Ask the Doctor ’Tis the Season -Some Questions and Answers About Flu and Flu Shots

Q. I’ve never been a big fan of the flu shot ever since I was vaccinated many years ago, then got sick shortly afterwards. I just don’t know what to think. Can you provide some insight?

A. I’m not sure exactly what you mean by being ‘sick’ afterward. So I will address several possibilities. If you are referring to having a low-grade fever and general aches after being vaccinated, those are common side effects experienced by some, but they are mild and don’t last for very long, usually one or two days. Also, I’m not sure what ‘many years ago’ translates into timewise, but side effects can differ for those opting for the newer nasal-spray vaccine, which can cause a runny nose, headache, sore throat, or cough.

While the flu vaccine is safe and rarely causes any serious problems, some people can have severe allergic reactions to the shot, especially those who are allergic to eggs. If that is your case, there are now flu vaccines that do not contain egg proteins, such as Flublok. There are also other flu vaccines approved by the U.S. Food and Drug Administration that do not contain egg proteins, and are approved for those 18 years of age and older. In extremely rare cases, some people have developed Guillain-Barre syndrome after getting the flu vaccine, a disorder in which the body’s immune system attacks part of the nervous system. Again, whatever your case may be, you should check with your doctor about which vaccine is best for you.

If you are referring to having a severe cold or flu-like illness after getting the shot, I can assure you it was purely coincidental. The flu vaccine does not contain any live flu virus, so you cannot get the flu from a flu shot. If you did indeed have influenza after getting the shot, you may have already been infected, or were infected shortly after receiving your vaccination. It takes around two weeks after vaccination for your body to make antibodies against the influenza virus.

Q. I hate to admit it, but needles scare me, and that’s another reason why I never get the shot.

A. You’re not alone, and it’s nothing to be ashamed of. Many people are afraid of needles. But there are alternatives today that may not have been available to you when you received your last flu shot. There is a nasal spray vaccine called FluMist. However, it cannot be used by children younger than 2 years of age or adults over age 49, as well as anyone with asthma, pregnant women, and those with compromised immune systems.

For those who have previously experienced arm pain after intramuscular injection of flu vaccine, there is a jet injector with a very short needle that injects vaccine just under the skin. It can be used for individuals who are 18 to 64 years old.

Q. Even if I do decide to get the flu shot, I had a heart attack two years ago, and my sister told me that, if you have a serious illness, then you shouldn’t be vaccinated.

A. I’m not sure what illnesses your sister may have, but please tell her that she is misinformed. On the contrary, vaccination is particularly important for those at high risk for serious flu complications, including young children, the elderly, those with heart disease, and pregnant women. The most important complication that can affect both high-risk adults and children is pneumonia. The flu can also aggravate and worsen chronic conditions such as heart disease, diabetes, and asthma.

Also, people age 65 and older are eligible for a new, high-dose vaccine containing four times the amount of antigen as a regular flu shot, and is associated with a stronger immune response and may translate into greater protection against the flu.

In general, everyone 6 months of age and older should be vaccinated unless their doctor recommends against it because of certain pre-existing conditions.

Q. I don’t mean to be negative, but it was widely reported in the media that last year’s vaccine was only marginally effective.

A. You are correct. Last year the flu vaccine was only 19{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} effective in reducing your risk of getting the flu, the lowest since 2004, when it was only 10{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} effective. More years than not, it has averaged between 47{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} and 60{06cf2b9696b159f874511d23dbc893eb1ac83014175ed30550cfff22781411e5} effective. What happens is that, each year, based on data identifying the most common strains circulating around the world throughout the year, experts decide on what three strains of the virus to include in the current year’s vaccine. However, a mutation in one of the flu strains after the virus had already been manufactured last year resulted in the poor match.

While effectiveness varies from year to year, it’s still a good idea to get vaccinated to protect not only yourself, but others around you who are more vulnerable to serious flu illness. If you do get the flu, having the flu shot may make your illness milder. Also, remember that adults and children are still hospitalized, and others die each year from the flu.

According to the Centers for Disease Control and Prevention, three kinds of flu viruses commonly circulate among people today: influenza A (H1N1) viruses, influenza A (H3N2) viruses, and influenza B viruses. All of the 2015-16 influenza vaccines are made to protect against these three viruses.

Q. If I decide to get the flu vaccine, am I too late?

A. No, it’s not too late. Flu season usually runs from October to May and normally peaks in January or February. But there have already been some documented cases of flu in the area. So getting your shot early is the best strategy, since, as I mentioned earlier, it takes around two weeks after vaccination for your body to make antibodies against the flu virus.

Q. How long will the flu shot last? Will I need another next year?

A. Not only does each year’s vaccine differ in the flu strains targeted, but the immunity provided by the vaccine wanes over time. Also, a new study just released reports that annual flu shots offer up to six months of protection. The findings were based on research of more than 1,700 Americans of all ages who got flu shots and were followed for four flu seasons. v

Sarah Haessler is a member of the Infectious Disease Division at Baystate Medical Center.