A 62-Year-Old Woman Comes to the Office for a Preventive

A 62-year-old woman comes to the office for a preventive visit.  She feels well and reports no active symptoms.  Medical history is notable for diet-controlled diabetes mellitus and hypertension.  The patient quit smoking 10 years ago and does not use alcohol.  She is up to date on age-appropriate cancer screening.  Vital signs are normal.  Physical examination is notable for moderate obesity and a prolonged expiratory phase of respiration.  Hemoglobin A1c is 6.8%.  Influenza vaccination is advised, and the patient responds, "I heard that the flu vaccine doesn't really work.  I would rather just take vitamin C and try to prevent the flu in a natural way."  Which of the following is the most appropriate response to this patient's concerns?

A) "Although the vaccine is not always effective, it reduces your chances of getting flu, and can reduce the severity even if you do get the flu."
B) "As a health care worker, I am required to get the flu vaccine.  In my experience, I have been able to avoid the flu when others around me have gotten sick."
C) "Getting the flu vaccine on top of taking vitamin C will lower your chances of getting the flu more than taking vitamin C alone."
D) "I understand and respect your concerns.  But as your doctor, I should advise you that the vaccine really does work."
E) "There is too much fake information on the internet and television these days.  Let me give you more reliable information."