
Julie Woon (04:28)
Interesting. And I have been seeing some news around different delivery methods. So I think everyone's sort of aware of the traditional stick, but there's been talk about nasal sprays or microneedle patches. Is there anything, you know, about these other possible forms that should be considered?
Dr. Alexandria Yarborough (04:48)
Yeah, Absolutely. So the nasal spray is an awesome option, especially for kids. It's approved for anyone who's ages two to 49. Unfortunately, if you are pregnant, you do have to get a traditional vaccine, but otherwise anyone 2 to 49. So that's great. However, one caveat to remember is it expires a lot sooner than the IM injection vaccine.
So you need to make sure you go ahead and get that in October, November, because it's not available for the entire season. And then I have done some research into the microneedle patches. So those are interesting. They definitely will be awesome once they come out. I know that they have gained some approval, but it has not become common practice at this time.
Julie Woon (05:29)
Do researchers decide which strains that they're going to include in that year's flu vaccine?
Dr. Alexandria Yarborough (05:34)
So the WHO or the World Health Organization, so they are tracking the flu constantly all year round, just not during flu seasons. And so what they do is they look at the different hemispheres and what happened in that previous season. So usually when you travel to different places, summer and winter are flipped with the hemispheres. And so our flu seasons are also kind of opposite. So they're able to make predictions based on what's circulating at a certain point.
Julie Woon (06:02)
And there's...a handful of misconceptions I think that fly around every year related to flu vaccines. Can you address just some of the most common ones that you've seen, I guess this year, just in general?
Dr. Alexandria Yarborough (06:12)
So every year I hear that the flu shot gives you the flu and that's just not true. It can give you some flu-like symptoms, but definitely not the flu. It's not made that way. So that's the biggest one.
Another one is that I'm young, I'm healthy, I don't need it. You know, I'm glad that you might think that you don't. I'm glad that you are healthy, but the flu can affect anyone no matter how healthy you are. And then some of the other ones are that it's just not effective. Some years, you know, we have better predicted strains that are put into our flu shot. Other years, not so much, but overall, if you get the flu vaccine and it's not a perfect match, it's going to make it less severe and not last as long if you were to get the flu.
Julie Woon (06:53)
Obviously getting the flu shot, that's the biggest one, but what other preventative measures could we be taking to help protect ourselves from the flu?
Dr. Alexandria Yarborough (07:00)
So just remaining healthy, eating a good diet of fruits and vegetables, making sure we exercise, wearing a mask when we're in highly populated areas, especially when we're traveling like at airports where there's a lot of people from a lot of different places, and then stress management as well. Now, cortisol decreases our...immune system. So the more stressed we are, the more likely we are to be susceptible to getting different types of illnesses, including the flu. And then one that a lot of people realize but don't necessarily do is wash your hands. So sure, we wash our hands before we eat and after we use the restroom, but maybe when we're shopping for a day, you know, we're going store to store, we're touching all different types of surfaces, make sure you wash your hands. That's a huge way to prevent the flu.
Julie Woon (07:43)
Yeah, that's a great tip that probably I wouldn't have just thought of that naturally. Like definitely, like you said, bathrooms, eating, that all makes sense. But just going out shopping, especially around holiday seasons and people are out, you've returned your Christmas gifts, you're going out for more. That's a great tip.
Julie Woon (08:01)
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Every year, I think one of the things that people see is it's really hard to distinguish the flu from a really bad cold, maybe COVID, maybe RSV, some other illness. How do people start looking at the delineation between those if they're not feeling so great?
Dr. Alexandria Yarborough (09:09)
Yeah, absolutely. So one of the big things with the flu is going to be fatigue and body aches. That's not necessarily seen as much in COVID or RSV. RSV is respiratory syncytial virus and it is very, it's a very heavy respiratory virus. Even though COVID and flu are also respiratory viruses, this one's characterized by a lot of breathing issues and wheezing specifically. So that's how you can distinguish that.
And then COVID, unfortunately, even though it's been around for a little bit, it's still kind of unpredictable. Some people can have mild to no symptoms. Other people will lose their sense of taste or smell. I had COVID earlier this year, unfortunately, and I thought I had strep throat because my throat was so swollen, but it was COVID. So if it's kind of a random presentation, a lot of times that tends to be more COVID. Flu tends to be kind of a whole body, like aches, fatigue, fever, like malaise.
And then RSV is strictly respiratory. What are the risks of getting a co-infection of the flu with maybe one of these other viruses? I mean, the biggest thing is going to be hospitalization for numerous different issues and it can exacerbate what comorbid conditions you already have. So if you have diabetes, it's going to be really hard to control your blood sugar when you're sick. So infections are going to exacerbate the worst of symptoms. If you're having trouble breathing, no nebulizer treatment is going to be able to help that much.
So that's kind of the biggest thing. then the fact that the severity, we don't know how it presents and, you know, someone could come in and then they could get pneumonia. mean, could be all these different things can happen just from these respiratory viruses that are mostly avoidable.
Julie Woon (11:45)
Yeah. Heaven forbid one of our listeners does get the flu. What are your recommendations for treatment this year?
Dr. Alexandria Yarborough (10:52)
So, there are some antivirals that are available, so I definitely encourage those. However, it's not like taking an antibiotic for an infection. And antiviral is only going to make your experience a little bit less lengthy and not as severe. So it's kind of more symptomatic relief. So definitely increase fluids. That's a big thing. Rest is huge. And then stay home because even though it's bad for you, it can be worse for so many other vulnerable populations.
Julie Woon (11:20)
That's a perfect segue into my next question. I was going to talk about special populations when we're looking at parents with young children, pregnant individuals, or the elderly. Is there any other like special recommendations you would make for those groups?
Dr. Alexandria Yarborough (11:33)
Well, now there is an RSV vaccine. So that is something I know we're specifically talking about the flu, but either one of these respiratory infections can be deadly, unfortunately. So vaccination is always my number one recommendation. If you're pregnant, you can get an RSV vaccine and small children get antibodies. However, the vaccine has proven more effective. And then if you're over 60 as well. So those are some things that you can do for sure.
Julie Woon (12:00)
Great. With the flu vaccine, there has been issues for people who have egg allergies in the past. Has there been any developments in that area?
Dr. Alexandria Yarborough (12:07)
There has been. So the CDC, as of this year, they no longer recommend any type of precaution if you have an egg allergy. So they've come to find out that they use such a small amount of egg protein in the early stages of vaccine development that it might affect one per one million people.
And if that was to happen, the good news is anywhere you get a vaccine, we are fully prepared to administer an EpiPen or any type of anaphylactic care. So yeah, so it's actually great news that we don't have to have that precaution anymore. However, if you are severely allergic to eggs and you still don't feel comfortable, there is a brand of flu vaccine called FluBlock that is available for anyone over 18 that has absolutely no egg protein in it. So we definitely have some great options.
Julie Woon (12:51)
And if someone does have that issue, is that something that they would just let their pharmacist or their physician know in advance before coming? Or does, you know, any kind of healthcare institution have that option on hand?
Dr. Alexandria Yarborough (13:03)
So they definitely need to let us know because a lot of times in community pharmacy, we don't get to choose the type of vaccine that is available to us, but we can definitely find it for you. And just knowing that you have any type of allergy, whether it be an egg allergy or an allergic reaction to any type of food or medicine is really important.
I recently had a patient who was allergic to a certain antibiotic that was used in flu vaccine development. She was over 65 and so it was recommended she get the higher dose vaccine, but that component was in it in the high dose vaccine. So I was able to give her the under 65 vaccine that didn't have it at all. So we can definitely work with you and find out the best choice for you so that way you can still get the vaccine no matter what.
Julie Woon (13:43)
What role does public health messaging play in preparing for and managing the flu season?
Dr. Alexandria Yarborough (13:50)
I think the biggest thing is just education. A lot of people don't trust their doctors and pharmacists like they used to. And now that we have the internet at our fingertips, a lot of times people don't go to the most reputable sources. So, as more people who decide that vaccines aren't necessary, the more we need to educate them and, you know, reiterate that they are, they are life saving and we can actually prevent so many other issues as well.
from getting it. I think public health just needs to, you know, listen to people, practice empathy, but definitely try to educate them in a way to encourage them to advocate for themselves and get the vaccine.
Julie Woon (14:26)
Got it. Makes sense. I know we've covered a lot of different elements and topics for the flu season this year. Is there anything we haven't talked about that you think is important to emphasize?
Dr. Alexandria Yarborough (14:37)
I think one of the things that I've been telling a lot of my patients is to have a flu plan ready, especially if you are a parent of kids or if your workplace doesn't necessarily have protocol. So if you were to get the flu, just kind of know what you would do if you would have to use PTO or if there's some kind of sick leave from your job. And then also too, if you have kids and one of them gets the flu who stays home, you know, having medication on hand, if they have fevers, getting some Pedialyte just in case they need to be hydrated.
Just taking that extra step, you know, it take five to 10 minutes just to discuss it with your partner or spouse or even for yourself can be really helpful if you were to get the flu because once you're sick and you're not feeling good, that's not really the time to try to figure everything out. Totally. I don't have kids myself yet, but I have pets and the time when I was single and had pets, that was always something that I would consider of like, if I'm ill, you know, and I can't get up to walk the dog, like, what is the game plan? How do I prepare?
And I'm sure with kids or maybe elderly parents, know, that equation gets even more complicated.
Julie Woon (15:21)
Yeah, that's great advice. And I know this was our short and sweet episode, but Alexandria, thank you so much for coming and for giving us all this information. I know we've got more planned with you coming up. So looking forward to speaking with you again soon. Thank you so much for the time. Awesome. Thanks so much. Thanks for having me.