Historically, classical homeopaths have not recommended yearly flu shots simply because we have many remedies for the treatment of flu.   Each season, after treating a number of flu cases successfully, a homeopathic physician should be able to see the pattern of symptoms emerge that will indicate a remedy for that year's flu. Once that remedy is determined, subsequent cases can be easily treated and that same remedy can be use to prevent the flu in the yet uninfected. It is important to understand several facts about influenza and flu vaccines.   First, influenza kills about 30,000 people a year in the Unites States. However, these deaths are rarely caused by the influenza virus itself. Most often, patients who die from influenza have pre-existing conditions that make them more vulnerable to viral pneumonia and possible bacterial pneumonia that typically can follow the flu. Cardio-pulmonary disease, autoimmune disease, and neurological disease can complicate influenza. Many patients are taking conventional medications that suppress natural immunity. For these patients a flu vaccine may be appropriate.   The second fact about the flu vaccine that needs to be understood is that it is NOT 100% effective. Flu vaccine efficacy is usually around 75% and this assumes that the correct strains are selected to make the vaccine. If the wrong strains are selected, the vaccine is 0% effective. Every year in the spring a committee meets and reviews influenza patterns worldwide. Usually three strains are selected and the manufacturing process begins in early summer so that the vaccine will be available by October. Unfortunately, between the spring selection and the October release date, the viruses can change. Protein markers on the outer surface of the virus will morph over time. This shape shifting behavior of the viruses renders the vaccine less than 100% effective. It is a little like first meeting someone on a beach dressed in a bikini in summer and the next time you see her, she is wearing a heavy, hooded coat during a snow storm in January. You (your immune system) may not recognize her so easily. This phenomenon is called antigenic drift.   For an appreciation of how homeopathy and osteopathy fared during the flu pandemic of 1918, read Dr. Masiello's article, Back to the Future: Bird Flu on History of Homeopathy and Other Alternative Viewpoints.