Get a Flu Shot

Every year, many people choose to get the flu shot (or nasal spray) to protect themselves against the seasonal flu. With the 2009 H1N1 (swine flu) virus making its debut, however, there's a bit more to consider. This article will outline how and under what circumstances you should get both vaccinations.

Seasonal Flu Vaccine

 * 1) Decide between the flu shot and nasal vaccine. The nasal vaccine is called live, attenuated influenza vaccine (LAIV) because it contains live but attenuated (weakened) influenza virus. The flu shot, on the other hand, has inactived (killed) influenza virus. One thing to consider is that if you need to get both vaccines at the same time, they must both be in the form of the shot (although it's generally recommended that you get each as soon as it becomes available, see further discussion below). Also, people who meet one or more of the following conditions should definitely get the flu shot instead of LAIV:
 * 2) *50 years of age or older
 * 3) *Between 6 months and 2 years of age
 * 4) *Younger than 5 with asthma or one or more episodes of wheezing within the past year
 * 5) *Have long-term health problems with heart disease, lung disease, asthma, kidney disease, liver disease, metabolic disease (e.g. diabetes), or blood disorders (e.g. anemia)
 * 6) *Have muscle or nerve disorders (like seizures or cerebral palsy) that could lead to breathing or swallowing problems
 * 7) *Have a weakened immune system
 * 8) *Are an adolescent or child on long-term aspirin treatment
 * 9) *Are pregnant
 * 10) *Are in close contact with anyone who has a severely weakened immune system (requiring care in a protected environment, such as a bone marrow transplant unit)
 * 11) **In clinical studies, transmission of vaccine viruses to close contacts has occurred only rarely. The current estimated risk of getting infected with vaccine virus after close contact with a person vaccinated with the nasal-spray flu vaccine is low (0.6%-2.4%). Because the viruses are weakened, infection is unlikely to result in influenza illness symptoms since the vaccine viruses have not been shown to mutate into typical or naturally occurring influenza viruses.
 * 12) *Have any condition which makes breathing difficult (e.g. very stuffy nose)
 * 13) Consult with a physician before getting a flu vaccine if you:
 * 14) *Have any severe (life-threatening) allergies. Allergic reactions to influenza vaccine are rare. Influenza vaccine virus is grown in eggs. People with a severe egg allergy should not get the vaccine. A severe allergy to any vaccine component is also a reason to not get the vaccine.
 * 15) *Have had a severe reaction after a previous dose of influenza vaccine.
 * 16) *Have ever had Guillain-Barré Syndrome (a severe paralytic illness, also called GBS). You may be able to get the vaccine, but your doctor should help you make the decision.
 * 17) *Are moderately or severely ill. You should wait until you recover before getting flu vaccine. If you are ill, talk to your doctor or nurse about whether to reschedule the vaccination. People with a mild illness can usually get the vaccine.
 * 18) Get the vaccine as soon as possible. Don't wait for the swine flu vaccine so you can get them at the same time. (See below for more notes about getting the two vaccines simultaneously.) Influenza can occur any time from November through May, but it most often peaks in January or February. You'll want the protection of the seasonal vaccine as soon as it becomes available. That being said, getting vaccinated in December, or even later, will still be beneficial in most years. Better late than never!
 * 19) *Children younger than 9 years of age getting influenza vaccine for the first time – or who got influenza vaccine for the first time last season but got only one dose – should get 2 doses, at least 4 weeks apart, to be protected.
 * 20) Be prepared for the side effects. The viruses in the flu shot are killed (inactivated), so you cannot get the flu from a flu shot. There are some minor side effects, however. If these problems occur, they begin soon after the shot and usually last 1 to 2 days:
 * 21) *soreness, redness, or swelling where the shot was given
 * 22) *hoarseness; sore, red or itchy eyes; cough
 * 23) *low-grade fever
 * 24) *aches
 * Note that LAIV may have slightly different side effects, noted in this government PDF.
 * 1) Call a doctor if you observe a severe reaction. Look for any unusual condition, such as a high fever or behavior changes. Signs of a severe allergic reaction can include difficulty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heart beat or dizziness. Tell the doctor what happened, the date and time it happened, and when the vaccination was given.
 * 2) *If in the US, ask your provider to report the reaction by filing a Vaccine Adverse Event Reporting System (VAERS) form. Or you can file this report through the VAERS website at www.vaers.hhs.gov, or by calling 1-800-822-7967. As of July 1, 2005, people who think that they have been injured by the flu shot can file a claim for compensation from the National Vaccine Injury Compensation Program (VICP).

2009 H1N1 ("Swine Flu") Vaccine

 * 1) Get the vaccine as soon as it becomes available, especially if you're in a target group. CDC’s Advisory Committee on Immunization Practices (ACIP) has recommended that certain groups of the population receive the 2009 H1N1 vaccine when it first becomes available. These target groups include pregnant women, people who live with or care for children younger than 6 months of age, healthcare and emergency medical services personnel, persons between the ages of 6 months and 24 years old, and people ages of 25 through 64 years of age who are at higher risk for 2009 H1N1 because of chronic health disorders or compromised immune systems.
 * 2) *If there is a shortage of the vaccine, the following groups should receive the vaccine before others: pregnant women, people who live with or care for children younger than 6 months of age, health care and emergency medical services personnel with direct patient contact, children 6 months through 4 years of age, and children 5 through 18 years of age who have chronic medical conditions.
 * 3) *Do not get this vaccine if you have a severe (life-threatening) allergy to chicken eggs or to any other substance in the vaccine.
 * 4) *Don't assume that you're already protected. The seasonal flu vaccine will not protect you from the 2009 H1N1 virus. Also, the 1976 swine flu virus and the 2009 H1N1 virus are different enough that it's unlikely a person vaccinated in 1976 will have full protection from the 2009 H1N1. People vaccinated in 1976 should still get the 2009 H1N1 vaccine.
 * 5) Expect to get a single dose. A single dose is anticipated to protect adults within 8-10 days (although children and certain other people may require multiple doses).
 * 6) If necessary, schedule the seasonal flu vaccine and the H1N1 vaccine at the same time. This is considered safe as long as both are shots (not nasal spray) and the injections are in two different anatomical sites.
 * 7) Expect side effects similar to the seasonal flu shot, and be on alert for severe reactions as described above.

Tips

 * It takes up to 2 weeks for protection to develop after the seasonal flu vaccination. Protection lasts up to a year.
 * People who should get the seasonal vaccine each year are:
 * Children aged 6 months up to their 19th birthday
 * Pregnant women
 * People 50 years of age and older
 * People of any age with certain chronic medical conditions
 * People who live in nursing homes and other long-term care facilities
 * People who live with or care for those at high risk for complications from flu, including:
 * Health care workers
 * Household contacts of persons at high risk for complications from the flu
 * Household contacts and out of home caregivers of children less than 6 months of age (these children are too young to be vaccinated)
 * Flu shots can be obtained from a variety of sources including health fairs, health departments, employee health offices, physician's offices and pharmacies.

Warnings

 * Some inactivated influenza vaccine contains a preservative called thimerosal. Some people have suggested that thimerosal may be related to developmental problems in children. Although no studies support these claims, there are options for those who wish to avoid thimerosal:
 * Thimerosal-free seasonal influenza shots are available. Multi-dose vials of seasonal influenza vaccine contain thimerosal to prevent potential contamination after the vial is opened; single-dose vials usually do not.
 * LAIV does not contain thimerosal or other preservatives.
 * The 2009 H1N1 influenza vaccines that FDA is licensing (approving) will be manufactured in several formulations. Some will come in multi-dose vials and will contain thimerosal as a preservative. Some 2009 H1N1 influenza vaccines will be available in single-dose units, which will not require the use of thimerosal as a preservative. In addition, the live-attenuated version of the vaccine, which is administered through the nose, is produced in single-units and will not contain thimerosal.

Related Tips and Steps

 * How to Prevent and Prepare for Swine Flu
 * How to Avoid the Flu at University
 * How to Stop the Spread of a Pandemic Flu Virus

Sources and Citations

 * The following public domain sources were used to assemble the information in this article, as of this revision:
 * http://www.cdc.gov/FLU/protect/keyfacts.htm
 * http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-flulive.pdf
 * http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-flu.pdf
 * http://www.cdc.gov/h1n1flu/vaccination/public/vaccination_qa_pub.htm