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Sunday, September 5, 2010


by JC Leahy, RN, BSN, MA, ACLS
Sigma Theta Tau's "100 Most Extraordinary Nurses Award"

Flu season in the United States generally starts in October or November and ends in April or May. The best time to get your flu shot is October or November in order to prevent an outbreak to the flu virus. Every year the flu virus changes. That is why last year's flu inoculation will not protect you against this year's flu virus. Each new flu season has it's own customized flu vaccine. . There are usually 3 deactivated or killed stains of the flu virus in the vaccine each new flu season.


Who should get a flu shot? Well, according to the CDC, these groups have the highest need to be inoculated::
  • Children between ages 6-23 months
  • Adults aged 65+
  • Individuals with chronic conditions aged 2-64
  • Women who are pregnant or may become pregnant during flu season
  • Residents of nursing homes/long term facilities
  • Children between 6 months to 18 years of age on chronic aspirin therapy (because they could develop Reye Syndrome if they contract influenza)
  • Health care workers that work in direct patient care.
  • Household contacts/out-side caregivers of children under 6 months of age

 Additionally, a flu shot is recommended for:
  • Anyone with long-term health problems, including heart disease, lung disease, asthma, kidney disease, liver disease, anemia or other blood disorders, or metabolic diseases such as diabetes.
  • Anyone with a weakened immune system. This includes persons with HIV/AIDS, long-term steroid treatment, and those undergoing cancer treatment with x-rays or drugs
  • Anyone with certain muscle or nerve disorders that can lead to breathing or swallowing deficits. This includes seizure disorders and cerebral palsy.
  • Residents of long-term care facilities such as nursing homes.
  • Anyone who comes into regular contact with persons at high risk for severe complications of influenza. This includes anyone caring for infants and children up to the age of 5 at home.
  • Anyone living under crowded conditions. This includes dormitories and prisons.
  • Anyone providing essential community services
  • Anyone planning on travel to the southern hemisphere between April and September or to the tropics at any time or in organized tourist groups at any time.
  • Anyone who just doesn't want to get influenza or give it to others.

 Some people should not get a flu shot without consulting their physicians. They are:

  • People who have severe allergies to chicken eggs
  • People who have an allergy to any component of the vaccine, including thimerosal
  • Those who have Guillain-Barre syndrome obtained after a flu vaccine should not receive get a flu vaccine
  • Anyone who has had a bad reaction to a flu vaccine in the past
  • Anyone who will have surgery in the next week or has had same-day surgery during the past two weeks or who has discharged from the hospital during the past 10 days for a surgical admission.
  • Any current hospital inpatient.


Flu shots that are delivered with a needle contain inactivated vaccine. This means that there is no live virus present. It is therefore impossible to get the flu from a flu shot. Nevertheless, there are possible side effects to getting a flu shot. Severe side effects are very, very rare.

Flu shots may contain preservatives. One common preservative is thimerosal.  Thimerosal contains 49% ethylmercury. As far as studies have shown, thimerosal is not harmful unless you are actually allergic to it. Nevertheless, it is probably better to give children thimerosal-free influenza vaccine. And here's a tip for everyone: single-dose vials of influenza vaccine don't require any preservatives at all -- only the multi-dose vials do.

Most people experience absolutely no flu shot side effects. If you do get side effects, they will probably be redness, swelling or soreness at the injection site; aches, or fever. These symptoms may last for a couple of days. Severe reactions include allergic retactions. These would probably occur from a few minutes to a few hours after the flu shot.

In 1976 there was a swine flu vaccine that was associated with Guillain-Barre Syndrome (GBS). The incidence was 1 or 2 cases per million flu shots. No other flu shot has been linked to GBS.


With the few caveats mentioned above, flu shots are safe.  The best tip for flu prevention is to get a flu shot ASAP unless contraindicated, and maintain a healthy immune system by getting plenty of sleep, exercise, and a healthy diet.

To learn more, go to the CDC website,

PS - There does exist an attenuated influenza vaccine that contains weakened virus. Attenuated flu vaccine is delivered as a spray into the nostrils. We're not talking about attenuated flu vaccine in the above article. -- JC Leahy

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