10 things you may not know about flu shots

SEATTLE – The message is out in full force: You need to get a flu shot! But when should you get it? And which vaccine is best?

We spoke with Dr. Ari Gilmore from PacMed’s Beacon Hill Clinic about some of the most common questions patients ask about the flu vaccine.

1. Can I skip the shot and get the nasal spray?

The biggest selling point for the nasal spray vaccine has always been the fact that it does not require a needle poke, but it turns out some patients may develop better flu resistance with the nasal spray as well.

Research has suggested that the FluMist nasal spray live-attenuated influenza vaccine by Medimmune is more effective than the inactivated vaccine for children between 2 and 7 years old.

Still, the Washington State Department of Health does not recommend vaccination be delayed for children if FluMist is not available.

Gilmore cautions that the nasal spray may be less effective for adults over 50. It is also not recommended for pregnant women or people with immune disorders, emphysema or asthma.

2. I got a flu shot last year; do I really need another one?

Gilmore explains that each year the flu viruses change quite a bit, so last year’s shot may no longer be effective in preventing against future infection.

For those who become infected with a flu virus after being vaccinated, research shows their symptoms are far less serious than those who are not vaccinated.

3. How many flu strains should I be vaccinated for?

For the first time ever, patients will be able to get quadrivalent vaccines during the 2013-2014 flu season. While flu vaccines were previously designed to protect against three flu strains (trivalent), a new kind protects against four.

Both vaccines protect against H1N1, H2N3 and one type B virus – which are predicted to cover 80 percent of flu cases this season – but the quadrivalent also protects against a second type B.

While it might seem best to be vaccinated against as many flu strains as possible, Gilmore says more research is needed to know whether the quadrivalent is actually better. At this time, the U.S. Centers for Disease Control and Prevention is not recommending the quadrivalent vaccine over the trivalent for the general population.

The quadrivalent vaccine is expected to be in short supply this season, and Gilmore says people should not delay getting vaccinated in search of the newest option.

“I would recommend people get whatever is available in their clinic,” he says. “There’s not enough data supporting the quadrivalent to go out searching for it.”

4. Can people with an egg allergy get the flu vaccine?

For those with egg allergies, there are two new cell-based vaccines this season that do not use the standard egg-based production method.

Flucelvax (by Novartis) uses antigens derived from influenza virus that is grown from mammalian cells instead of chicken eggs. Flubok (by protein Sciences) uses recombinant DNA technology and insect cells.

5. Does the vaccine give me an excuse to skip my workout?

On the contrary, Gilmore says exercising after receiving your flu shot should get your blood flowing and may ease arm soreness the next day.

6. Do I need a high-potency vaccine?

Clinical trials comparing standard and high-dose flu vaccines among people over 65 years old have shown that patients have greater immune response (more antibodies) after being given the high-dose vaccine. Still, further research is needed to know whether this leads to greater protection against influenza, DOH reports.

“There is some evidence people over 60 don’t get a strong immune response to the normal vaccine,” Gilmore says.

He especially recommends the high-dose vaccine to adults over 65 who have multiple health conditions.

Those getting the high-dose vaccine may experience increased site tenderness, but should not experience any other side effects, Gilmore says.

7. Why can’t I get vaccinated while I’m sick?

People with cold symptoms or a fever may be asked to wait to get a flu vaccine because their immune system is already working to address an existing virus. To get the best immune response, Gilmore recommends people wait until they feel healthy again to get a vaccine.

8. I’m expecting, is a flu shot safe for my baby?

The CDC recommends all women who are pregnant, or trying to get pregnant, be vaccinated against the flu. Pregnant women who get influenza vaccine pass their immunity to their babies in the form of flu antibodies which can last for several months after birth.

Gilmore says women who become infected with a flu virus while pregnant are more likely to experience serious symptoms and may even have an increased risk of miscarriage.

Pregnant women get an inactivated vaccine shot, according to the CDC. Postpartum women can receive a live vaccine, and pregnant women do not need to avoid contact with persons recently vaccinated with the live vaccine.

9. Celebrity science has me wondering, is the flu vaccine safe?

Despite endlessly circulating hype, a 2004 comprehensive review by the Institute of Medicine found that there is no relationship between certain vaccine types and autism.

Additionally, Gilmore says this year’s vaccines contain no preservatives or mercury.

10. When is the best time to get a flu shot?

To stay ahead of flu season, Gilmore recommends people get their vaccine in October or early November.

“Some people will wait for the outbreak, but earlier is better,” he says. “Occasionally, places will run out of the vaccine so you want to get yours soon.