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Influenza Vaccination

Influenza vaccination is recommended for the following people:

  • EVERYONE aged 6 months and older
  • All household contacts of infants less than 6 months
  • All adults and children with chronic lung disease including ASTHMA
  • All adults and children who have chronic medical conditions including heart, kidney, or liver disease, blood disorders, or metabolic disorders (including diabetes)
  • All adults and children who are immune-suppressed
  • All adults and children who have any condition (such as a seizure disorder, cerebral palsy, or neuromuscular disorder) that can affect respiratory function or handling of respiratory secretions
  • All close or household contacts or caregivers of children under 5 years and adults over 50 years
  • All close or household contacts or caregivers of persons with medical conditions that put them at risk for complications from influenza
  • All people over 50 years

Children's Health Partners will be offering seasonal influenza vaccination by two modes of delivery:

  • Inactivated influenza injection (traditional flu shot), and
  • FluMist: Live attenuated influenza vaccine (vaccine by nasal spray)

If your child is less than nine years of age and has never received an influenza vaccination before, he will require an influenza booster immunization 4 weeks after the first dose in order to be adequately protected. It usually takes about two weeks after the second dose for protection to begin, so if your child needs 2 doses, please plan ahead to make sure your child is fully immunized prior to the onset of influenza activity in the community.

What is influenza?

Influenza is a respiratory infection that is spread when an infected person coughs or sneezes near a susceptible individual, or through contact with respiratory secretions on a contaminated surface. Typical symptoms include the abrupt onset of fever, muscle and body aches, headache, fatigue, cough, sore throat, and nasal congestion. Symptoms typically last 3-7 days, but not uncommonly can last for greater than 2 weeks. Common complications of influenza include pneumonia, asthma exacerbations, sinusitis, and ear infections. The incubation period for flu is 1-4 days, and people can be infectious two days before starting symptoms to as many as 10 days after the onset of symptoms.

Why is influenza vaccination important?

  • An average of 36,000 Americans die annually from the flu.
  • In children under 5 years, an average of 92 deaths per year in the US are attributable to the flu, and half of these children are considered healthy and without other risk factors.
  • Hospitalization rates are highest in people over 65 years and children under 2 years.

Why should I vaccinate my healthy children who are over 5 years of age?

Although healthy children over 5 are unlikely to die or be hospitalized as a result of the flu, they are still likely to become quite ill. School age children are at high risk of contracting the flu due to close contact with other children. Typically, influenza causes high fever for 2-5 days. Body aches, respiratory symptoms such as congestion and cough, and fatigue can last for up to two weeks. Also, healthy individuals between 5 and 65 years mount a greater immune response than the very young, the elderly, or individuals with chronic health conditions. Therefore, vaccinating this group helps to protect less healthy household contacts and members of the community.

Who can receive the FluMist nasal spray?

FluMist nasal spray is approved for healthy non-pregnant individuals between the ages of 2 and 50 years. For the 2018-2019 season, we are recommending that children age 2-4 get the flu shot due to data supporting improved protection against the H3N2 strains in this particular age group; however, parents can still choose to use the FluMist.

Who cannot receive FluMist nasal spray?

FluMist nasal spray should not be given to the following High Risk groups:

  • children younger than 2 and adults 50 years and older
  • pregnant women
  • anyone with a weakened immune system
  • anyone with a long-term health problem such as heart disease, lung disease, asthma, kidney or liver disease, metabolic disease such as diabetes, anemia and other blood disorders
  • children younger than 5 years with asthma or one or more episodes of wheezing during the past year
  • anyone with certain muscle or nerve disorders (such as cerebral palsy) that can lead to breathing or swallowing problems
  • anyone in close contact with a person with a severely weakened immune system (requiring care in a protected environment, such as a bone marrow transplant unit)
  • children or adolescents on long-term aspirin treatment

How is FluMist nasal spray different than the traditional flu shot?

FluMist is a live attenuated vaccine. This means that it is a weakened flu virus. The traditional flu shot is completely inactivated.

Are there any side effects with FluMist?

FluMist works by replicating the weakened flu vaccine strain in the nose. It is temperature sensitive and therefore cannot replicate in the warmer lungs, thus preventing the possibility of lung congestion or infection after vaccination. Potential side effects include runny nose, nasal congestion, fever, headache, vomiting, and body aches. These side effects were only slightly more commonly reported in vaccine versus placebo recipients in studies, and were generally mild and resolved in 1-2 days.

What are the side effects with the flu shot?

The most frequent side effect is soreness at the injection site lasting <2 days. This is generally mild and doesn't usually interfere with normal activities. Other side effects include fever, malaise, and body aches. These reactions typically begin within 12 hours of administration and last for less than 2 days and are generally mild. These effects are more common in younger children and people receiving a flu vaccine for the first time.

Is it possible to get the flu from the flu shot?

NO! This is a common misconception. The flu shot is completely inactivated, and only part of the flu virus. The flu virus requires all of its parts to replicate and cause disease, and the shot simply does not contain all the necessary viral parts. Flu shots are given during cough and cold season, which is a common time to come down with other viruses that mimic the flu. People often mistakingly attribute their symptoms to a flu shot that was given around the time that they contracted a different virus (that the flu shot cannot prevent).

Why are flu boosters recommended?

Flu boosters are recommended because many children who receive only one dose of vaccine will not achieve protective antibody levels to influenza. Children who only get one dose but need two doses can have reduced or no protection from a single dose of flu vaccine. Two doses are necessary to protect these children. Flu boosters are needed for all children under the age of 9 who are receiving the flu vaccine for the first time or if they only received one dose the previous year when it was their first year getting it.

Do flu vaccines really work, anyway?

Yes, flu vaccines do work, although it is true that like all vaccines, they are not perfect. The closer the vaccine is to circulating strains, the better it will work. Also, if the flu is contracted by an individual who received vaccination, it is likely to be more mild than in a non-vaccinated individual.

Who shouldn't receive an influenza vaccination?

Previously, people with egg allergy were instructed to not get the flu vaccine as the virus is cultured on fluid from chicken embyros during the manufacturing process. After many years of research and clinical experience, it has been found that the majority of people with egg allergy can safely receive the flu vaccine as the amount of egg protein contained in the vaccine is very small. People who are severely allergic to eggs should receive their flu vaccine in their allergist's office. Patients with egg allergy who have only experienced a mild hive-like rash as their only reaction can receive their flu vaccine in their primary care provider's office. Additionally, those patients with egg allergy who have previously received the flu vaccine without a reaction can receive their flu vaccine in their primary care provider's office. Ask your provider or allergist if you are not sure if you or your child can receive the vaccine.