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Topic of the Month : Seasonal Flu

There are two types of vaccines:

  • The "flu shot" — an inactivated vaccine (containing killed virus) that is given with a needle, usually in the arm. The flu shot is approved for use in people older than 6 months, including healthy people and people with chronic medical conditions.
  • The nasal-spray flu vaccine — a vaccine made with live, weakened flu viruses that do not cause the flu (sometimes called LAIV for "live attenuated influenza vaccine" or FluMist®). LAIV (FluMist®) is approved for use in healthy* people 2-49 years of age who are not pregnant.

Each seasonal influenza vaccine contains three influenza viruses-one A (H3N2) virus, one regular seasonal A (H1N1) virus (not the 2009 H1N1 virus), and one B virus. The viruses in the vaccine change each year based on international surveillance and scientists' estimations about which types and strains of viruses will circulate in a given year. About 2 weeks after vaccination, antibodies that provide protection against influenza virus infection develop in the body.

The seasonal flu vaccine will not provide protection against 2009 H1N1 flu.

When to Get Vaccinated

Yearly flu vaccination should begin in September or as soon as vaccine is available and continue throughout the influenza season, into December, January, and beyond. This is because the timing and duration of influenza seasons vary. While influenza outbreaks can happen as early as October, most of the time influenza activity peaks in January or later.

Who Should Get Vaccinated

In general, anyone who wants to reduce their chances of getting seasonal flu can get a seasonal influenza vaccine. However, it is recommended by ACIP that certain people should get vaccinated each year. They are either people who are at high risk of having serious seasonal flu-related complications or people who live with or care for those at high risk for serious seasonal flu-related complications. During flu seasons when vaccine supplies are limited or delayed, ACIP makes recommendations regarding priority groups for vaccination.

People who should get the seasonal vaccine each year are:

  1. Children aged 6 months up to their 19th birthday
  2. Pregnant women
  3. People 50 years of age and older
  4. People of any age with certain chronic medical conditions
  5. People who live in nursing homes and other long-term care facilities
  6. People who live with or care for those at high risk for complications from flu, including:
    1. Health care workers
    2. Household contacts of persons at high risk for complications from the flu
    3. Household contacts and caregivers of children <5 years of age with particular emphasis on vaccinating contacts of children <6 months of age (these children are at higher risk of flu-related complications

Use of the Nasal Spray Flu Vaccine

It should be noted that vaccination with the nasal-spray flu vaccine is always an option for healthy* people 2-49 years of age who are not pregnant.

The ACIP has issued separate recommendations on who should get the 2009 H1N1 vaccine.

Who Should Not Be Vaccinated

There are some people who should not get a flu vaccine without first consulting a physician. These include:

  • People who have a severe allergy to chicken eggs.
  • People who have had a severe reaction to an influenza vaccination.
  • People who developed Guillain-Barré syndrome (GBS) within 6 weeks of getting an influenza vaccine.
  • Children less than 6 months of age (influenza vaccine is not approved for this age group), and
  • People who have a moderate-to-severe illness with a fever (they should wait until they recover to get vaccinated.)

Vaccine Effectiveness

The ability of a flu vaccine to protect a person depends on the age and health status of the person getting the vaccine, and the similarity or "match" between the viruses or virus in the vaccine and those in circulation.

Vaccine Side Effects (What to Expect)

Different side effects can be associated with the flu shot and LAIV.

The flu shot: The viruses in the flu shot are killed (inactivated), so you cannot get the flu from a flu shot. Some minor side effects that could occur are:

  • Soreness, redness, or swelling where the shot was given
  • Fever (low grade)
  • Aches

If these problems occur, they begin soon after the shot and usually last 1 to 2 days. Almost all people who receive influenza vaccine have no serious problems from it. However, on rare occasions, flu vaccination can cause serious problems, such as severe allergic reactions. 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)External Web Site Icon.

The nasal spray (also called LAIV or FluMist®): The viruses in the nasal-spray vaccine are weakened and do not cause severe symptoms often associated with influenza illness. (In clinical studies, transmission of vaccine viruses to close contacts has occurred only rarely.)

In children, side effects from LAIV (FluMist®) can include:

  • runny nose
  • wheezing
  • headache
  • vomiting
  • muscle aches
  • fever

In adults, side effects from LAIV (FluMist®) can include

  • runny nose
  • headache
  • sore throat
  • cough

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