Are you planning on getting a flu shot this year?

If you are a member of the high-risk population (infants, the elderly, people with compromised immune systems) you should get the yearly vaccine no matter what the strain.

As far as H1N1 is concerned, if you are over age 52, you probably have some immunity to it already; if you are not you may wish to consider getting the vaccine when it comes out in October.

WHO (World Health Organisation) warned a week or so back against getting the H1N1 shots before contracting the disease. They say that Tamiflu and the like should not be used as a prophylactic.

The flu shot doesnt stop you from getting the flu – they inject you with a virus to build up immunity to it. And as the virus is constantly evolving, there is no garuantee that it will actually work. In alot of cases, having the flu shot makes you contract the flu.
If you dont usually catch it, why would you want to inject yourself with the virus?
Pretty Pointless.

I have already taken my daughter to get her flu shot. They tried very hard to talk me into the nasal mist for her, but I refused. It is supposed to be better, but it does contain the live virus. I have heard of several people (including a good friend and a mother in the waiting room) who chose the the mist last year and their children promptly got the flu. The doctors can say what they want, I’m inclined to believe the actual experiences of others.

I will be getting mine as well. I never got them before I had my daughter and haven’t had the flu in at least a decade, but I have to do everything I can not to get the flu. I can’t imagine trying to look after her if I felt like that.

@DarkScribe So you are supposed to get the vaccine after you already get sick from the virus? Isn’t the point of a vaccination to keep you from getting it in the first place? I believe you, I just don’t understand it.

@Sariperana

Are you sure it’s ”a lot of cases”?

I get flu shots now ever since I had that really bad flu in 2007 that lasted for a week. I have not gotten the flu since.

@Supacase

I remember last year when I got my flu shot they offered me the nasal mist but said there was a higher risk of getting the flu from it, so I’m like “no freakin’ way…”

@Supacase So you are supposed to get the vaccine after you already get sick from the virus?

Yes, apparently so. If you get it beforehand you reduce its general efficiency and risk creating resistant strains of the virus. It isn’t an inoculation in the same manner as the conventional flu shots.

@Sariperana your analysis isn’t precisely correct. The recommendation is that those in the “at-risk” population get the vaccine in any event. Here is a link from the CDC with much useful information.

r2d2? hahahaha

I am just getting over a nasty case of the flu. In our area, it is very early for the regular flu, so all flu cases are presumed to be H1N1 (or R2D2, which I like better!). I can’t even get the regular vaccine until 10/1, and they are saying they won’t have the H1N1 shot until after that. I’ve been getting the flu shot for years and am in a high risk category… does all of this mean I now should or shouldn’t get the H1N1 shot when I can? I’m confused. :/

Shilolo – where are you?

No thanks. Never have; probably never will.

@augustlan The CDC link above really is most useful.

Okay, to answer the question…No. I don’t do flu shots. I’m in a category that should be getting them (pregnant) but I most definitely would not inject myself with something like that, especially while pregnant. My son will not get it either.
We’ve been sick for a month now, which is super rare for us. It started with a head cold, to fever, to almost allergy like symptoms. I want it to go away!
Everyone I know that thinks they have the flu, go to the doctor and get diagnosed with pneumonia. That’s just been recently though.

I hope I don’t jinx myself here, but I’ve never had a flu shot and I’ve never had the flu. Neither have my kids. We don’t fall into any of the risk categories, so I don’t think I’ll bother this year either.

There’s such a media frenzy over the swine flu, whether or not to get flu shots, and all kinds of articles and interviews saying the shots are dangerous. At least, all kinds of articles getting posted on facebook. I know a few people who had the H1N1 virus, two of them children, and they didn’t have to go to the hospital or anything. All are otherwise healthy, like we are, so I’m not really concerned about it.

Well i didnt research the statistics online, but our government sets up free flu shots every winter and everyone i have ever spoken to about the flu shots has gotten really sick. When i did it i copped the flu 3 times in one hit – lasted for 4 weeks. So from my experience, @pdworkin, yes my analys is correct regardless of what online stats you have pulled up from google.

Maybe the flu shots in america are somewhat superior to our ones here in australia, but they certainly have not done me any favours, nor anyone i know that has had one.

“what online stats I pulled up- from Google.” That was very rude. I subscribe to the morbidity and mortality index, and many other informative publications from the CDC. Your answer is anecdotal, my answer provides a highly respected source.

@pdworkin so my experience is not highly respected? Whats the point of this site if ones experiences are not respected? The whole point is to get peoples opinions and advice from personal experience – which is what i gave.
I dont really care that my answer was not ‘precisely correct’ in your eyes and from your morbidity and mortality index that you subscribe to – everyone on here is entitled to an opinion and that is mine. to say that it is wrong isnt exactly polite on your part. rude indeed. pffft.

My, you are charming.

@pdworkin it has been a pleasure…

Another quote some may find useful:

The American Academy of Pediatrics (AAP) has updated current recommendations for routine use of trivalent seasonal influenza vaccine and antiviral medications for the prevention and treatment of influenza in children. The updated guidelines are published in the September issue of Pediatrics.

“Trivalent seasonal influenza immunization is recommended for all children aged 6 months through 18 years,” write Joseph A. Bocchini Jr, MD, chairperson, and AAP colleagues. “Healthy children aged 2 through 18 years can receive either [trivalent inactivated influenza vaccine or live-attenuated influenza vaccine].”

The AAP recommends annual trivalent seasonal influenza immunization for all children aged 6 months through 18 years, including those who are healthy and those who have conditions that increase the risk for complications from influenza. Other groups for whom AAP recommends annual trivalent seasonal influenza immunization are healthcare professionals, pregnant women, and household contacts and out-of-home care providers of either children with conditions that place them at high risk or healthy children younger than 5 years.

Key Points for 2009 to 2010 Flu Season

Specific key points especially relevant for the 2009 to 2010 influenza season are as follows:

* Annual trivalent seasonal influenza immunization is recommended for all children aged 6 months to 18 years of age. Clinicians should especially target children at high risk for influenza complications, such as those with chronic medical conditions or immunosuppression. The greatest influenza disease burden is in school-aged children, who are at significantly greater risk compared with healthy adults of needing influenza-related medical care. Lowering influenza transmission among school-aged children is anticipated to decrease influenza transmission to household contacts and community members.
* To decrease the risk for exposure to influenza for young children, who are at serious risk for influenza infection, hospitalization, and complications, household members and out-of-home care providers of all children and adolescents at high risk and of all healthy children younger than 5 years of age should also receive annual vaccination against influenza. Use of influenza vaccine has not been approved for children younger than 6 months of age.
* All children 6 months through 18 years of age, particularly those at high risk for complications from influenza, should be identified, and their parents should be notified that annual influenza vaccination is available and recommended.
* The B vaccine strain has been changed in the trivalent seasonal vaccine for the 2009 to 2010 influenza season to match the anticipated predominant strain, based on global surveillance of circulating influenza strains.
* The World Health Organization has declared a pandemic for the novel influenza A (H1N1) virus, which supports the need for ongoing development of a vaccine protective against this strain. Recommendations for the use of an additional monovalent pandemic influenza vaccine in the 2009 to 2010 season may in part be based on the novel strain’s pattern of spread in the Southern Hemisphere during the influenza season. Providers must be aware and updated regarding their local and state health department recommendations, which are available on the CDC Web site and the AAP Red Book Online Influenza Resource Page. The AAP Web site will also frequently post updated details on the H1N1 virus for pediatricians and families.
* As soon as vaccine is available, even as early as August or September, all children should be offered seasonal influenza vaccine, because the protective response to vaccination should remain throughout the influenza season. Even after influenza activity has been confirmed in a community, however, immunization efforts should continue throughout the entire influenza season, which often extends even into March and beyond. Furthermore, there may be more than 1 peak of activity in the same season. Immunization through at least May 1 can therefore still protect vaccinees during that season, while offering sufficient opportunity to administer a second dose of vaccine to children needing 2 doses in that season.
* The recommended number of trivalent seasonal influenza vaccine dose(s) is based on age, as follows:
o Children 9 years and older who have not previously received trivalent seasonal influenza vaccine should only receive 1 dose in their first season of vaccination.
o Children younger than 9 years of age who are given the trivalent seasonal influenza vaccine for the first time should receive a second dose during the same season and 4 weeks or more after the first dose.
o Children younger than 9 years of age given only 1 dose of trivalent seasonal influenza vaccine in the first season they were vaccinated should receive 2 doses of trivalent seasonal influenza vaccine the following season and 1 dose each season thereafter. This recommendation applies only to the influenza season following the first year that a child younger than 9 years of age is given influenza vaccine, because data are not available for other scenarios of trivalent seasonal influenza vaccine.
* Because concurrent circulation of multiple influenza strains with different susceptibility patterns is anticipated during the 2009 to 2010 influenza season, the recommended use of antiviral medications for chemoprophylaxis or treatment is more complex than in previous years. Treatment options include amantadine, rimantadine, oseltamivir, and zanamivir. Seasonal influenza A (H1N1) virus (A/Brisbane/59/2007) is resistant to oseltamivir and is susceptible to the other drugs. Pandemic influenza A (H1N1) virus, seasonal influenza A (H3N2) virus, and seasonal influenza B (B/Brisbane 60/2008, Victoria lineage) virus are resistant to amantadine and rimantadine and susceptible to oseltamivir and zanamivir.
* To achieve the target immunization of all children 6 months through 18 years of age, healthcare professionals, influenza campaign organizers, and public health agencies should cooperate to develop and implement plans for expanding outreach and infrastructure. Some examples include creating walk-in influenza clinics, making vaccine available during all clinical hours, extending hours during vaccination periods, and collaborating with schools, child care centers, churches and other institutions to increase venues where vaccination can take place.

“Concerted effort among the aforementioned groups, plus vaccine manufacturers, distributors, and payers, also is necessary to appropriately prioritize administration of trivalent seasonal influenza vaccine whenever vaccine supplies are delayed or limited,” the guidelines authors conclude. “Continued evaluation of the safety, immunogenicity, and effectiveness of [live-attenuated influenza vaccine] for young children is important. Development of a safe, immunogenic vaccine for infants younger than 6 months also would be valuable.”

All authors have disclosed that they filed conflict of interest statements with the AAP, and any conflicts have been resolved through a process approved by the board of directors.

Pediatrics. Published online September 7, 2009.
Clinical Context

Given the current influenza pandemic, there is increased interest among patients and healthcare providers in the influenza vaccine this year. The current recommendations provide updates on the trivalent seasonal vaccine. The vaccine will contain the same 2 strains of influenza A as in 2008, but the B strain has been changed.

Clinicians need to be aware of potential complications of both the inactivated influenza vaccine and the live-attenuated influenza vaccine. Soreness at the injection site and fever are the most common adverse events associated with the trivalent inactivated vaccine, whereas the live-attenuated vaccine may produce mild symptoms consistent with influenza infection. The live-attenuated vaccine should be avoided among patients with a history of chronic pulmonary or cardiovascular disease; it is indicated for healthy individuals between the ages of 2 and 49 years.

Source

@Sariperana I don’t know about the Australian vaccine, but the shot in the US does not contain the live virus. It used to (and my grandfather used to get sick every time he got it) but they changed that several years ago (and he no longer gets sick after the shot.)

The nasal mist does contain the live virus, though a weakened version that they say should not make you sick.

@Supacase Thanks for the clarification.

I already had my flu shot. The kids like the mist and have never had a problem with it. Unfortunately, we can’t seem to get a convenient appointment with the doctor, so they may have to get shots at CVS or something.

@pdworkin well i guess if you know how to copy and paste then you must know what you are talking about.

I copied and pasted that because the source requires a password. You are very welcome.

@Sariperana but our government sets up free flu shots every winter and everyone i have ever spoken to about the flu shots has gotten really sick

This is nonsense. A few people feel a little bit off briefly after a Flu shot – that is normal but really sick in every case would make headlines. My wife an I travel a lot and always get shots – and neither we or anyone I have ever known has become “really” sick from a Flu shot. Some people are allergic to some of the things contained in Flu shots – that is noted on the addendum sheet included with the shot – and those people need to avoid them. Others have no problem.

@Sariperana in so my experience is not highly respected? Whats the point of this site if ones experiences are not respected? The whole point is to get peoples opinions and advice from personal experience – which is what i gave.

The whole point is not to give credence to the opinion of all comers – it is simply to allow all comer to express their opinion. You have expressed yours, it flies in the face of consensus and many, like me, will ignore it. My experience and most reported experiences, and the findings of numerous surveys are quite different to your undefined opinion. A bad reaction to a Flu shot, although it “occasionally” happens – is rare.

The problem is that there are some members of the community who are genuinely at risk – people who might not survive Flu. If they listen to less than credible unsubstantiated opinions such as yours – and give them credence, the results could be fatal.

Now this article has me freaked about the swine flu vax even more.

@casheroo The most important sentence in that link is: ”...many large, thorough studies have shown no harm caused by thimerosal in vaccines.”

@casheroo

Regarding your first comment, isn’t pneumonia worse than the flu, though? That’s how the flu kills, often, by mutating into pneumonia.

@augustlan I’m not one to believe it causes autism, so don’t think I’m that type of person. But, I believe there’s no way to really test it. And I think the main reason they are doing it is for profit. More mercury means longer shelf life which equals more money in their pockets for unsuspecting and scared victims. I do not believe it is safe.

@DominicX Pneumonia can kill you, especially if you get it as a complication of the flu because of your weakened immune system, but usually pneumonia itself can be treated if caught early. Just as the flu can, if they have no complications and the person isn’t a high risk patient.

I will get the flu shot, as I have been getting one every year for >15 years (since the start of medical school). To clarify a few points and misconceptions:
1. You absolutely, positively CANNOT get the flu from the flu shot. It is an INACTIVATED (meaning killed/dead virus) and thus is not infectious. Period.
2. You will not be more susceptible to a flu infection if you get the vaccine. The vaccine may not “work” for several reasons, but that doesn’t mean you are more or less susceptible. Some people don’t mount effective immune responses to a lot of vaccines, and you might be one of them. Alternatively, the targeted strains may not circulate but rather other strains for which the vaccine is not designed may predominate.
3. The mist is superior to the shot. I wish I could get it, but the mass inoculations at my hospital are done by shot only.

Here is more information about the vaccine from the CDC. Below are more explanations from prior questions (before H1N1’s arrival).

Flu shot, help or hype
Do you get a flu shot?
Do I need a flu shot?

thanks, @shilolo

@shilolo

But is it true that the nasal mist contains the live virus?

@DominicX The nasal mist contains a cold-adapted live virus, yes. The cold adaptation means it can only replicate in your nose rather than your airways since the former is much cooler than the later. By replicating there, the mist vaccine generates IgA antibodies (a different type of antibody) leading to the establishment of effective mucosal immunity that is preferable to the IgG formed by the dead virus shot.

In lay terms, there are 5 different types of antibodies that your body can form. IgA (mucosal), IgE (allergic, antiparasitic), IgM (early serum antibodies), IgG (the major form of antibody) and IgD (bound to B-cells). IgA is effective at mucosal surfaces where it is secreted and where the virus first comes into contact with the body. Thus, for influenza, IgA > IgG and mist > shot.

never had a shot, never had the flu, no thank you!

@shilolo

Interesting to know. I was just referencing last year when I went to get a flu shot and they offered me the mist and I heard the words “live virus” and I was just like “nope”.

I didn’t end up getting the flu, so, all was good.

NYS has passed legislation this past August to require all health care workers with direct/indirect patient exposure to receive the flu vaccines as a condition of employment. Thus, I will definitely be getting the regular flu vaccine (as I do every year) and will be getting the H1N1 vaccine if there is enough availability (the requirement is pending available supply).

What are your thoughts about employers requiring the flu vaccine(s)?

Haven’t read the above. No, I am not getting one.

@Cupcake Wow. I had not heard that some people were required to get the shots as a term of employment. I wonder if the company is paying for the vaccinations. Where I work there was a general announcement about taking sick days if you are sick with a list of dos and don’ts about things such as washing your hands and covering your mouth when you cough.

Thank you for your opinions on this question.

@Cupcake Do you mean just health care employers requiring vaccination, or employers in general? If it’s the former, I’m all for it. If it’s the latter, that would make an interesting question on its own, and you should ask it.

I am not for people being required to take the vaccination. I think in some states or counties it might be a requirement not only by the employer but possibly law or a regulation. I work at a hospital and when I refuse I have to sign a waver and state why.

@augustlan I would not take it if I were you. I associate some of my health problems kind of starting around the time I had a tetanus shot given to me too close to my previous one. I had an accident that was indoor, there was not really reason to give me that shot, I had had mine 5 years before the accident, and they said that was the cut off, so I took the shot. I had a bad reaction, I never had a bad reaction before before, and now I have muscle trouble. It was not all of a sudden like what mothers claim about autism, but it kind of started to happen around the same time. No way for me to really know if it is connected. I do get my tetanus titer checked every so often to make sure I am safe and it is always VERY high. Check out this clip, specifically towards the end concerning fyrbromyalgia http://www.youtube.com/watch?v=E1z7KSEnyxw Of course there are differing views by health officials, so I am not saying this MD holds the gospel, but his specific comment about autoimmune disease really meant somethign to me. My mother used to work in vaccinations in FDA and she never takes the flu shot.

@JLeslie I would hesitate to use Fox News as my source for anything, much less rigorous scientific data. More importantly, they use this doctor as their infectious disease “expert”. His own website lists his expertise in “chronic infections”, which I take to mean chronic lyme. This would go along with his other areas of expertise, namely, fibromyalgia and chronic fatigue, which of course he mentioned twice in his interview on Fox News. His own website states he is a diplomate of the American Academy of Anti-Aging Medicine, which is not a recognized speciality. No where does it list an Infectious Diseases fellowship or board certification in infectious disease.

So, why did Fox News use a self-proclaimed “expert” rather than a true influenza or ID expert from the CDC or elsewhere? I’m sure it is because of his controversial viewpoint (including the old canard, that vaccines and thimerosal cause autism and other disorders). He has no data to support his outlandish claims, but of course, when has that stopped Fox News.

@shilolo I am no fan of Fox News, but I found it interesting that he raised the autoimmune issue. I had never heard that before. My father, a sociologists, who spent his career reviewing studies for scientific method to be authorize grant money from the US government, certainly spent plenty of time talking to me about the validity of studies. So, I understand that there is no evidence, just some suspicion. But, when you feel like shit every day already and it is a mystery, and the likelihood of getting the flu and becoming deathly ill is remote, I would err on not taking the vaccine. That’s me. Now, my mom, who worked for the FDA in vaccinations, does not take it because she saw enough VAERS reports that it isn’t worth the risk to her.

@JLeslie He raised the autoimmune issue for self-serving reasons, namely, that his area of expertise is in treating such things as fibromyalgia and chronic fatigue as autoimmune diseases (though that is controversial). Only two vaccinations in history have demonstrable links to autoimmunity (a rabies vaccine and a swine flu vaccine both led to central nervous system disorders at very low rates). Everything else is just speculation.

To provide a counter argument, there are many people with autoimmune diseases taking immunosuppressants for whom influenza could be life-threatening. It would be irresponsible to tell those people to avoid the vaccine, given the high risk of morbidity and mortality from influenza in those with weakened immune systems. Furthermore, this doctor does pregnant women a huge disservice by suggesting they are at risk from the vaccine. The exact opposite is true. Pregnant women are at very high risk from severe influenza. I’ve personally attended to multiple serious cases and deaths of otherwise healthy pregnant women from H1N1, and the CDC agrees. His words are very dangerous and reprehensible, and reflect his ignorance on the dangers of H1N1.

@shilolo You obviously have some good points. I do agree if you are on immunosuppressants you might be at grave risk regarding influenza, so that is tricky. Also, I think pregnant women are probably slight immunosurpressed just carrying a foreign body inside of them, but that is just my own guessing/reasoning. It says on yur link “Six percent of confirmed fatal 2009 H1N1 flu cases thus far have been in pregnant women while only about 1% of the general population is pregnant. While hand washing, staying away from ill people, and other steps can help to protect pregnant women from influenza, vaccination is the single best way to protect against the flu.” It does not say what percent of unpregnant women died? Unless I am misunderstanding? Plus, pregnant woman are more likely to seek a doctor when having high fevers, so their cases would be reported more often. I would never go to the doctor if I had the flu, if I could control the fever, unless I had serious complications or the severe symptoms lasted more than 5 days. If I were pregnant I would at minimum call my doctor, and probably want to be checked.

@shilolo Can you get the h1n1 strain, and it just not hit you that hard? Or does it present itself at the same severity in everyone? I’m truly convinced my family just had it, but I don’t believe in risking others for illness unless I was truly sick..I felt under control at home with lots of fluids and rest.

@JLeslie Fatalities would have ended up in the hospital anyway (eventually), so I doubt the numbers represent an underrepresentation of the general population (as you imply). According to a recent study from the CDC that was published in the Lancet, “based on US CDC data, from April 15 to June 16, 2009), six of 46 deaths (seven of 87 deaths to June 23, 2009) occurred in pregnant women with confirmed or probable H1N1 infection”.

They go on to report “On the basis of the number of deaths to June 23, 2009, the size of the increased mortality risk in pregnant women compared with that in the general population seems high (crude relative risk 7·7, 95% CI 3·3–16·7). The wide confidence interval, however, reflects the small number of cases on which the risk estimate is based. Updates on the risk estimate would be valuable. Age or other confounders cannot, however, be adjusted for in the absence of equivalent data in the comparison population. Obtaining an accurate interim estimate of the increased mortality risk is thus difficult.” Thus, despite a general lack of data, the relative risk of mortality from H1N1 is ~7 fold for pregnant women, which is significant.

I suspect that only after the pandemic passes through will a “truly accurate” assessment be available. That said, the CDC and WHO are tasked with overall public health, and so interim analyses are a vital component in the tracking and containment of the pandemic.

@casheroo Yes, different people can manifest illness in different ways. So, recently in my household my daughter had a febrile “something” for 10 days, my son caught it and was sick for 4, including a bought of croup, and my wife was sick as well. Only I avoided serious illness (lucky me).

@shilolo Oh, I agree if you died from it we would know. All deaths would be reported. What I meant was not all cases of non-pregnant sick people who didn’t die would be reported. So the percentage of deaths of H1N1 in non-pregnant people will most likely be… over-reported…which actually helps your case LOL.

@JLeslie It is hard to get accurate statistics “on the fly”. Lots of confounding issues (like the one you raised). Others include the lack of reliability of the standard initial test for H1N1 (I hate it. I’ve seen at least 5 cases where the initial test was negative, only for the more sensitive PCR test to be positive). Take @casheroo however. She is pregnant, and suspects she and her family had H1N1. She stayed home. Is it possible she had H1N1? Sure. Could it have been something else? Absolutely. We’ll never know, since she pulled through :-)

@shilolo so do you think @casheroo should get both flu vaccines this year? Just because she had one flu does not prevent her from gettinng another, and we cannot be sure which one she had. I am assuming you would recommend vaccinating her.

@JLeslie I plan on getting both vaccines and vaccinating my kids. Yes, I would recommend both vaccines for her. I don’t know her precise timeline, but most of the serious cases in pregnant women have occurred in the 3rd trimester.

@shilolo I was exposed to it by a cousin, who had a confirmed case, and then was in the ER for an unrelated matter..my husband and I sat in the waiting room for three hours with people there for flu symptoms it was horrible I think my son got it the worst, he was sick the longest, with fever for two days then a nasty cough for two weeks, and now he’s got a runny nose that is finally going away. He never gets sick, but since I had it first I knew he’d get something. I had it pretty bad, was very exhausted but drank a ton of fluids.
@JLeslie We don’t do flu shots.
@shilolo I’m about 20 weeks, I don’t think the vax for it is out yet, right? I’ll probably be in my third trimester by the time it comes out. Would that be too late for the vaccine to be useful anyways? What studies are they doing on the h1n1 vax on women in their third trimester?

@casheroo I doubt there are any specific studies being done for that population. The seasonal flu vaccine is already available (at least at giant pharmacies), so if you were interested, you could get that one today (especially since you are confident that you already have been exposed to H1N1). The H1N1 vaccine is not available yet, though it might be a moot point for you.

@casheroo I didn’t mean to use you as an eaxample behind your back in front of your face :) Hope you didn’t mind.

Did. I do it every year. Last year I was the only one in my household who did, and I was the only one who got off easy during the flu season. Just a coincidence, perhaps.

Just spent three hours yesterday to get the kids flu shots.

Yes, I got one. As it turned out my company had an open clinic with free shots on site this week. I think I still need the H1N1. I had bronchitis already this year so I am up for anything that improves my chances of being healthy this season.