Dear Doctors: I'm 23 years old and hardly ever get sick, not even a cold. I usually skip getting a flu shot, but my dad keeps telling my brother and me that it's really important to get one this year. Can you explain why? Is it going to protect us against the coronavirus?

Dear Reader: Kudos to your dad for spreading the word about flu shots. Although the annual flu shot won't safeguard against the novel coronavirus that causes COVID-19, it will add an important measure of protection during a particularly perilous flu season. As many of you already know, there can be a great deal of overlap in symptoms of the flu and COVID-19. Both are respiratory illnesses that affect the lungs and interfere with the ability to breathe. Symptoms in each can include fever, chills, body aches, shortness of breath, sore throat, headache, cough, chest congestion, difficulty breathing and fatigue. Both the flu and COVID-19 can lead to pneumonia, hospitalization and even death. During last year's flu season, 490,600 people were hospitalized, and 34,200 people died. And even when it's not life-threatening, the flu guarantees a week or two of misery.

As we said earlier, a flu shot won't protect against the novel coronavirus. However, it does reduce the risk of becoming infected with the influenza virus. Some people do get the flu despite having had the vaccine. However, they often have milder symptoms and shorter illnesses than those who go unvaccinated. And this year, with the spread of COVID-19 not yet under control, it's important to do everything we can to make sure medical resources are available for those who are the most seriously ill. It's quite possible we'll see another surge of COVID-19 this winter. With health care workers and facilities already overburdened, we should do everything we can to lessen the strain.

The Centers for Disease Control and Prevention recommend that everyone 6 months of age and older be vaccinated against the flu each year. Inactivated influenza vaccines are approved for children as young as 6 months. That's important because children under the age of 5, and particularly those younger than 2, are at high risk of developing serious complications when they become ill with the flu. That includes ear infections, dehydration and pneumonia. Your child's health care provider will advise you on the appropriate vaccine for your child. Most people get a standard flu shot. Adults 65 years and older, whose immune systems have slowed down, are urged to get the high-dose vaccine formulated specifically for senior citizens. For people with an egg allergy, there is an egg-free version of the flu vaccine that may be appropriate.

The good news is that flu shots are already widely available. They're free with most types of insurance and are often available at discounted rates at flu shot clinics. Free flu shots are also available through community organizations and public health departments. For flu shot locations in your area, visit vaccinefinder.org.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctors: I keep hearing different things about at what age and how often a woman should be getting a mammogram. Can you please go over the latest advice?

Dear Reader: It’s true that screening guidelines regarding mammography have changed in recent years. These shifts arise when ongoing research, and the collection of data, suggest a new screening approach that is safer for the patient, or one that offers a better outcome. Various organizations, such as the American Cancer Society, the U.S. Preventive Services Task Force and the American College of Physicians, have slightly different guidelines. To avoid confusion, we’ll focus on the newest advice from the American Cancer Society, released in 2015, and then talk about the specific reasons these guidelines changed.

Women between the ages of 40 and 44 years should have the choice to begin having annual mammograms. Those who wish to do so should speak with their health care provider about the potential benefits and risks. For women between the ages of 45 and 54, the American Cancer Society recommends getting a mammogram each year. Starting at age 55, the organization recommends switching to having a mammogram every other year. However, women can still make the choice to continue annual yearly screenings. Women who are 55 and older should continue to have biennial breast cancer screenings if they are in good health and are expected to live another decade or more.

It’s important to note that these guidelines are for women of average risk. This means they don’t have a family history of breast cancer and have not tested positive for certain genes that are associated with elevated risk for breast cancer. Women who are considered to be at high risk for breast cancer are advised to get a mammogram and an MRI each year. Women with dense breasts, which can affect the accuracy of a mammogram, should discuss the potential efficacy of screening with their health care provider. And don’t forget, adult women of all ages are urged to perform a breast self-exam at least once each month, and to also have a clinical breast exam performed by a health care professional every year.

Although very rare, breast cancer can occur in men. It often presents as a firm lump beneath the nipple. Men with this symptom should see their doctor.

Changes to breast cancer screening guidelines were adopted because of a growing body of evidence that the disease occurs less often in women in their early 40s. Because their breasts are denser, younger women are at increased risk of receiving a false positive result in a mammogram. This would not only cause the woman unnecessary anxiety but would also lead to a range of follow-up procedures. Another concern was over-diagnosis -- that is, the discovery of a cancer that didn’t pose an immediate risk but would then lead to surgery, such as a lumpectomy, and possible follow-up treatments, such as radiation or hormone therapy. The risks of early annual screenings were therefore seen to outweigh the benefits. Ultimately, though, decisions about screening rest with the patient and her health care provider.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctors: A friend had to get one of his cervical discs replaced because it got damaged from surfing. He was surprised when his doctor said that getting a new disc is also why a constant itch along his right forearm finally went away. What’s the connection? Why would neck surgery fix that itch?

Dear Reader: You’re referring to a condition known as brachioradial pruritus. Pruritus is just a fancy word for itchiness. Brachioradial refers to the source of the itch -- a certain muscle located in the forearm. Known as the brachioradialis, it flexes the forearm at the elbow. Taken together, the term brachioradial pruritus refers to localized itching, tingling, burning or stinging sensations that run along the outer part of the forearm. It can affect one or both arms and, in rare cases, the itchiness can spread to the neck, shoulders and even the lower leg. The condition is more common in women than in men, particularly those with lighter skin tones, and it occurs most often between the ages of 45 and 65. Instead of irritants that directly affect the skin, the itchiness from this condition arises due to a nerve disorder. That’s why scratching the area won’t alleviate the itch. Some people with the condition have reported that scratching only makes the itchiness worse.

The exact cause of brachioradial pruritus isn’t quite clear. However, it’s generally understood to be related to spinal problems that affect the nerves that animate the arm. Conditions such as osteoarthritis, in which the cartilage of the joints wears away, or a herniated disc, as in your friend’s case, can lead to brachioradial pruritus. Sun damage appears to play a role, as well. Prolonged exposure to UV light from the sun, which can damage certain nerve fibers in the skin, may cause increasing sensitivity to sensations of pain and itch. Studies have indicated that people who take part in a lot of outdoor activities -- like tennis or golf, which expose them to the sun and, thus, to ultraviolet light -- may be at increased risk of developing the condition. Some theories suggest that brachioradial pruritus is caused by a combination of nerve damage and UV exposure.

Diagnosis includes a physical exam to pinpoint the location of the itching. This is usually followed by imaging tests, such as an MRI or an X-ray, to identify the presence of any spinal abnormalities. Treatments vary. Some people are helped by using ice packs on the affected areas. Topical products, such as cooling menthol creams or local anesthetic creams, may be prescribed. Physical therapy to stretch and strengthen the spine can also bring relief.

In your friend’s case, it appears that the herniated disc in his cervical spine had compressed a nerve. That, along with spending so much time in the sun while surfing, put him squarely in the at-risk category for the condition. In the course of replacing the damaged disc, his surgeon was able to release the pinched nerve, which allowed the maddening itch of brachioradial pruritus to abate.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)