The Flu vaccine - What you need to know.
By Mark Bilella, MD

As flu season approaches, many patients are asking about the flu shot. As you may recall, last year was one of the worst flu seasons in recent history. Hopefully, this year will not be as severe, but an ounce of education and prevention can go a long way to keep our communities safe and healthy.

First, let us understand exactly what we are preventing. The “flu” is an illness caused by a virus. This virus has different particles attached to its surface. Like most viruses, these particles constantly change and mutate. Prior to each flu season, the Centers for Disease Control and the World Health Organization predict the viral structure that will be most prevalent and harmful that year. They then create a vaccine, which is composed of the specific inactivated viral products. The vaccine will boost your immune system so that you will not get as sick, if you are exposed to the virus. In short, you need an updated flu shot each year to be protected from the latest viral structure.

There are a few things to remember about this process. First of all, this vaccine must be produced nine months before the flu season starts in order to manufacture sufficient quantities on time. Therefore, predicting which strains will be most prevalent is a challenge. Also, there are many different strains of influenza and there are countless other viruses that can cause upper respiratory tract infections; so just because “YOU GET THE FLU SHOT, IT DOESN’T MEAN THAT YOU WON’T GET SICK THIS SEASON.”

Overall, there is a definite benefit to vaccination. Vaccinating our communities helps prevent countless hospitalizations and many fatalities due to the influenza virus. On average, there are over 100,000 hospitalizations and 35,000 deaths due to influenza annually, but without immunization there would be many more.

In addition to protecting yourself, getting immunized helps to protect your community. As more people are immunized, transmission of the influenza virus in the community is greatly decreased. Currently children from 6 months to 2 years, household contacts of children under 2 years, pregnant women in their 2nd and 3rd trimesters, elderly people, healthcare workers and those considered “high-risk” for infection due to chronic illness are most strongly encouraged to get vaccinated. Of course, anyone can get a flu shot to help protect themselves and their communities.

Some people are apprehensive about getting the flu shot because of potential adverse reactions. Fortunately, however, the side effects are relatively minimal. I have patients tell me, “I don’t want the flu shot because the only time I was vaccinated, I got the flu.” Approximately 5% of patients do get a flu-like syndrome (which is not the flu) that consists of low-grade fevers, muscle aches, and mild fatigue lasting eight to twenty-four hours. This is actually just the immune system reacting to the vaccine, rather than a true influenza infection. These symptoms may be inconvenient, but a true infection can be much more severe.

Some of my patients ask about the new intranasal flu vaccine. This is currently approved for healthy individuals ages five to forty-nine years. Unlike the inactive injectible vaccine, this is a weakened form of the live influenza virus. Children less than nine years need two doses, six weeks apart, while older children and adults need only one dose. This vaccine is favorable, because it is given as a nasal spray so there are no needles involved. However, the disadvantages include a slight decrease in efficacy, a higher cost, and the potential for more side effects, as it is a weakened form of the live virus. Ask your doctor for more information if you are interested.

Of course, the vaccine is not the only way to prevent getting sick or getting the flu this year. Simple measures such as hand washing can prevent transmission of the virus. If you are sick, avoid close contact with other individuals, cover your mouth when you cough, and again, wash your hands as often as possible. Since the virus is transmitted via respiratory droplets, these techniques can prevent spread of the infection to others.
I wish you healthy fall and winter seasons for you and your families!

By Mark Bilella, MD
Board Certified Pediatrics
Board Certified Internal Medicine