Q: When driving past my local pharmacy two days ago, I noticed they are already advertising flu shots on their outside signs. That’s okay but I’ve also heard this years serum is different from last year’s. Can you tell me what I can expect when I get my shot?
A: Influenza is a contagious respiratory disease that is caused by an influenza virus. The Centers for Disease Control recommend that everyone six months of age and older receive the vaccine. This includes people with a compromised immune system, those on long-term steroid use for any condition, residents and those working in a nursing home, hospital or health care environment, individuals with lung or heart disease, and even pregnant women. Adults require one single flu shot each year; however, children under the age of 9 should get two shots a month apart unless they previously had two in one season since July 2010. A child’s pediatrician, family physician or nurse practitioner would be the best source for this recommendation.
Prior to this season, protection was a one-type-for-all, with the exception of whether it was administered as an injection or nasal spray. Now, the vaccine will take on a different style. To begin with, certain vaccines will guard against four strains instead of the usual three. Children are more likely to catch the newly-added strain more readily than their parents so it will be geared toward them, yet the quadrivalent vaccine, as it is known, will be a mere fraction of the nation’s available supply. They will share the limelight with egg-free injections that have prevented individuals with an allergy to eggs from being immunized in the past. There is also a vaccine concocted just for those individuals 65 and over; and lastly, there is a needle designed to just pierce the skin and not enter as far as the normal injection for those who don’t like needles.
Now, let’s consider what a physician must take into consideration when ordering his or her vaccine for the fall season. Are his patients all geriatric, children, have an allergy to eggs, or do they simply have a phobia regarding having a needle stuck in their arm? How many parents of children will determine they want their child to have two shots spaced according to the recommendation and how many patients will get into their doctor’s office and opt at the last minute for a shorter needle?
Type A influenza causes more deaths and serious disease than does type B which is more mild but can still sicken individuals and cause deaths. There are two distinct type B families that virtually circle the globe. Rather than throwing a dart at a board for a guess as to which one to include, adding both seems to solve the problem. Type B influenza appears to target children more than it does those older.
The names of this year’s versions are marketed under the names Fluzone Quadrivalent, FluLaval Quadrivalent and Fluarix Quadrivalent. Fluzone High-Dose protects against the three strains of flu we’ve known of in the past but it quadruples the standard vaccine dose in an effort to jump-start the immune systems of older individuals that don’t respond well to regular flu shots. FluMist Quadrivalent is a nasal spray for healthy individuals between the ages of 2 and 49 who are not pregnant. It is estimated this high-dose immunization to be about 24% more effective, according to past reports. Flu vaccine is commonly made from viruses grown in eggs. Those between the ages of 18 and 49 with an egg allergy may request Flu-Blok which is produced with cell technology. It is estimated that almost 140 million doses will be produced, with only about 30 million offering the four-strain protection.
My guess is that your physician will make an educated decision as to which vaccine(s) are best for his or her patients. While signs are up now indicating the vaccine is ready and waiting for you, my personal feeling is to wait until mid-to-late October before being immunized so patients will have the protection later in the flu season when their resistance may be a bit lower following a long winter. It takes approximately two weeks following the injection for it to become effective, so just coming off a wonderful summer, readers have a little time to ponder which form of immunization is best for them. Having said this, the CDC recommends getting the vaccine as soon as it becomes available in the fall because the flu can be seen as early as October. Good luck.
