When’s the right time for a regular flu shot? other options than coffee during pregnancy

 

 

Q: Should I wait to get my flu shot until we know when a COVID vaccine is available? I don’t want to get them too close together, do I? — Charlene R., Rochester, New York

A: We don’t know yet if social distancing and mask wearing will cut down on the number of flu cases this season. But we do know that if the flu and COVID-19 hit hard at the same time, our health care system could be brought to its knees. Centers for Disease Control and Prevention director Robert R. Redfield said in an interview with the editor of the journal JAMA, “This is a critical year for us to try to take flu as much off the table as we can.”

And there’s no reason to wait. Dr. Susan Rehm, vice chair at the Cleveland Clinic’s Department of Infectious Diseases, says the smart move is to get your flu shots ASAP. The vaccine is maximally effective for about six months and getting it now should carry you through until the risk of influenza dies down again next spring. The CDC adds that waiting too long (like until the end of October) increases the risk that you will catch the flu before your immunity kicks in (it takes a couple of weeks after you get the shot).

Seniors should receive a high-dose version; a peer-reviewed study sponsored by the manufacturer found that it is about 24 percent more effective than the standard shot at preventing the flu. Whatever dose you get, the influenza vaccine reduces your risk of being admitted to intensive care with the flu by 82 percent.

As for its compatibility with a COVID-19 vaccine? An opinion piece in The Pharmaceutical Journal, put out by the Royal Pharmaceutical Society in the U.K., says there’s a chance that it will eventually make sense to have both vaccines in one shot! So until then, get your flu shot now and the COVID-19 vaccine when it is available.

Q: I am three months pregnant and my doctor said I should give up coffee. I only drink a cup or two in the morning.

Is that really necessary? — Janet T., Missoula, Montana

A: For quite a while, it’s been recommended that pregnant women should limit their intake to about two cups a day of mild- to medium-strength coffee. But researchers in Iceland decided to doublecheck the data in multiple studies to see if it was really good advice. Their review, published in BMJ Evidence-Based Medicine, found that the majority of observational studies and metastudies they looked at “indicate that maternal caffeine consumption is reliably associated with miscarriage, stillbirth, low birth weight and/ or small for gestational age, childhood acute leukemia and childhood overweight and obesity, but not preterm birth.”

Not everyone agrees: In an email to CNN, Dr. Christopher Zahn, vice president of practice activities for the American College of Obstetricians and Gynecologists, wrote that there is no need for “immediate change to the current guidance” based on this research. “Our guidance remains that moderate caffeine consumption, less than 200 mg per day, does not appear to be a major contributing factor in miscarriage or preterm birth.”

However, why take a chance? You can go back to caffeine once you’re done with breastfeeding. Instead, enjoy a beverage made from hot water with lemon or another citrus. Warm vegetable or chicken broth is also satisfying. A word of caution: Many herbal teas are associated with risks to the fetus or there is simply not enough data to know if they are safe. Teas that some research suggests are risky include those made with fennel, fenugreek, sage, vervain, borage, pennyroyal, licorice, thyme, motherwort, lovage, blue and black cohosh, and chamomile in large amounts. In one study in The Journal of Maternal- Fetal & Neonatal Medicine, the researchers said, “With the exception of ginger, there is no data to support the use of any other herbal supplement during pregnancy.”

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 health and wellness questions to Dr. Oz and Dr. Roizen at youdocsdaily(at sign)sharecare.com.

(c)2020 Michael Roizen, M.D. and Mehmet Oz, M.D. Distributed by King Features Syndicate, Inc.

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