Medically Speaking: Article 10

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Articles and Publications: Medically Speaking

Medically Speaking: Archives

On Gearing Up for Flu Season
By Margaret T. Hessen, MD and from the physician members of the Delaware County Medical Society

Flu season may still be several months away, but flu vaccine season is upon us. Physicians and public health authorities recommend that vaccine be given during the months of October through December. In Pennsylvania, influenza is usually seen in mid to late December, and lasts through the end of February or the middle of March.

There are two types of vaccine available—injectable and nasal spray. Both result in immunity within about two weeks. It should be noted that the nasal spray, unlike the injection, is made with live (but attenuated, or weakened) virus, and is approved only for healthy people between the ages of 5 and 49 years. The vaccines are a little different from year to year, based on scientific predictions about what strains are likely to circulate during the coming winter, so vaccination given in the past will not necessarily protect one in the next flu season.

There are a number of common misperceptions about flu vaccine that should be corrected:

In our country, we have generalized the term “flu” to mean almost any winter time illness. The result of this common (but inaccurate) usage is that many people believe that flu vaccine should protect them from all kinds of common colds, gastrointestinal upsets and the like, and become disillusioned with the vaccine when it fails to provide such all-inclusive protection. The truth is that influenza is a severe viral respiratory infection, characterized by high fevers (often higher than 102 degrees), sore throat, painful muscles, and a deep racking cough. It can be complicated by pneumonia and can worsen underlying heart and respiratory conditions. It may cause death in the elderly and others with weakened resistance. This is the disease that flu vaccine is designed to prevent, and it is one well worth avoiding.

People often say, “Flu vaccine gave me the flu one year, so I don’t get it anymore.” The virus in the injectable vaccine (by far the most commonly used) is dead, and can’t give anyone influenza. What is much more likely in these situations is that the person had the low grade fever and mild achiness that sometimes occur with the vaccine (but do not represent infection), or developed a cold of another type, but not true influenza as described above.

There is therefore no reason for most people not to get flu vaccine. For many, NOT getting the vaccine can increase the risk of significant, even life-threatening, illness. Those include:

1. People age 65 and older.

2. All children 6-23 months of age.

3 .People who live in nursing homes and other long-term care facilities.

4. Adults and children (6 months and older) with chronic heart or lung conditions (including asthma).

5. Adults and children (6 months and older) who needed regular medical care or were in the hospital for diseases like diabetes, kidney disease, weakened immune system (e.g. from cancer treatments, HIV, etc.).

6. Children 6months to 18 years who are on chronic aspirin therapy.

7. Women who will be pregnant during flu season.

8. People with any condition that weakens respiratory function or the ability to handle respiratory secretions (e.g. people who can’t swallow properly or cough effectively because of stroke or spinal cord injury).

All of these people should receive flu vaccine unless there is a justifiable medical reason to withhold it (see below). Others for whom the vaccine is recommended include:

People 50-64 years old (the risk of complications is not as great in this age group as in those over 65 or under 23 months, but is still higher than in the younger population).

People who could transmit flu to others at high risk. This includes health care workers, infant day care workers, and close (e.g. household) contacts of those in numbers 1-8 above.

Last year, there was a shortage of vaccine, and vaccination was limited to the priority groups listed above. Although no shortage is anticipated this year, the CDC currently recommends that vaccine be limited to priority groups until October 24. If all goes well with vaccine production, as expected, anyone who wants vaccine will be eligible thereafter.

Flu vaccine is safe and effective. It’s a good idea from both the individual and the public health standpoint. As stressed above, there is no reason for most people not to get it. There are a few exceptions though. Flu vaccine should not be given to someone with a true allergy to eggs (not a dislike of eggs or GI intolerance); to people who have had a severe reaction to flu vaccine in the past; to people who developed Guillain Barre syndrome (a paralytic illness) within 6 weeks of receiving flu vaccine in the past); to children younger than 6 months; or to people with a current fever (but may receive vaccine when the fever resolves).

If you have more questions about influenza or the vaccine, talk to your doctor, or the staff at your physician’s office. You can also check the Centers for Disease Control’s, (CDC) website www.cdc.gov and search “influenza.” The best resource as to the advisability of vaccine for any individual is, of course, one’s personal physician.

Note: this article is presented through the efforts of the Delaware County Medical Society and is intended for informational purposes only, the contents should not be intended as medical advice. “You and Your Doctor – Preserve the Relationship”.

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