The Flu Vaccine: Some Pain, Much Gain

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By Vincent Chen, MD

You are not feeling well; your nose starts to run, your sinuses clog up and your throat is sore. You are extremely tired, your muscles ache terribly, you start to get chills and your head is aching too. You call out of work or school and crawl back into bed as one question runs through your mind—‘Why didn’t I get the flu shot this year?’

Influenza, commonly called the flu, is a viral infection caused by influenza types A or B. It primarily affects the nose, throat, and respiratory tract causing symptoms of fever, chills, runny nose, sinus congestion, dry hacking cough, muscle aching and extreme fatigue. Outbreaks typically occur every winter with varying degrees of severity. About 96 million cases of influenza are reported each year in the U.S. Flu season in the U.S. typically runs from November to April each year.

Here are some general tips to avoid the flu or to avoid spreading the flu:
• Cover your nose and mouth with a tissue when you cough or sneeze, and throw the tissue away after its use.
• Wash your hands with soap and water or an alcohol based hand rub.
• Avoid touching your eyes, nose and mouth.
• Avoid close contact with people that are ill.
• If you are sick with the flu, stay home until at least 24 hours after your fever is gone (except to get medical care or for other necessities).
• While sick, limit contact with others as much as possible to keep from infecting them.

The best way to avoid getting the flu is to get the flu vaccine. There are two types of flu vaccines that individuals can get. The Inactivated Influenza Vaccine is made of killed flu virus and is given by injection into muscle. The Live Attenuated Influenza Vaccine is made of living, but weakened, flu virus and is given as a nasal spray. It takes two weeks after vaccination to develop antibodies that protect against flu infection.

Each year, the flu vaccine contains three types of influenza viruses: Influenza A virus (H3N2), a seasonal Influenza A virus (H1N1) and Influenza B virus. The flu vaccine is designed to protect against flu viruses that are expected to cause disease in the upcoming flu season based on surveillance forecasts. Even if the flu strains chosen are not a “good match,” the flu shot still offers protection against related strains of flu.

Common side effects of the flu vaccine include soreness, redness, or swelling at the injection site, low grade fever and muscle aching. Itching, fatigue or red, itchy eyes may also occur. If these side effects do occur, they usually begin soon after the vaccine and last for one to two days. Life threatening allergies to flu vaccine are very rare and would occur within a few minutes of receiving the vaccine. In 1976, the Swine Flu Vaccine was associated with Guillain-Barre Syndrome, which causes paralysis. Since then, no flu vaccine has been clearly linked with Guillain-Barre Syndrome. The risk of this syndrome is approximately one or two cases for every million people vaccinated. This risk is much lower than the risk associated with getting an influenza infection. Vaccine safety is constantly monitored.

Influenza is a serious disease that can lead to hospitalization and even death. Everyone should get vaccinated against the flu as soon as possible for their own protection, as well as the protection of their loved ones. Some groups of people are at higher risk of getting the flu or can have more serious complications from flu infection.

The high-risk individuals who must get the flu vaccine include:
• Anyone 50 years of age or older
• People who live in long-term care centers, such as nursing homes
• All children 6 months or older
• Adults and children 6 months or older who have chronic heart or lung problems, such as asthma
• Adults and children 6 months or older who have chronic diseases like diabetes, kidney disease or weakened immune system (including HIV)
• Women who will be pregnant during flu season
• People with any medical condition that makes it hard to breathe or swallow (like brain injury or muscle disorders)
• People who can give the flu to others. This includes health care workers and close contacts of anyone in the above categories

Some people should not get the flu vaccine. These include:
• People who have life-threatening allergies to chicken eggs
• People who have had life-threatening reactions to the flu vaccine in the past
• People who have developed Guillain-Barre Syndrome within six weeks of getting a flu vaccine in the past
• Children younger than 6 months of age
• People who are sick with fever—they may get the flu vaccine when their symptoms improve

There are many common myths about the flu vaccine that deter people from getting vaccinated. Let’s address some of these.

Myth—Influenza is annoying but harmless.
This is a common misconception. The flu is not just a bad cold. It makes you feel much worse than a cold and usually costs you work days or school days. Influenza infection hospitalizes 200,000 people in the U.S. every year and kills 3,000 to 49,000 people each year.

Myth—The flu vaccine gives you the flu.
The injectable flu vaccine only contains dead virus. The nasal vaccine is a live virus vaccine in which the viral parts causing infection have been removed. Thus, the flu vaccine cannot cause infection. This myth may persist because vaccine side effects can sometimes appear similar to mild flu symptoms. Also, the flu vaccine is given during the cold season, so coincidental colds may appear to have been caused by the flu vaccine.

Myth—If you are young and healthy, you don’t need the flu vaccine.
Everyone should get the flu vaccine. Why suffer the miserable effects of influenza if it can be easily avoided? By getting vaccinated, you can avoid time lost from work or school. Additionally, you help protect your loved ones by not being contagious.

Myth—You can skip years between flu vaccines.
The flu vaccine must be administered every year because the dominant flu strains are different each year. Your flu vaccine from last year would not protect against the flu viruses that are likely to be dominant this year.

Myth—Vaccines are dangerous.
Some believe that there is a link between the flu vaccine and developmental disorders in children, such as autism. However, there is no evidence that vaccines cause autism. The benefit of preventing potentially life-threatening influenza illness far outweighs the risk of side effects of the flu vaccine.

In conclusion, the influenza virus can cause serious illness. It can be easily prevented by the influenza vaccine. The flu vaccine not only protects you, but your loved ones as well. With the influenza vaccine, a little pain leads to much gain. For more information about the influenza vaccine, visit www.kp.org/flu or www.cdc.gov/flu.

Biography
Vincent Chen, MD, is the Mid-Atlantic Medical Group’s Assistant Chief of Adult Primary Care and Physician Site Leader for the Burke and Springfield Medical Centers. In this role, he oversees and mentors fellow physicians as well as practices beside them.

Dr. Chen received his MD from the George Washington University School of Medicine and Health Services in Washington, D.C. Dr. Chen completed his residency at Washington Hospital Center in Washington, D.C. He is board certified in internal medicine.

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