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Dr. Roach Writes: As I write this, another gun tragedy has taken place in the United States. By the time it gets published, about 1,500 more people are likely to have been killed by guns, many accidentally. Physicians have a responsibility to protect the health of their patients and the public, and I can’t be silent on this any longer.

Gun violence is a major cause of morbidity and mortality in the U.S. With over 10,000 deaths yearly, including accidental deaths and suicide, gun violence is a more important cause of death than many of the conditions I discuss in this column. Unfortunately, the U.S. Congress has repeatedly failed to fund research on gun violence by the Centers for Disease Control and Prevention, the best-placed U.S. agency to follow what can reasonably be described as an epidemic. This has prevented research on the best ways to reduce gun deaths.

Governments have attempted to keep doctors silent on gun violence. Florida passed a law preventing them from discussing gun safety with patients (this was struck down in 2017 by a federal appeals court). The goals of discussing gun safety are to educate and to consider a means of cutting risk of injury (such as trigger locks, gun safes and storing weapons and ammunition separately). This is important in a patient with a history of violence, mental health problems, or drug and alcohol abuse.

As a doctor, it’s not my place to discuss changes in the law or in public policy; however, it is a physician’s place to make recommendations to gun owners for reducing risk. As gun violence continues to escalate, it’s important for physicians to be part of the solution to cut gun injury. It’s still up to politicians to write laws to protect the public; until that happens, a physician’s brief discussion on gun safety certainly won’t stop all gun violence, but it can reduce gun injuries, especially accidental ones, and especially in households with children.

Dear Dr. Roach: I just read your article on the various types of flu vaccines. I really need your opinion on whether I should get one of the vaccines. I am a 79-year-old woman in good health and not allergic to eggs.

I know the flu virus is dead and you can’t get the flu from a shot. But when it first became available in the 1950s, I had it in two doses and became very sick for about two weeks with flulike symptoms. So, I avoided it, and throughout the years, I had the flu a few times — once, when I was in my 20s, very bad with type A, and it attacked my nervous system. I was not able to drive for three months. I also got sick after a flu shot in the 1980s.

I am hounded to get the flu vaccine, but I am afraid to. Now that there are various kinds available, I wonder if I should try one.

M.T.

Dear M.T.: I’d certainly recommend it. I normally would recommend a high-dose version for a woman in her late 70s, but you clearly have a robust immune system and I suspect that is why you have had a strong reaction. However, vaccine technology has dramatically improved, and I would recommend a standard-dose flu shot. You also might take a Tylenol right after having the vaccine. (There is some evidence that this may reduce the effectiveness somewhat; however, I still think it’s better than no vaccine at all.)

Email questions to ToYourGoodHealth@med.cornell.edu.

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