The Flu Vaccine – To Give or Not To Give.
With the onset of the fall season, we look forward to the comfort of cooler weather, falling leaves and crisp, clean air. One not so comforting consequences of same season is the sound of nebulizers running in pediatric offices. In the past two weeks I have been dealing with more wheezing children. With divine intervention, all the patients so far have recovered fully and swiftly. Two of them however, required overnight hospitalizations at LIJ – Cohen’s Children’s Hospital (enjoying a comfortable and swift ride via Hatzolah of the Five Towns – a tremendous asset to our community!)
The reason I mention these facts is twofold:
A. To remind all the parents of asthmatic children to make sure that their nebulizers are working. Not to hesitate and receive immediate medical attention if their children are in any respiratory distress.
B. To encourage those parents of asthmatic children, or children with history of heart disease, lung disease, prematurity or patients receiving immune suppressing medicine to inoculate their children with the Flu vaccine as soon as possible.
I know that many parents in the Five Towns and all over the world have their own reservations about the Flu vaccine. As a general rule, I do not force the vaccine on any patient. However, every fall season, I send an email to my parents to inform them that the Flu Vaccine is available and set special office hours to accommodate administering the vaccine after school hours.
When I am asked for my opinion about the Flu Vaccine, I answer that there is no doubt that it is a safe and effective vaccine. I do recommend the vaccine to all my patients. If a mother mentions during a routine visit that she is against the vaccine or is very hesitant about it, I ask her the following question: “Are you going to lose sleep if your child receives the Flu Vaccine?” If the answer is “yes”, I tend to agree with the mother she should not give it. I inform her of the risk and danger of the flu virus as opposed to the benefits of the vaccine. In the vast majority of cases, if a family actually contracts the flu virus in one year, the heads of the household decided to vaccinate their kids in subsequent years. And on the flip side – very often, when a parent is “forced” to receive the Flu Vaccine, any illness contracted during the entire winter season will be blamed on……….the Flu Vaccine (that includes Strep Throat, Mono, Common Colds and even chronic fatigue).
I do tend to spend much more time convincing parents to give the vaccine if their children have wheezed in the past or have the above mentioned risk factors. Those are the kids that tend to get critically ill from the flu virus. The vaccine is recommended to all children above the age of 6 months. I should also mention that in the adult population, patient over 65 years of age and patient with history of heart and lung disease, pregnant and post-partum women as well as healthcare workers are highly encouraged to receive the Flu Vaccine.
Why Vaccinate?
According to the CDC 200,000 patients are hospitalized yearly with influenza, of them 20,000 are children below the age of 5.
Sadly, during the 2013-2014 flu season 107 children died due to the flu and its complications. Half of these deaths were in previously healthy children.
What Are the Different Types of The Flu Vaccine?
There are 2 types of flu vaccines.
Inactivated influenza vaccine (TIV or QIV) is given as a shot. There are 2 kinds of shots. The intramuscular (into the muscle) shot is licensed and recommended for children 6 months and older and adults, including people with and without chronic medical conditions.
Live-attenuated influenza vaccine (LAIV) is sprayed into the nose. LAIV is recommended for healthy children 2 years and older. This vaccine should not be given to:
Children under 5 years old with history of wheezing
Pregnant women
Immune compromised patients should also avoid this vaccine
Both types of flu vaccine are very safe and work well to protect your child from the flu. This year, the CDC recommended the flu mist over the flu injection for patients aged 2-8 years old if there are no contraindications.
Both vaccines contain egg particles. So if your child is highly allergic to eggs, please consult with your allergist whether you should give the vaccine or not.
When?
Get the vaccine as soon as it is available. This should provide protection if the flu season comes early. You can get the vaccine as long as illness is occurring in your community. Influenza can occur at any time, but most influenza occurs from October through May. In recent seasons, most infections have occurred in January and February. Getting vaccinated in December, or even later, will still be beneficial in most years. Adults and older children need one dose of influenza vaccine each year. But some children younger than 9 years of age need two doses to be protected. Ask your doctor.
Influenza vaccine may be given at the same time as other vaccines, including pneumococcal vaccine.
Some people should not get the Flu Vaccine or should wait:
Tell your doctor if you have any severe (life-threatening) allergies, including a severe allergy to eggs. A severe allergy to any vaccine component may be a reason not to get the vaccine. Allergic reactions to influenza vaccine are rare.
Tell your doctor if you ever had a severe reaction after a dose of influenza vaccine.
Tell your doctor if you ever had Guillain-Barré Syndrome (a severe paralytic illness, also called GBS). Your doctor will help you decide whether the vaccine is recommended for you.
People who are moderately or severely ill should usually wait until they recover before getting Flu Vaccine. If you are ill, talk to your doctor about whether to reschedule the vaccination. People with a mild illness can usually get the vaccine.
What are the risks from the Flu Vaccine?
A vaccine, like any medicine, could possibly cause serious problems, such as severe allergic reactions. The risk of a vaccine causing serious harm, or death, is extremely small.
Serious problems from inactivated influenza vaccine are very rare. The viruses in inactivated influenza vaccine have been killed, so you cannot get influenza from the vaccine.
I hope this information will help you make the right decision about the Flu Vaccine for yourself and your loved ones.
Wishing you a happy and healthy fall season.
David Elazar Simai M.D.