Flu Vaccine FAQs

Influenza (flu) is a contagious disease which affects the lungs and can lead to serious illness, including pneumonia. Even healthy people can get sick enough to miss work or school for a significant amount of time or even be hospitalized. A flu vaccine is your best defense against this common virus. Vaccines have changed the face of healthcare, especially for children. But you may still have some questions, like why you have to get it every year, or when it’s best to receive the vaccine. Our expert providers give answers to these questions and more below.

Are vaccines safe?
Yes!  They have been given to hundreds of millions of people for more than 50 years and have a very good safety track record. Each year, the Centers for Disease Control and Prevention (CDC) works closely with the U.S. Food and Drug Administration (FDA), and other partners to ensure the highest safety standards for flu vaccines. Before a vaccine is approved for use in the U.S., it goes through years of careful testing and clinical studies. The FDA also inspects the sites where vaccines are made to ensure they follow strict manufacturing guidelines. And once a vaccine is licensed, the CDC and FDA continue to monitor its use, effectiveness, and safety.

Can I get sick with the flu directly from the vaccine?
No. Flu vaccines cannot cause flu illness. The viruses used to make the vaccines are ‘inactivated’ (killed) or attenuated (weakened). Flu vaccines cause antibodies to develop in the body about two weeks after vaccination. Like any medication, some may experience side effects from the vaccine. For example, some may feel achy or may have a sore arm where the shot was given, but these side effects are NOT the flu. Instances of these reactions are also usually mild and last only 1-2 days.

Why do I need to get a flu vaccine every year?
Because the flu viruses are constantly changing, flu vaccines are updated each season. Scientists and physicians use research to make a vaccine that will protect against the viruses that are most likely to circulate each season. A person’s immunity toward a particular virus does decline over time. Annual vaccination against the flu is necessary for optimal protection.

There are several types of flu vaccines. What is the difference and which is best for me?
For years, flu vaccines were designed to protect against three different flu viruses (trivalent). This type of vaccine included protections against an influenza A (H1N1) virus, an influenza A (H3N2) virus, and one influenza B virus. But there are two different lineages of B viruses that circulate during most flu seasons, leaving the public vulnerable to one of these groups. The quadrivalent vaccine was designed to combat this problem, providing protection against two influenza A viruses, and two influenza B viruses.

The vaccine is recommended for everyone six months of age and older, with rare exception. The CDC recommends a high-dose vaccine for those 65 and older, as they are especially vulnerable to the risk of flu. Receiving any type of flu vaccine is better than no vaccine at all, but it is best to consult with your primary care provider. Other high risk populations include young children, pregnant women, and people with certain chronic medical conditions like asthma, diabetes, and heart disease.

I’m pregnant, so I shouldn’t get the vaccine, right?
You should absolutely get the vaccine. The flu vaccine actually protects babies from getting influenza in the months following their birth. Pregnant women who get the vaccine pass their immunity to their babies through the flu antibodies they develop. This protection lasts for several months after birth. Studies have documented influenza protections in newborns up to 4 months after birth.

Where can I receive a flu shot? Do I have to schedule a separate appointment?
For your convenience, Medical Associates Clinic offers flu vaccine at all of our clinic locations. If you have an appointment already scheduled with your primary care provider this fall, you do not need to schedule a separate flu shot appointment with us. Simply ask to receive your vaccine then. If you do not have an appointment coming up with your primary care provider, click this link to view all the information on flu clinic locations, dates, and times. Find the one that works best for you and call to schedule an appointment.

Also, to better accommodate our busy patient families, our pediatrics department will vaccinate all children and parents in one visit.

Please be sure to keep record of when you received your vaccine and avoid getting a duplicate shot. And if you have any further questions regarding the flu vaccine, please call your doctor’s office.

For further general information about flu vaccination, visit http://www.cdc.gov/flu.



Sources: www.cdc.gov, health.clevelandclinic.org

Delivering Positive Experiences – Birth Plan Options for Expecting Moms

Settling on the right OB and birth plan are very personal choices for expecting mamas. However, it is important to know the facts and learn about each option before creating the right birth plan for you. One key decision of your plan is how you will labor. The board certified obstetricians at Medical Associates have summarized several of the main options and facts below to help you make this decision.

Laboring in an upright position has many benefits. Whether it be standing, leaning forward with your hands on your knees, sitting, or squatting, many women find gravity to be a natural helper during labor. When you’re lying down, the brunt of the weight and force is going against gravity. Being upright or leaning forward allows your contractions to work in a more efficient manner, working with your body, not against it. Your blood flow (the baby’s oxygen supply) is less likely to be compressed while upright, and it helps to open up your pelvis as well. Movement such as swaying, walking, and even dancing can help reduce discomfort, as well as help move your baby into the optimal position to navigate the birth canal.

Another popular method is laboring in warm water. Our obstetricians encourage any expecting mom to labor in the tub if they wish. There is evidence that laboring in a tub can be a successful method of pain management for women, and it may even shorten labor for some. This is because immersion in warm water promotes increased blood flow back to the heart and fluid movement within the body which reduces swelling. Advocates say it also helps to relax laboring moms by reducing their stress.

However, once it’s time to deliver that baby, we believe it’s also time to get out of the tub. On the topic of water births, Medical Associates follows the recommendations of the American College of Obstetricians and Gynecologists (ACOG). They advise that “given the facts and case reports of rare but serious effects in the newborn, the practice of immersion in the second stage of labor (underwater delivery)”2 is not recommended. The American Academy of Pediatrics (AAP) have also agreed with this recommendation.

There will come a time when you need to lie down for a break or for other health reasons. While lying down, there is another birthing tool that can help with your labor’s progression. It’s called a peanut ball and it’s a new option to moms delivering at Mercy Medical Center – Dubuque. Mercy offers the first and only certified ambassador for the peanut ball in Iowa. The peanut ball is an exercise or therapy ball that is shaped like a peanut and can be used in a variety of labor positions:

  • With mom in a semi-reclined position, one leg is placed to the side of the ball, and the other leg over it. A nurse then pushes the ball as close to the mother’s hips as is tolerable to her. This position promotes dilation and descent with a well-positioned baby.
  • If mom is in a side-lying or semi-prone position, the peanut ball can be used to lift the upper leg and open the pelvic outlet. This position helps rotate a baby in a less-favorable posterior position to a more favorable position for delivery.

The use of the peanut ball helps with the descent of your baby in your pelvis. Utilizing this birthing tool has even proven to help reduce the need for an emergency C-section.

At Medical Associates, we take the care of mom and baby very seriously while also being supportive of your wishes. What you will find most helpful during labor will depend on many things. And even the most perfectly prepared birth plan can also change in an instant. Knowing your options and preparing different techniques before birth can help your labor to progress more smoothly.

To help you formulate your birth plan and communicate your needs and wishes to your obstetrician, please utilize this Birth Plan Worksheet offered by Mercy Medical Center in Dubuque.


The Department of Obstetrics/Gynecology & Infertility provides complete obstetrical and gynecological care. Specialized services offered by our board certified physicians include: diagnosis and treatment of diseases, problems, or pathology affecting the female reproductive system. Professional infertility services include routine evaluation of infertile couples, diagnosis of infertility problems and treatment such as induction of ovulation and artificial insemination. Call 563-584-4435 to schedule an appointment.


1. http://pediatrics.aappublications.org/content/133/4/758
2. https://www.acog.org/About-ACOG/News-Room/News-Releases/2016/ObGyns-Weigh-In-Laboring-in-Water-is-OK-but-Deliver-Baby-on-Land

What you need to know about Antidepressants

Antidepressant medications are effective for depression, anxiety, and some pain conditions. However, they might be slower to become effective than other medications that you may have taken. Researchers are uncertain why these medications take weeks to reach effectiveness, but your patience and adherence with taking your antidepressant daily is an important part of getting well. Some patients improve in a couple weeks, and others may not fully respond for 6 to 12 weeks. Not only is the time that you’ve taken the antidepressant important in evaluating your response, each antidepressant has a range of dosages and your healthcare provider may consider dosage increase or other strategies if you are not responding as expected. It’s important to keep follow-up appointments and discuss your response (or lack of response) to the antidepressant medication with your prescriber. Your healthcare provider has other treatment options including increasing the medication dosage, switching to a different antidepressant, adding another medication, or adding psychotherapy.

All medications have potential adverse effects and current commonly prescribed antidepressants have low risk for serious negative effects. Often, mild nausea, dry mouth, headache, bowel habit change, or sleep disturbance are signs that the medication is starting to take effect and these effects frequently go away after a few weeks. If you are concerned that you are experiencing intolerable side effects, or don’t think that you want to continue taking the antidepressant medication, you should contact your prescriber to discuss your concerns. Abrupt discontinuation of some antidepressants can result in unpleasant withdrawal-like symptoms, and some patients develop sudden worsening.

Alcohol and recreational drug use can negatively affect the effectiveness of antidepressant medications. Alcohol and sedatives are powerful drugs that cause depression, and sometimes rebound anxiety, so that antidepressants don’t work very well. Your healthcare provider can more effectively help you if you are open about your alcohol and other drug use.

Once you’ve responded well to antidepressant medication, follow your prescriber’s recommendations for maintenance treatment.

Increasingly, research has found that depression, anxiety, and pain are chronic or recurring conditions over a lifetime, so that the illness is better managed by maintaining on the full dosage that was initially effective. Each individual has personal factors that can be discussed with your healthcare provider to develop your best treatment plan.


lee, yasyn
Dr. Yasyn Lee, Psychiatrist
Medical Associates Clinic




The Department of Psychiatry & Psychology is made up of a specialized support team trained to care for individuals of all ages with emotional, cognitive, and behavioral concerns. Our board-certified psychiatrists, nurse practitioners, and physician assistant, along with our licensed psychologists, provide services that span the full range of mental health disorders and behavior problems. Please call 563-584-3500 or visit our website for more information. 

Pelvic Health During Pregnancy and Postpartum

A woman’s body goes through significant changes during pregnancy and the postpartum period to prepare the body for development, growth, labor, and delivery of the baby. Many women experience pain, discomfort, difficulty with previously easy activities, or urinary leakage. It’s easy to brush these symptoms off, thinking they will improve shortly after the baby arrives, but that isn’t always the case. Whether you are currently expecting, a new mom, or a seasoned veteran, pelvic floor physical therapy could help – especially if the pain, incontinence, or discomfort lasts longer than three months postpartum. It is optimal to begin pelvic floor physical therapy at the start of your pain instead of waiting to see if it improves. This decreases the risk of further injury or worsening pain during pregnancy or postpartum.

Over the course of your pregnancy, pain can come from a variety of sources. Relaxin, a hormone that causes ligaments to become more relaxed, causes a change in the center of gravity as the uterus grows. Carrying a progressively larger load around with each activity changes how the body moves, predisposing pregnant women to pain or subsequent injury. This pain can be felt in the low back, pelvic girdle, and hips, but also in the neck, shoulders, and upper back.

With pelvic floor physical therapy, your therapist can assess the strength and function of your pelvic floor muscles and inner core. You can learn how to carry grocery bags, pick up your other children, clean the house, perform your work tasks, and anything else you need to do but in a way that decreases the strain to your pelvic floor, back, and core. Physical therapy can help improve your strength and your therapist can help you find ways to exercise that are gentle, beneficial, and individualized to your needs.

Another common pregnancy issue is urinary incontinence. During delivery, your pelvic floor muscles endure a great deal of stress and they must stretch to allow for the baby to pass and then adjust as the load they were just helping to support is now gone. If you experience leakage that lasts longer than four weeks postpartum – pelvic floor physical therapy can help; even if you delivered many years ago. Continence can be maintained during pregnancy and postpartum with the right training program and learning how to move optimally.

Pelvic floor physical therapists are equipped to assess the pelvic floor after delivery. An assessment of strength, endurance, coordination, tension, episiotomy scars, C-section scars, and/or a separation to the abdominal muscles can all be beneficial during the postpartum healing process. This is true even if you are feeling well and not experiencing pain, leakage, or did not have an episiotomy, C-section, or tearing. Interventions are available that allow the healing process to be better supported and more complete without developing other habits or strategies for movement that are less than optimal.

If you are pregnant, newly postpartum, or know someone who is, ask about pelvic floor physical therapy. Rest assured your therapist should work closely with your OB-GYN to understand any precautions or contraindications that are important to your care. Call 563.584.4465 to schedule an appointment or submit an electronic inquiry by following this link.

Gosse_B_2017_ultiproBrittany Gosse, DPT
Department of Physical Therapy
Medical Associates Clinic