Fall is for Flu Shots

Horizons in Hemophilia, October 2011 

By Jeff Cornett RN MSN, Director of Training, Research, and Advocacy

It's time to get a flu shot (the vaccination against influenza).  Getting the shot now allows your body time to build up resistance to the flu viruses before the yearly flu season begins.  If you wait until you hear of people getting sick, it may be too late.  The vaccine may not have enough time to strengthen your body's defenses.  The following information is based on recommendations from the Centers for Disease Control and Prevention (CDC).

The CDC recommends a yearly flu shot for everyone 6 months of age and older as the first and most important step in protecting against this serious disease.

The flu (influenza) is caused by two main types of viruses:  influenza A viruses and influenza B viruses.  Each year the CDC decides which types are most likely to cause flu epidemics in the United States.  A vaccine is made from viruses of each chosen type.  The vaccine lowers your chance of catching the flu this year, but it is no guarantee.  There could be a flu epidemic caused by another type of influenza virus.

The usual symptoms of the flu are a fever that comes on quickly, an aching body, a sore throat, and a dry cough.  You may feel very sick for several days.  The flu can lead to pneumonia, especially in people who are in poor health.  Thousands of people die each year in the United States from complications of the flu.  Infants younger than six months are at high risk for getting seriously sick from the flu.  Since they are too young to vaccinate, it is very important that those around them get the shot.

You have to get a flu vaccination every year for two reasons.  One is that the type of flu viruses that are going around can change from year to year.  The other reason is that the resistance your body gains from the vaccine may not last until the next flu season.

You only need one flu shot each year unless you are a child under nine years old getting a flu shot for the first time.  Then you have to get two doses a month apart.

Side effects from the flu vaccine are very rare.  Since the shot is made from killed viruses, it cannot give you the flu.  Some people getting the shot have a sore arm for a day or so.  Some young children run a fever for a couple of days.  It is possible to have an allergic reaction to the vaccine.  This is most likely to happen in someone who is strongly allergic to eggs.  Eggs are used to grow the viruses for the vaccine and a little egg protein may be in the injection.  So people who are allergic to eggs should talk to their doctor before being vaccinated.

Flu shots are available at many doctors' offices, county health departments, and pharmacies.  Because of the healthcare reform law (the Affordable Care Act) most people will discover that their health insurance now covers the flu shot with no co-pay.

There are three approved ways to get the flu vaccine:  through a shot into a muscle, through a shot into the skin, or through a nose spray. 

• A shot into a muscle (intramuscular injection) is the most common way to receive the flu shot.  In older children and adults, it is given into the deltoid muscle in the shoulder.  In babies and younger children, it is given into the thigh.
  
• The shot into the skin (intradermal) is only to be used in people ages 18 through 64.
  
• The nasal spray uses live but weakened flu virus. It is for healthy people ages 2 through 49 who are not pregnant.

Shots into the muscle can cause a bleed, but are unlikely to do so in those with mild hemophilia.  Therefore people with hemophilia should talk to their HTC to find out how they should get vaccinated. The nasal spray has no risk of bleeding, so for those 2-49 years of age who have a normal immune system and do not take care of someone with a weakened immune system, it may be the best option.  The hematologist may want you to get the vaccine that is made to go into the muscle, but get it injected subcutaneously (under the skin).  Unfortunately the flu shot designed to be given into a muscle may not be as effective when given under the skin.  For that reason, the hematologist may want you to take factor first and then get the shot into the muscle.  Discuss the pros and cons of this approach with your hematologist, particularly if you have not used much factor before.

You can get more information about the flu and flu shots by visiting the CDC’s website on the Internet: https://www.cdc.gov/flu.