Flu For the Holidays? Don't Give the Gift that Keeps on Giving, Says Loyola Specialist

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Egg allergies and fear of needles are no longer arguments to avoid getting a flu vaccine, thanks to improvements newly available this year. Good news because the flu virus has already struck. Loyola University Health System diagnosed its first case of the flu for the 2013-2014 season on Nov. 5. “Autumn usually signals the traditional beginning of the flu season in America so one case in early November is normal and right on schedule,” says Jorge Parada, MD, MPH, medical director of the infection prevention and control program at Loyola. “Last year we had an unusually early flu season and we diagnosed cases in early October.” Flu season usually peaks around mid-February and ends in March but can extend as late as May.

“A new flu vaccine is offered this year that protects against four strains of the flu; the traditional flu vaccine protects against three strains,” says Parada. “The four-strain variety is available in very limited quantity and will likely be more widepread next year if it is effective.” Loyola recently completed its fifth year of mandatory flu vaccination for employees, students, volunteers and vendors. “Loyola administered the three strain vaccine to our staff and we will potentially offer the four strain version of the vaccine next year, depending on data regarding efficacy and side effects,” says Parada, who leads the flu vaccination protocol for Loyola.

Also new this year, those who have egg allergies now have access to a completely egg-free vaccine. “Flublok is available to adults ages 18 through 49, and is recommended for those with a severe anaphylactic egg allergy,” says Parada.

Those who have a fear of needles can now benefit from the intradermal flu vaccine that uses a very fine needle that is 90 percent smaller than the needles used for regular flu shots. “The intradermal flu vaccine is injected into the superficial skin instead of the deeper muscle and is preferred by some patients,” says Parada. The needless vaccine is also available administered through a nasal flu mist option that is limited to those ages two through 49 who are healthy.

“Washing your hands continues to be the best advice to prevent the flu, and, of course, everyone should get a flu vaccine, early in the season is preferred, to protect themselves, their family and friends, and to prevent the spread of the flu virus overall,” says Parada, who recently was appointed a fellow in the Society of Healthcare Epidemiology of America (SHEA). “Herd immunity is a medical term that refers to the prevention of infectious disease due to mass public vaccination and herd immunity has helped to erradicate smallbox, and control measles, whooping cough, polio and many other deadly illnesses including the flu.”

The flu shot is readily available and is recommended any time during the flu season. “The earlier in the season you receive it, the longer you will be protected,” says Parada, who began administering the flu shot within the Loyola System in September.

The flu vaccine has a long track record and is a safe and reasonably effective vaccine. On the other hand, catching the flu is not safe and certainly is unreasonably uncomfortable. “Seriously, who wants to spend the holidays sick in bed, and perhaps being responsible for getting other friends and family members sick?” asks Parada. “The flu is not a good holiday gift idea but the flu shot certainly is for those who have yet to be vaccinated.”

Here are some common myths about the flu vaccine that Parada and his colleagues frequently hear at Loyola:

I have the stomach flu. “The flu is a respiratory illness and rarely are nausea, diarrhea and vomiting the main symptoms,” says Parada. “People may have diarrhea and other stomach upset, and it may be from a virus infection, but it is unlikely to be from the flu virus.”

I got the flu from the flu shot. "It is not true to say that the flu shot can give someone the flu,” says Parada. “Remember, it takes two weeks from vaccine injection for a person’s protective immunity to become effective. Thus, if a person gets exposed to the virus right around the time he or she gets the vaccine, they may experience the flu during that window before the vaccine has time to kick in. In these cases it is not the flu shot that gave the person the flu, but rather that they did not get the flu shot early enough to be protected when they were exposed and infected by the flu virus.”

Parada also notes that there are many varieties of flu, and depending on which vaccine you get, it will target the three or four dominant strains. "People may not know that typically three to four dominant varieties of flu circulate every season. As a result, people can get the flu multiple times within a season, but they are actually getting different varieties of the flu," he notes. “All the more reason to get the flu shot!”

I got my flu shot last year so I do not need one again. “The vaccine is effective for one flu season, so everyone needs to get the vaccine every year,” he says. “People with chronic conditions may be advised by their physician to get a second flu booster later in the season to provide best protection.”

I am allergic to the flu shot. “New this year is an egg-free flu vaccine and latex-free formulas have been around for some time,” says Parada. “It is becoming increasing rare that people have true vaccine reactions, and those who had them in the past may be happy to know that they may no longer have problems with the new vaccines today.”

The flu shot was first distributed in the 1940s to American soldiers by the US government. Loyola University Health System was one of the first academic medical centers to offer mandatory flu vaccines to not only its employees but also vendors, medical students and volunteers, says Parada.

Many pharmacies and retail outlets now offer flu shots. "The greater the access to health care by the general public, the better off the entire community," says Parada. "Many retail providers rush to be the first to offer the flu vaccine because it generates profits to the store. That may create a false sense of urgency."

Parada feels a benefit to getting a flu shot from your primary-care physician is that it encourages a conversation. "Most people do not readily go to the doctor; especially at a time when they are not actively sick," he says. "A visit to the doctor to get the flu shot is an opportunity to discuss health matters, get basic health maintenance and get follow-up care if necessary, which is a good thing."

Vaccines are designed to protect against the influenza viruses that experts predict will be the most common during the upcoming season. Three kinds of influenza viruses commonly circulate among people today: Influenza A (H1N1) viruses, influenza A (H3N2) viruses, and influenza B viruses. Each year, these viruses are used to produce seasonal influenza vaccine. Some years a second Influenza B strain also circulates in large numbers, and that is why the four variety vaccine was developed.

The 2013-2014 trivalent influenza vaccine is made from the following three viruses:

· an A/California/7/2009 (H1N1)pdm09-like virus;

· an A(H3N2) virus antigenically like the cell-propagated prototype virus
 A/Victoria/361/2011;

· a B/Massachusetts/2/2012-like virus.

The quadrivalent vaccine contains the above three viruses and a B/Brisbane/60/2008-like virus.

Source: Loyola University Health System

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