It's a blustery fall day and I'm inside Cleveland's Public Auditorium. The Collinwood High School marching band is playing enthusiastically to a crowd of about a thousand people. Nearly everyone is over 65.
They've gathered for Cleveland's annual Senior Walk. It's a chance for older folks to get some exercise and learn about community resources for healthy living. And for some, it's also a chance to get their annual flu shot. There's a line for the table giving them out . but not everyone is in it.
"Well, I'd rather just depend on the Lord to take care of me and he's done that so far and so I'm OK with it," says Josephine Macklin.
Macklin, who stood outside after the event, says she has seen too many people get sick after getting the shot so she won't get near the vaccine. But Macklin's friend, Ethel Moore, says she get it because she was convinced to do so by her doctor.
"It's just been recommended so highly. And the doctor's like you need this and so I take it. And I might be like Josephine if I wasn't a diabetic, which leaves me open for it more. I probably wouldn't be taking it either," Moore says.
This mistrust and reluctance is frustrating to someone like Mary Jo Slattery, a registered nurse in the senior outpatient program at MetroHealth.
"Flu is so deadly to seniors. Up to 30,000 seniors can die from the flu every year and people still do not understand the importance of the flu vaccine," Slattery says. "They don't understand what the flu vaccine is."
The body's immune system weakens with age. And it can struggle to fight viruses even more if it's already suffering from chronic conditions such as diabetes or high blood pressure. The National Council on Aging says that each year, nine out of 10 flu-related deaths occur in seniors. Hospitalization rates are high as well.
Vaccinations are the best protection from the virus. And federal officials believe so strongly in the shots that they map vaccination rates among those enrolled in fee-for-service Medicare . For Northeast Ohio about 50 to 60 percent of seniors were vaccinated during the last season. And that rate is actually a bit higher because the data doesn't account for those enrolled in private Medicare insurance plans who get vaccinated.
Still it's frustrating to Slattery that the rates aren't any higher.
"Influenza is a very, very serious respiratory disease that can lead to multiple complications such as pneumonia, sepsis - which is overwhelming infection - and therefore death," she says..
But what of the concerns, like those expressed by Macklin? Will the vaccine make her sick?
"The flu vaccine is not a live virus. You cannot get the flu," Slattery says.
While there is a version of the vaccine out there that contains a weakened live virus, it's not recommended for the young and old. And those over 49 will only be given the standard/ inactivated flu shot. Healthy seniors can also ask for a higher-dose shot that offers more protection.
In addition, Slattery says it's normal to get the chills, achiness and to run a slight fever after getting the shot.
"But that's gone within 24 hours. That's just your body's response to building up the antibodies. It's fighting it, that's actually a good thing," she says.
As for those who do get sick? Well, perhaps they have another seasonal bug-the flu shot only protects you from the top viruses in circulation. Or they could've gotten the vaccine too late.