Every year we receive multiple inquiries about the wisdom of using a “flu shot,” otherwise known as an influenza vaccination. There are actually two types of vaccines: an inactivated vaccine that is given by injection and a live attenuated influenza vaccine (LAIV) called FluMist™ that is given intra-nasally to people who are not pregnant and between the ages of 2 to 49 years old. We have created this brief summary of information to assist our patients in making an informed decision about the use of these vaccines.To begin, we want to provide you with the standard medical recommendations that are widely circulated within the conventional medical system. According to the Centers for Disease Control and Prevention (CDC), while almost anyone can get a flu vaccination, there are particular people who are considered at high risk and should get vaccinated every year. These include:1.People at high risk for complications from the flu, including:
- Children aged 6 months until their 5th birthday,
- Pregnant women,
- People 50 years of age and older, and
- People of any age with certain chronic medical conditions;
- People who live in nursing homes and other long term care facilities.
2.People who live with or care for those at high risk for complications from flu, including:
- Household contacts of persons at high risk for complications from the flu (see above)
- Household contacts and out of home caregivers of children less than 6 months of age (these children are too young to be vaccinated)
- Healthcare workers.
The CDC recommends that the following populations not receive the nasal-spray flu vaccine LAIV (FluMist™):
- People less than 2 years of age
- People 50 years of age and over
- Health care workers or other persons who care for people with severely weakened immune systems
- People with a medical condition that places them at high risk for complications from influenza, including those with chronic heart or lung disease, such as asthma or reactive airways disease; people with medical conditions such as diabetes or kidney failure; or people with illnesses that weaken the immune system, or who take medications that can weaken the immune system
- Children less than 5 years old with a history of recurrent wheezing
- Children or adolescents receiving aspirin
- People with a history of Guillain-Barr syndrome, a rare disorder of the nervous system
- Pregnant women
The CDC and other sources also mention that there are people who should not be vaccinated without consulting a physician. These include:
- People who have a severe allergy to chicken eggs. Signs of an allergic reaction can include: difficulty breathing, hoarseness, wheezing, hives, paleness, pronounced weakness, rapid heartbeat, or dizziness.
- People who have had a severe reaction to an influenza vaccination in the past.
- People who developed Guillain-Barr syndrome (GBS) within 6 weeks of getting an influenza vaccine previously.
- Influenza vaccine is not approved for use in children less than 6 months of age.
- People who have a moderate or severe illness with a fever should wait to get vaccinated until their symptoms lessen. Flu vaccinations should also not be given to anyone with an acute respiratory infection or serious illness involving a fever.
- Individuals undergoing immunosuppressive therapy may not develop a normal immune response to an influenza vaccination. This include people taking high doses of systemic steroids.
- People with asthma and other chronic respiratory conditions, as well as people with immunosuppression issues should not receive LAIV. Persons with these disorders should receive inactivated influenza vaccine.
Thiomersal, formerly and still commonly known in the US as thimerosal, is an organomercury compound that is used as a preservative in multi-dose flu vaccine vials. It is currently being phased out as a preservative for vaccines. According to the CDC, “all routinely recommended licensed pediatric vaccines that are currently being manufactured for the U.S. market, with the exception of influenza vaccine, contain no thimerosal or only trace amounts. Thimerosal preservative-free influenza vaccines are available, but in limited quantities.” The use of this preservative is controversial because some critics of the vaccine allege that there is a connection between thiomersal and autism. More information is easily found online. Here is a sample of an article that supports the link between autism and thimersal (http://www.newstarget.com/011764.html) and one that does not support the link. (http://slate.com/id/2123647/)In terms of side effects, these vary between the inactivated injection and the nasal spray. Since the injection contains an inactivated form of the virus, the side effects are typically more mild and include inflammation at the injection site, low grade fever, and body aches. There is always the chance of an allergic reaction to the injection, however, which can be severe.The side effects for the nasal form (FluMist™) are more numerous and can be more intense. For children, who are at greatest risk for side effects, these include runny nose, wheezing, headache, vomiting, muscle aches, and fever. For adults, these can include nasal discharge, headache, sore throat, and cough. FluMist, however, does not contain thiomersal or any other preservative.When the question of flu vaccinations comes up, our patients often want to know if they should or should not obtain one. This is a complex question that cannot be answered by blanket recommendations. Each person’s situation is different and therefore some research and thought is required in order to come to an appropriate decision. For example, one of the main things to consider is how effective your lifestyle and behaviors are at helping you to resist the flu as compared to using a vaccination given your age, gender, occupation, etc. Individuals who understand and use a natural medicine approach to immune support do much better in this regard.For more information on this and many other issues concerning the influenza vaccination, please see our patient handout on The Flu and You.