Dear Doc: Get your flu shot | VailDaily.com
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Dear Doc: Get your flu shot

Dr. Drew Werner
newsroom@vaildaily.com
VAIL CO, Colorado

We all love roller coasters. Whether by choice or happenstance, intention or the whim of others, our lives are filled with ups and downs, curves and bends just like the best of the amusement park rides. It is not completely beyond our control, even if it sometimes seems that way.

This week, I suggest leaving less to happenstance. Follow the Colorado Department of Public Health and Environment’s flu campaign advice: “Do Something Easy.” Get a flu vaccine.

So where is the best place to get one? The simple answer is the easiest place for you to get one. For expert advice, look to the CDC (Center for Disease Control), the federal authority on disease prevention, treatment and control. For the second year in a row they recommend that everyone over 6 months of age get a flu vaccine. They go on to recommend getting vaccinated beginning now, especially considering that it takes up to two weeks after receiving a flu vaccine to develop immunity. They also recommend getting your flu vaccine through your doctor’s office because it is then documented as part of your permanent record. There are other options however, each with its own advantages.



It is important to know that all flu vaccines are essentially the same no matter where you receive them. There is no such thing as a higher quality or lower quality vaccine. No matter where you get your flu shot then, you will be getting an excellent vaccine. Each of the available vaccines this year covers H1N1 flu, which caused the 2009 flu pandemic; the yearly A strain called Perth/16/2009 (H3N2); and the B influenza strain called Brisbane/60/2008. These are actually the same flu strains given in last year’s flu vaccine. Immunity from last year – if you received the vaccine – is likely diminished so a vaccine this year remains necessary. With that in mind however, there are two types of flu vaccine and four different ways of administering the vaccine.

The most common way to receive a flu vaccine is a shot. All influenza shots contain an inactivated or killed flu virus. There are four types of flu shots available. The first is a lower dose vaccine for children ages 6 months to 35 months. A second standard dose vaccine is for children over 36 months of age through adulthood. For seniors over age 65, who are believed to have a less active immune system, there is a high dose vaccine, which may be more effective. It is not completely clear if the high dose vaccine in fact works better in those over 65 years of age, so if it is available you may want to consider it, but is not absolutely necessary.



There is also a new flu shot option this year, which is given as an intradermal shot using a very small needle in the deep layer of the skin rather than an intramuscular shot, which requires a longer and larger needle. That Intradermal flu shot is only for persons ages 18 through 64. It uses 0.1cc of vaccine material rather than 0.5cc of vaccine and delivers 9 ug per strain of influenza antigen rather that 15 ug in the standard intramuscular vaccine. Because it is new, it is not widely available so check with your doctor. In the coming years we will have more experience about how comfortable it is and its effectiveness.

The last option for a flu vaccine is a nasal spray. It does not involve a shot, but uses a weakened or attenuated form of the flu virus rather than a killed virus. For that reason it is only recommended for healthy individuals from 2 through 49 years of age.

In children from 6 months to 8 years old, standard recommendations are to give two vaccines no sooner than four weeks apart the first year they receive the flu vaccine. This has been shown to greatly improve the effectiveness of the vaccine. This year we have a unique situation, however. Because the flu strains contained in the vaccine are the same as last year, your child only needs one vaccine this year if they only received one vaccine last year. Talk to your doctor and they will let you know for sure.



Other vaccination considerations are convenience and cost. Vaccines provided through the workplace are great and often free. Don’t look a gift horse in the mouth, as they say, just get vaccinated.

No matter where you choose, get a flu vaccine. Grocery stores and pharmacies have been offering them already and they bring a lot of convenience and sometimes other discounts. If you need more help deciding, know that our country spends $1.7 billion treating children with the flu and looses another $2.1 billion in parent’s lost time from work. Those dollars could go a solid way to boosting rather than hurting our economy and that is good for us all!

Dr. Drew Werner is a medical staff leader at Valley View Hospital in Glenwood Springs, a family physician at TotalHealth Care and the Eagle County health officer. He lives in Eagle with his family. Email comments about this column to cschnell@vaildaily.com.


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