Vaccination against seasonal flu began September 1, and is now available. The federal Centers for Disease Control and Prevention encourages an earlier-than-usual start to seasonal flu vaccination in 2009, and has stated that the vaccine will offer protection for the entire flu season even if it was given in September. Getting vaccinated at any time throughout the flu season will still be beneficial.

An annual flu shot is recommended if you:

• Are age 50 or older
• Are six months to 18 years old (two doses may be required)
• Work or live in a long-term care facility
• Are a woman who will be pregnant during flu season
• Are a healthcare professional
• Have a chronic health problem such as asthma, heart disease, emphysema, diabetes, HIV or sickle cell disease
• Live in a household with or provide care to a child less than five years old or an adult 50 or older
• Live in a household with someone who has a medical condition that puts them at high risk for severe complications from the flu (such as someone with a chronic health problem, HIV or cancer)
• Want to reduce the risk of becoming ill with flu or transmitting flu to others this year

The vaccine against the novel H1N1 pandemic flu virus (also called swine flu) is available for:

• Pregnant women because they are at higher risk of complications and can potentially provide protection to infants who cannot be vaccinated
• Household contacts and caregivers for children younger than 6 months of age because younger infants are at higher risk of influenza-related complications and cannot be vaccinated. Vaccination of those in close contact with infants less than 6 months old might help protect infants by “cocooning” them from the virus
• Healthcare and emergency medical services personnel because infections among healthcare workers have been reported and this can be a potential source of infection for vulnerable patients. Also, increased absenteeism in this population could reduce healthcare system capacity
• All people from 6 months through 24 years of age
• Children from 6 months through 18 years of age because we have seen many cases of novel H1N1 influenza in children and they are in close contact with each other in school and day care settings, which increases the likelihood of disease spread, and
• Young adults 19 through 24 years of age because we have seen many cases of novel H1N1 influenza in these healthy young adults and they often live, work, and study in close proximity, and they are a frequently mobile population
• Persons aged 25 through 64 years who are at higher risk for novel H1N1 because of chronic health disorders or compromised immune systems

• Are under six months old
• Have a fever of 101.5° or more
• Have an allergy to eggs/egg products or had a reaction to a prior flu vaccine
• Have been diagnosed with Guillain-Barre Syndrome in the past

• Are under 2 years of age, or older than 49 years of age
• Have a fever of  101.5° or more
• Have an allergy to eggs/egg products or had a reaction to a prior flu vaccine
• Have a long term health problem or chronic medical condition
• Have asthma or reactive airway disease or recurrent wheezing or use an inhaler or nebulizer
• Have a weakened immune system because of HIV/AIDS or another disease that affects the immune system, long-term treatment with drugs such as steroids, or cancer treatment with x-rays or drugs
• Are receiving asprin therapy or asprin-containing therapy
• Are pregnant, breast-feeding or could become pregnant in the next month
• Have been diagnosed with Guillain-Barre Syndrome in the past
• Live with or expect to have close contact (in the next 7 days) with a person whose immune system is severely compromised and who must be in a protective environment (for example- bone marrow transplant patients or patients in a hospital room with reverse air flow)
• Have received any other live vaccination in the past 28 days such as MMR, Varicella/chicken pox, yellow fever

* If you are allergic to Benadryl or Epinephrine, you should only receive the flu vaccine in a medical office with a licensed provider present who is capable of ordering emergency treatments.

The ability of flu vaccine to protect a person depends on the age and health status of the person getting the vaccine, and the similarity or "match" between the virus strains in the vaccine and those in circulation. Testing has shown that both the flu shot and the nasal-spray vaccine are effective at preventing the flu.

For more information about the H1N1 vaccine and its effectiveness, visit the Centers for Disease Control and Prevention H1N1 vaccination page.

Note: The H1N1 vaccine will be similar to a seasonal flu vaccine in all respects, so this list will likely apply to it. However, extra testing is being done on this vaccine before it is released. Further information on that testing and its results will be posted on this page from the Centers for Disease Control and Prevention.

Different side effects can be associated with the flu shot and LAIV.

The flu shot:  The viruses in the flu shot are killed (inactivated), so you cannot get the flu from the flu shot.  Some minor side effects that could occur are:

• soreness, redness, or swelling where the shot was given
• low grade fever
• aches

If these problems occur, they begin soon after the shot and usually only last 1-2 days.  Almost all people who receive the flu vaccine have no serious problems from it.  However, on rare occasions, flu vaccination can cause serious problems, such as severe allergic reactions. 

LAIV (FluMist®):  The viruses in the nasal spray are weakened and do not cause severe symptoms often associated with influenza illness.  (In clinical studies, transmission of vaccine viruses to close contacts has occurred only rarely.)

In children, side effects from LAIV (FluMist®) can include

• runny nose
• wheezing
• headache
• vomiting
• muscle aches
• fever

In adults, side effects from LAIV (FluMist®) can include

• runny nose
• headache
• sore throat
• cough

People who have systemic allergic reactions to eggs or chicken protein (such as trouble breathing) should not receive flu vaccine. 

Anyone who wants to reduce their chances of getting the flu should get the seasonal vaccine. (And really, who wants to encourage fevers, chills, runny nose, body aches, and fatigue?)

If you’re a health care worker and you come in contact with patients in any way, you should get the vaccine not only to protect yourself, but to protect your patients, too -- especially those with weakened immune systems. You can transmit flu to someone else for 24 hours before you even know you’re sick!

According to public health officials, people who should make sure to get the seasonal flu vaccine are:

1. Children aged 6 months up to their 19th birthday
2. Pregnant women
3. People 50 years of age and older
4. People of any age with certain medical conditions (such as asthma, lung disease, heart disease, diabetes, and diseases or treatments that affect the immune system) that make them more likely to develop complications from the flu.
5. People who live in nursing homes and other long-term care facilities
6. People who live with or care for those at high risk for complications from flu, including:

• Health care workers
• Household contacts of persons at high risk for complications from the flu
• Household contacts and out of home caregivers of children less than 6 months of age (these children are too young to be vaccinated)

In fact, the only people who should NOT get a seasonal flu vaccine are those who are under six months old, who currently have a fever of 101.5° or more, who have an allergy to eggs/egg products or had a reaction to a prior flu vaccine, who have been diagnosed with Guillain-Barre Syndrome in the past or who are currently receiving chemotherapy.

There are a few other groups that can receive the injected flu vaccine but should not receive the nasal vaccine (FluMist) - see our general vaccine page for a list.

The seasonal flu vaccine is not expected to protect against the novel H1N1 pandemic flu, also commonly called swine flu.

The vaccine against H1N1 is being produced now, and is expected to be available this fall. However, the run-of-the-mill seasonal flu can be inconvienent at best and deadly at worst. Every year, on average, 5 to 20 percent of the U.S. population gets the flu, more than 200,000 people are hospitalized from flu-related complications and 36,000 people die from flu-related causes. So it’s nothing to sneeze at.

Flu vaccination provides protection that will last for the whole season. Vaccination can begin as soon as the vaccine is available. Studies do not show a benefit of receiving more than one dose of vaccine during a flu season, even among elderly persons with weakened immune systems.  In addition, there is a lack of evidence for late season outbreaks among vaccinated persons that can be attributed to waning immunity. 

How well the flu vaccine works depends on how well the match is between the influenza (flu) vaccine and the types of flu viruses that are circulating that year. Scientists try to predict what strains of flu viruses are most likely to spread and cause illness each year to put into the vaccine. In years when the vaccine strains and the virus strains are well-matched, the vaccine can reduce the chances of getting the flu by 70 to 90 percent in healthy adults. The vaccine may be somewhat less effective in elderly persons and very young children, but vaccination can still prevent serious complications from the flu.

• The "flu shot"— an inactivated vaccine containing killed virus that is given with a needle, usually in the arm. The flu shot is approved for use in people older than 6 months, including healthy people and people with chronic medical conditions.

• The nasal-spray flu vaccine — a vaccine made with live, weakened flu viruses that do not cause the flu (sometimes called LAIV for “live attenuated influenza vaccine” or FluMist®). LAIV (FluMist®) is approved for use in healthy people 2-49 years of age who are not pregnant.

For more information on these two options, visit our general vaccine page.

In randomized, blinded studies, where some people got flu shots and others got placebo (“dummy” shots), the only differences in symptoms was increased soreness in the arm and redness at the injection site among people who got the flu shot. There were no differences in terms of body aches, fever, cough, runny nose or sore throat.

Unlike the flu shot that’s given via a needle, the nasal spray flu vaccine does contain live viruses. However, the viruses are weakened and cannot cause flu illness. The weakened viruses are cold-adapted, which means they are designed to only cause infection at the cooler temperatures found within the nose – which is how the weakened viruses prompt the body to mount an immune response that will then protect you if you’re exposed to the live virus. The weakened vaccine viruses cannot infect the lungs or other areas where warmer temperatures exist.

To learn about vaccination options for U-M patients and members of our local community, visit our Flu shots page. Depending on insurance coverage, the vaccine may be free or inexpensive.

Because flu vaccination is important for health care workers, to avoid infecting vulnerable patients, free seasonal flu shots are available to UMHS employees. See our Web site for more information about when and where to get a vaccine. The vaccine is free to all UMHS faculty and staff, medical/nursing students, and UMHS volunteers.

The H1N1 vaccine currently is not available but should begin to be available in late October.  

The H1N1 influenza vaccines are being made with the same methods and facilities that are used annually to produce seasonal influenza vaccine. Every year, new strains of flu are targeted by the seasonal flu vaccine. This year, the H1N1 strain is being targeted in just the same way.

The vaccines are undergoing additional clinical trials to determine the size of the dose and the number of doses that will be needed for protection.

Additional safety monitoring will be conducted throughout the flu season after H1N1 vaccination begins, as precaution. But health officials stress that the H1N1 vaccine is expected to be as safe as the seasonal vaccines that have been given hundreds of millions of times. 

Health officials expect the H1N1 vaccine to be just as safe as the seasonal flu vaccines that have been given to Americans hundreds of millions of times. The H1N1 vaccine is being produced in the same way as these "regular" flu vaccines. The only difference is the particular strain of flu that is being used.

Additional safety monitoring will be conducted throughout the flu season after H1N1 vaccination begins, as a precaution. This will go above and beyond the safety monitoring that is normally performed for flu vaccine.

Every vaccine has potential side effects, but flu vaccine side effects are typically mild. Learn more about them here.

More information on H1N1 vaccine safety for pregnant women is available from the Centers for Disease Control and Prevention here.

Data from early 2009 H1N1 influenza cases in the United States show that pregnant women account for a disproportionate number of deaths, making them a high-priority group for vaccination. 

Current studies indicate that the risk of infection, hospitalization, and death from the H1N1 influenza virus among persons age 65 years and older is less than is the risk for younger age groups.

Studies suggest that there is some degree of preexisting immunity to the 2009 H1N1 strains, especially among adults older than age 60 years. One possible explanation is that some adults in this age group have had previous exposure, either through infection or vaccination, to an influenza A (H1N1) virus.

People age 65 years and older are included as a priority group if they live with or care for infants younger than age 6 months or are a healthcare or emergency services provider.

Once public health authorities at the local level determine that the H1N1 influenza vaccine demand for the five target groups has been met, providers will be notified that they can administer the vaccine to healthy people ages 25 through 64 years. Once demand for H1N1 influenza vaccine among younger age groups is met, vaccination should be expanded to all people age 65 and older.

If a patient is in a risk group to receive H1N1 influenza vaccine, they should be vaccinated. Studies suggest that vaccination with season influenza vaccine will not provide protection against the 2009 H1N1 influenza virus.

You can in most cases. See the points below.

•  A person can receive both of the needle-based vaccines (the inactivated seasonal flu vaccine and the inactivated H1N1 influenza vaccine) at the same visit, using separate syringes and sites, or at any time before or after each other.
• A person can receive the needle-based inactivated seasonal and live nasal-spray H1N1 influenza vaccines together or at any time before or after each other.
• A person can receive the live nasal spray-based seasonal vaccine and the needle-based inactivated H1N1 influenza vaccine together or at any time before or after each other.
• However, a person should NOT receive the two different nasal spray-based vaccines at the same visit because of concerns about competition between the two vaccine viruses. If a person wants to receive both vaccines via nasal spray, he or she should wait four weeks between the seasonal vaccine and a dose of H1N1 vaccine.

The elbow cough is in vogue this year. If a tissue is not handy, cough or sneeze into your arm or elbow – not your hands where you could easily spread germs. Ideally, use a tissue for sneezes, coughing or blowing and then throw it out.

Don’t come to work sick. Try to make emergency back up plans for working from home.

Wash your hands frequently and don’t touch your eyes, nose and mouth. Hum “The Victors” as you scrub your hands with soap and water and you’ll be in good shape.

Use alcohol-based hand sanitizers.

Do all the right things: eat a balanced diet, get regular exercise, plenty of sleep and try to avoid stress.