Guest Column: Should you get the flu vaccine?

September 29, 2010

By Brenda Neumann, R.N.

Pneumonia and influenza are the eighth leading cause of death in the U.S. The best way to prevent the flu is by having a flu vaccine. The vaccine is about 70-90 percent effective in preventing the flu and flu-related complications, and can reduce the chances of death from flu-related complications in nursing home residents by 80 percent.

Most people are good candidates to receive the vaccine. People most highly recommended to receive it are more vulnerable to its complications; children younger than 5 years old, people older than 65 years, people with chronic health issues or compromised immunity, pregnant women, nursing home residents and closely associated contacts of these populations.

In the United States, 5-20 percent of the population of roughly 300 million people becomes ill with the flu annually. About 226,000 are hospitalized, and 36,000-51,000 people die from complications. Even more people would become ill and die if not for the fact that approximately 30 percent of U.S. citizens get an annual flu shot. The majority of flu cases occur in children under 5 years old—20 percent, and people older than 65 with medical complications—51 percent. Flu occurs in about 7 percent of healthy adults aged 18-49. The majority of people who got one of the major flu strains did not receive the vaccine.

H1N1 (swine flu) deaths totaled almost 12,000 (2009-2010). Although the H1N1 epidemic is essentially over for now, nobody knows for sure if or when it could resurface, and with how much severity. This virus differs from the seasonal flu in that it affects people younger than 65 years of age the majority of the time, including 90 percent of hospitalizations and 87 percent of all deaths.

Many flu-related deaths occur one or two weeks after a person’s initial infection. The flu can aggravate chronic illnesses, such as heart disease, asthma and diabetes, or cause severe illness and even death due to pneumonia and other secondary or opportunist infections.

Most flu cases occur between November through May, with the peak during January and February. The best time to be vaccinated is anytime between August and October. Getting vaccine up until almost the end of flu season is better than not at all.

How much does the flu cost? Close to 70 million working days are lost because of the flu each year in the United States. Annual cost of the flu to the U.S. economy: $87 billion.

The flu is caused by influenza viruses that infect one’s respiratory tract: nose, throat and lungs. Viruses are passed person-to-person and surface-to-person via respiratory droplets; sneezes and coughs. Symptoms can include fever, chills, fatigue, muscle/body aches, headaches, sore throat, cough, runny/stuffy nose and sometimes nausea and diarrhea that can last for 7-10 days or longer if complications occur.

This year’s vaccine will help protect you from three major strains of seasonal flu and H1N1; an all-in-one vaccine. People who had the actual illness of flu or H1N1 in 2009 or early 2010 should consider being vaccinated. It takes two weeks after receiving the vaccine to achieve maximum immunity. There are two types of vaccine, the non-live injection and the live intranasal spray. Check with your health care professional for dosing information.

Some people should not receive the vaccine: those with a severe allergy to chicken eggs, have had a severe reaction to a prior flu vaccine, have developed Guillain-Barre syndrome (GBS) within six weeks of receiving a flu vaccine, children younger than six months of age, and people who have a moderate-to-severe illness with fever. People with temporary febrile illness can wait until they recover to receive the vaccine.

You cannot get the flu from the inactivated injectable version of the flu shot, and it is highly unlikely you would get the flu from the live, intranasal version. Severe reactions or death are exceedingly rare from getting the flu vaccine. The majority of side effects usually occurs with young children receiving their first vaccine, and usually starts within 6-12 hours after receiving the vaccine and lasts for 1-2 days. Side effects can include injection site soreness, redness or swelling, red, watery eyes, hoarseness, cough, fever, malaise or body aches. Since 1976, flu vaccines have not been associated with Guillain-Barre syndrome. Millions of flu vaccines have been given without incident over the past several years. Allergic reactions of hives and anaphylaxis are rare, can be life-threatening and are usually a result of a person who is allergic to eggs receiving the vaccine. Careful screening of each vaccine recipient is done via a questionnaire/consent combination form.

Some people have concerns regarding preservatives contained in vaccines, namely thimerosal. Thimerosal, used in vaccines since the 1930s, is 50 percent mercury by weight, is quickly metabolized and eliminated from the body, so does not accumulate or reach harmful levels in the body. It is used to kill or prevent growth of harmful microorganisms, bacteria and fungus that could be life-threatening to vaccine recipients. Since 2001, thimerosal has not been used in routine childhood vaccines except for some flu vaccines. It is only present in trace amounts of 1 microgram or less per dose. It has a proven track record of being safe in the small amounts used in some flu vaccines. Potential adverse effects are infrequent and  usually limited to injection site soreness and redness. There are rare cases of thimerosal allergies, which usually do not materialize into reactions from the flu vaccine. The Food and Drug Administration (FDA) is working with vaccine manufacturers to reduce and eventually eliminate thimerosal from vaccines as an extra precaution. For a list of which vaccines do or do not contain Thimerosal, consult the U.S. Food and Drug Administration ( website. Any consumer or doctor can report possible side effects and reactions to the Vaccine Adverse Event Reporting System (VAERS), a safety surveillance program maintained by the FDA and CDC.

The flu vaccine poses a minuscule risk to the majority of recipients. Very few are not good candidates to receive it. The impact of getting the flu, including lost work days, loss of personal comfort for several days, the chance of infecting others and the risk of flu-related complications is greater than any possible adverse effects from the flu vaccine.

Sources:,, World Health Organization

Brenda Neumann, R.N., is an Occupational Health and Travel Medicine Nurse for a local hospital. Next week: An opposing viewpoint.

From the Sept. 29-Oct. 5, 2010 issue

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