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When Should I Get A Flu Shot?

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By RICHARD F. LOCKEY, M.D.

Published: October 4, 2007

Fever, chills, dry cough, sore throat and muscle aches signal the onset of flu season every winter. More than 200,000 people are hospitalized yearly with influenza complications, and an estimated 36,000 die — mostly elderly, according to the Centers for Disease Control and Prevention.

If you want to reduce your chances of getting the flu, the flu vaccine is a simple, safe and very effective preventive measure.

Each year, the CDC anticipates which flu virus strains are most likely to strike during the upcoming season so that a new vaccine can be designed to protect against the strains predicted. Flu season usually runs from November through May, peaking in January or February. October or November is the ideal time to get the flu shot, keeping in mind that the vaccine takes two weeks to become fully effective.

Both standard flu shots (inactivated influenza vaccine) and nasal-spray flu vaccines (live attenuated influenza vaccine) will be available for the 2007-08 season. The newer nasal-spray vaccine (FluMist®) appeals to the needle-shy. However, this vaccine is approved for use only in healthy, nonpregnant people ages 5 to 49.

The flu vaccine is recommended for the following high-risk groups:

Children ages 6 months to 5 years. Children younger than 9 receiving the vaccine for the first time should be administered two doses at least four weeks apart.

Adults age 50 or older.

Children and teenagers receiving long-term aspirin treatment.

Pregnant women.

Adults and children 6 months and older with chronic conditions, such as heart, lung (including asthma) or kidney diseases; diabetes and other metabolic diseases; anemia and pituitary disorders; and anyone with a weakened immune system (including HIV/AIDS) or taking medications that cause immunodeficiency.

Residents of nursing homes or long-term care facilities

Health care professionals, home health care workers, and others who live with or care for high-risk individuals.

People living in dormitories or other crowded conditions, and frequent travelers, to prevent outbreaks.

Anyone can benefit from the flu vaccine, but when supplies are limited, those at highest risk receive priority. This year, health officials expect ample supplies for everyone.

Adverse effects from the flu shot are low — most often including soreness, redness and swelling at the injection site. Generalized aches and pains occasionally occur within one or two days.

The vaccine contains some residual egg protein; therefore, people who cannot eat eggs should not receive a flu shot because it can cause a severe allergic reaction. High-risk patients who cannot be vaccinated may be prescribed an antiviral medication to help prevent or treat the flu. If you take the drug within two days of getting sick, it may decrease the severity of infection.

Life-threatening allergic reactions are extremely rare, usually occurring within minutes after injection. I ask patients to wait in the office at least 20 minutes after any immunization, including the flu vaccine, so any reaction can be effectively treated. Guillain-Barré Syndrome, a severe paralytic illness, has not been associated with today's flu vaccines.

Some people are concerned that thimerosal, a preservative in some vaccines, is related to developmental problems in children even though a 2004 Institute of Medicine report indicates no evidence of a link. If you are worried about thimerosal, ask your doctor about thimerosal-free flu vaccines.

Even if the vaccine doesn't prevent you from catching the flu, it reduces the risk of life-threatening complications such as pneumonia, heart attack and stroke. Its protective benefits far outweigh any risks.

Richard Lockey is a Distinguished University Health Professor at USF Health, where he directs the Division of Allergy and Immunology and holds the Joy McCann Culverhouse Chair in Allergy and Immunology.

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