Last year’s flu season started late and ended up being one of the mildest ever, but that’s no reason to be complacent this year. The Centers for Disease Control is again recommending universal vaccination–a flu shot for virtually everyone age six months and older as soon as possible after the vaccine becomes available in your area.
Flu seasons vary in severity and timing; the only thing that can be predicted is that there will be one. Between 1976 and 2006, flu-associated deaths have ranged from 3,000 to 49,000 a year.
Factors that can affect the severity include what flu strains are circulating, how well the vaccines for that year match those strains, how much vaccine is available and how many individuals get the vaccine.
Although some individuals are more likely to get the flu and some are more vulnerable than others to the most severe consequences, public health officials have determined that the best way to protect everyone is through universal immunization, building herd immunity.
For most of us, the flu means a week or two of misery and significant lost time from work or school. That’s bad enough, but a certain number of persons each year develop life threatening complications such as pneumonia or worsening of asthma or heart failure.
Immunization is crucial for the most vulnerable persons, including:
• persons with chronic medical conditions such as asthma, diabetes; heart problems or lung disease;
• pregnant women;
• seniors age 65 and over, and
• young children, particularly those under two years of age.
Caregivers Also at Risk
Persons who live with or care for persons at risk of complications should also be sure to get a flu shot.
Those who should not get a shot include anyone who:
• has a severe allergy to chicken eggs;
• has had a severe reaction to a previous flu shot;
• is moderately to severely ill with a fever at the time; or
• has a history of Guillain-Barre Syndrome.
Flu viruses are constantly changing, and the vaccine each year is developed to protect against the three viruses public health experts expect to be most prevalent, based in part on flu activity in the southern hemisphere as well as experience from the previous northern hemisphere flu season.
This year, the vaccine is made from:
• an A/California/7/2009 (H1N1)pdmo9-like virus,
• an A/Victoria/361/2011 (H3N2)-like virus,
• a B/Wisconsin/1/2010-like virus from the B/Yamagata lineage of viruses.
The H1N1 virus is the same as the one used last year, but the H3N2 and B vaccines are different.
Although flu season usually peaks in January and February, infections can start occurring as early as October and continue through April and May. Since it takes about two weeks for the antibodies to develop and start providing full protection, doctors recommend getting a flu shot as soon as the vaccine becomes available.
If the match is good and a large percentage of the population is immunized, then the flu will have a minimal impact, as it did last year. However, even if the match is less than ideal, immunization will provide some protection. The match has been good 18 of the last 22 years.
You don’t have to make an appointment with your doctor to get a flu shot, although you can if you wish. For your child, you should probably schedule a shot from your pediatrician. A child getting his first flu shot will need two doses.
Otherwise, shots are readily available in most communities–at pharmacies, supermarkets, shopping centers, schools, churches and community centers. If you don’t see a notice in the paper or on the bulletin board, contact your local health department, Visiting Nurses’ Association or American Lung Association. You can also use the Flu Vaccine Finder at www.FLU.gov or Google.
Any worry about catching the flu from a getting a shot is unfounded; the vaccine is made from a killed or inactivated virus that has been tested and approved for use.
You have three options:
• the regular shot for persons age six months and older;
• a high-dose shot for individuals age 65 and over; and
• an intradermal shot (injected into the skin rather than a muscle using a small needle) for persons age 18 to 64.
Possible mild side effects include soreness, redness or swelling at the injection site, fainting (mainly in adolescents), headaches, fever and nausea.
In addition, there is a nasal spray made from weakened rather than killed virus. It is a mist to be sprayed into the nose and is recommended for healthy persons age 2 to 49 but not for pregnant women. The weakened virus can infect tissues in the cooler temperatures of the nose but not in the warmer temperatures of the lungs or other areas inside the body.
Potential mild effects of the spray include a runny nose, wheezing, headache, vomiting, muscle aches and fever. From either the shot or the nasal spray, these mild effects can occur right after the shot and last one to two days.
Serious side effects are also possible and can occur within a few minutes or a few hours after the shot. Watch for difficulty breathing, hoarseness, swelling around the eyes or lips, hives, paleness, weakness, a racing heart, dizziness, high fever or behavior changes. These symptoms call for immediate medical attention.
Unfortunately, vaccination against the flu is not 100 percent effective. Any flu illness you get, however, is likely to be less severe if you’ve had a shot.
Other ways to protect yourself are the same as for other upper respiratory infections such as colds. Viruses are usually spread on airborne droplets so it’s important to steer clear of anyone around you who seems to be coming down with an infection. You should also practice good cough etiquette yourself and teach it to your children.
The virus can also linger on surfaces such as doorknobs and stair railings so frequent hand washing during flu season is important, particularly when someone in your household is ill. Generally, the virus can be transmitted during a period from one day before to a week after symptoms start.
As a viral infection, the flu will not respond to antibiotics, but antiviral medications such as Tamiflu and Relenza can lessen the effect of the illness. Much more than a bad cold, the flu may require a trip to the doctor.
REFERENCES:
Troy Brown, “Influenza mild in the US during 2011-2012 season: CDC,” Medscape Medical News, June 11, 2012.
Troy Brown, RN, and Nancy Cox, Ph.D., “CDC hard at work on H5N1 influenza,” CDC from Medscape, June 14, 2012.
Centers for Disease Control, “What you should know for the 2012-2013 influenza season: questions and answers,” last reviewed June 14, 2012.
Centers for Disease Control, “Vaccine virus selections for the 2012-2013 influenza season, last reviewed July 2, 2012.
Centers for Disease Control, “Seasonal influenza; flu basics,” last reviewed June 15, 2012.
Centers for Disease Control, “Key facts about influenza (flu) & flu vaccine,” last reviewed July 14, 2012.
Centers for Disease Control, “Influenza vaccine: what you need to know, 2012-2013.
CIDRAP, “FDA picks two new vaccine strains for 2012-13 flu season,:” February 28, 2012.
Rahul Ganatra, et al, “Update: influenza activity–United States, 2011-2012 season and composition of the 2012-2013 influenza vaccine,” Morbidity and Mortality Weekly Report, July 11, 2012.
Vincent Ianelli, M.D., “Find a flu shot–flu shot clinics,” About.com Pediatrics, updated September 7, 2011.
Vincent Ianelli, M.D., “Avoiding the flu,” About.com Pediatrics, updated February 8, 2009.
“Vaccination & vaccine safety,” FLU.gov.
Virtual Immunization Communication Network, “Influenza outlook: strategies and plans for the 2012-2013 flu season.”
Sandra Yin, “Flu vaccines safe during pregnancy,” Medscape Medical News, May 11, 2012.
Sandra Yin, “How medical practices doubled their flu vaccination rates,” Medscape Medical News, May 13, 2012.
09/06/2012
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