The Doctor Weighs In

by Pat Salber

It's that time of the year to think about getting vaccinated against influenza.  I got my flu shot at work last week.  I barely felt it thanks to new needle technology and a skilled nurse.  Flu shot clinics are everywhere and, often, the price is quite reasonable.

So why doesn't everyone who should get one do it?  Fear of needles?  Laziness?  Misunderstanding of the potential seriousness of the disease?  I have also heard people say, "I got my shot but I got the flu anyway, so why bother?"

Here are some facts that may help motivate you.  Flu and complications of flu cause about 36,000 deaths and 236,000 hospitalizations per year. Also, if you have ever had the flu you know it is no fun.  Muscle aches, fatigue, malaise, dry cough, headache, and fever are common symptoms.  But you can also have a runny nose and sore throat making it hard to distinguish from a cold. 

Individuals at high risk for bad outcomes from influenza include:

• Adults over the age of 50
• Children ages 6 months to 59 months
• Adults or kids with chronic lung disease, heart disease, blood diseases, diabetes and certain other chronic conditions
• Individuals with conditions that comprise breathing (e.g., spinal cord injury), handling of secretions, or that predispose to aspiration 
• People on long-term aspirin therapy because that can place them at risk for Reye's syndrome, a serious and often fatal complication of influenza

Healthy people who are close contacts of high risk persons should also be immunized.  This includes household members (including children); health care workers and other caregivers, including day care workers. 

Vaccination currently is offered to anyone who wants it providing there is an adequate supply of vaccination and no contraindications to receiving the vaccine (see below).

There are two types of vaccination available.  One is the familiar flu shot which contains three different strains of killed influenza virus.  It must be give every year because flu strains change year to year.  There is also a shot alternative available - the live attenuated influenze vaccine which is administered by nasal spray.  It also contains three strains of virus, but the virus is a live virus that has been attenuated (weakened).

The flu shot can be administered to almost any one (over 6 months of  age).  People who should not get the flu shot include people with a history of serious allergic reactions to eggs or other components of the vaccine.  Vaccination should be posponed if the individual has a moderate or severe febrile illness, although it is ok to get it is you have an illness with a mild fever.  A history of Guillain-Barre syndrome that occured within 6 weeks after a previous flu shot generally (but not always) is a reason not to get the shot.

The intranasal vaccine is currently approved for use in healthy, nonpregnant people ages 5 to 49.  Because this is a live virus vaccine it should not be used when the person being vaccinated is or is in contact with severely immunosuppressed people.

So make your choice (based on the recommendations above) - shot or spray - and call your doctor or get on-line to find out where you can get your flu vaccination.  It is best if you get it now, but, if possible,  no later than the end of November.