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The flu season is upon us once again, so it is important to start talking about how to protect children as well as adults from getting the flu. The flu is, of course, a virus that causes fever, cough, nasal congestion, runny nose and body aches. During the 2013-2014 flu season, the peak of flu activity across the country was from December through February, and the Center for Disease Control (CDC) confirmed 108 pediatric deaths in the US due to the flu last year.


The current recommendations from the CDC as well as the American Academy of Pediatrics (AAP) is for everyone 6 months and older to receive the flu vaccine. The very young, those children with underlying lung problems such as asthma, people with low immune systems, as well as those who are pregnant are at highest risk for the more serious complications from the flu. Even if someone received a flu vaccine during the 2013-2014 flu season, it is important for them to have the vaccine again this year. Flu vaccines generally provide immunity from the flu for only short periods of time, somewhere between 6-9 months, which is why it is critical to receive a vaccine each fall.


There are two flu vaccines again available this season. The trivalent vaccine protects against 3 strains of the flu while the quadravalent vaccine protects against 4 strains of the flu. It should be noted that both vaccines protect against 2 strands of influenza A virus, which accounted for almost 90% of positive flu cases across the country last year.  The flu vaccine comes in two forms…a shot and a nasal spray. For those 2-49 years of age who are otherwise healthy and are not pregnant, the flu mist is recommended. In fact, based on recent studies showing improved efficacy of the flu mist in children 2-8 years of age, the CDC is now recommending the nasal flu vaccine over the shot for that age group. If your child is under 2 year of age or any child with a history of wheezing or asthma, someone with a lowered immune system or if they are around someone with a very low immune system, then the flu shot is recommended over the nasal spray.


So what are the side effects of the flu shot and flu mist? The most common side effects seen with the shot include soreness or redness at the injection site, fainting, headache, and muscle aches. As for the nasal mist, children can have mild runny nose, sore throat, or cough that usually lasts 1-2 days. One very rare side effect called anaphylaxis is an acute and severe allergic reaction that would occur within 1-2 minutes of receiving the vaccine (so while you are still in the doctor’s office). It is estimated that anaphylaxis to a vaccine occurs in less than 1 in a MILLION doses. For those people with a history of significant egg allergy or those with a history of Guillain-Barre syndrome (GBS), which is an acute, paralyzing neurologic illness, they should talk with their doctor before receiving the flu vaccine.


There are certainly myths out there in regards to the flu vaccine. Getting the flu shot cannot give you the flu! The shot is inactivated flu, meaning there is no live virus present, so there is no way to become sick with the flu from the shot. The nasal spray is a live virus vaccine but the virus is attenuated, meaning it is a much weakened version of the flu and can therefore NOT cause the true flu. This weakened flu strain that is present in the flu mist is “cold-adapted” which means it cannot cause any type of infection in warm places like the lungs.


It should be noted that it takes your body about 2 weeks from the time you get your flu vaccine to make the appropriate antibodies against the flu, so you are just as susceptible to the virus during that time period. Also there will always be “breakthrough cases” of the flu in those people who have gotten the flu shot. This is because the vaccine is not a 100% guarantee.   However, in my experience and from surveillance studies, those children who have gotten the flu vaccine and still get the flu virus, are less ill and have the illness for a shorter period of time.