When do you get your flu vaccine?

[diamondseeker2006]

Here's a good source for summaries of unbiased scientific studies on flu vaccine and many other medical treatments for those who are interested:

http://summaries.cochrane.org/CD001269/ARI_vaccines-to-prevent-influenza-in-healthy-adults

http://summaries.cochrane.org/CD004879/ARI_vaccines-for-preventing-influenza-in-healthy-children

http://www.nlm.nih.gov/bsd/cochrane.html

I am a strong proponent of making educated choices on healthcare based on unbiased scientific evidence (not paid for by the companies that stand to profit) .

 

[Tanzigrrl]

I got my flu shot this year on 9/30/14. I usually aim to get it in late August or September

 

[JaneSmith]

The most compelling population data comes from Ontario, Canada, where they have had a ongoing attempt to maximize the vaccination of the whole population against influenza (PubMed). The other Provinces did not see fit to try and vaccinate everyone, continuing with targeted influenza vaccination.

This represents an interesting natural experiment. If the effects of the influenza vaccine are less in preventing disease but more in decreasing secondary endpoints like death, hospitalizations, or antibiotic usage, it may show up in population studies. There are numerous issues with this kind of study, but are “appropriate for assessing the public health impact of a population-wide intervention.”

During the period in the reference, Ontario experienced greater uptake of vaccine than any other Province:

“Between the pre-UIIP 1996–1997 estimate to the mean post-UIIP vaccination rate, influenza vaccination rates for the household population aged ≥12 y increased 20 percentage points (18%–38%) for Ontario, compared to 11 percentage points (13%–24%) for other provinces (p < 0.001) (Table 2). For those <65 y, the vaccination rate increases were greater in Ontario than in other provinces, while for those ≥75 y, the increase was smaller in Ontario. For all age groups, Ontario always achieved higher vaccination rates than other provinces.”

And the results of all that vaccination:

“After UIIP introduction, influenza-associated mortality for the overall population decreased 74% in Ontario (RR = 0.26, 95% confidence interval [CI], 0.20–0.34) compared to 57% in other provinces (RR = 0.43, 95% CI, 0.37–0.50) (ratio of RRs = 0.61, p = 0.002) (Table 3). In age-specific analyses, larger mortality decreases in Ontario were found to be statistically significant only in those ≥85 y.”

Not Bad.
...
The flu vaccine is not our best vaccine for at least three reasons.

First, every year they have to make an educated guess which influenza strains will be circulating 9 months in the future. The better the guess, the better the protection the vaccine should provide. Some years they choose better than others. But often the match between the vaccine and the disease is not optimal, so vaccine efficacy can be decreased. The vaccine works best when there is a good antigentic match between the vaccine and circulating strain of influenza.

Second, response to the vaccine is not 100%. The older and more immunoincompetent are the least likely to develop a good antibody response to the vaccine. In a bit of medical irony, the more likely a patient is to need protection from the vaccine, the less likely they are to get a protective antibody response from the vaccine.

Third, vaccination rates are often suboptimal to get benefit in populations, i.e. herd immunity. The elderly will more likely benefit if they are not exposed to influenza at all rather than relying of vaccine mediated protection. It may be more important if those around them, say their health care provider or family, receives the vaccine and as a result does not pass flu on to more vulnerable people. But we rarely (never, ever, never) get vaccination rates at levels for herd immunity to kick in.

So it’s a suboptimal vaccine. And that’s a problem. One, because it will make it more difficult to prove efficacy in clinical studies and two, there is a sub group of anti vaccine goofs who seem to require that vaccines either be perfect, with 100% efficacy and 100% safe, or they are not worth taking.

The influenza vaccine is not 100% efficacious in preventing disease, but it is as close to 100% safe, and much safer than the disease.
...
Do flu vaccines work? It depends on what the meaning of is is. If you are simplistic and like binary answers, yes or no, then you can pick yes or pick no, and find studies to support your contention that the vaccine doesn’t work.

If you realize that medicine is subtle and nuanced, and often the answers are filled with qualifiers and uncertainty, that the practice of medicine is messy, I think the answer is that the flu vaccine is of benefit. And that the more people who get the vaccine, the greater the benefit for everyone. You do not know how much it pains me to quote Donald Rumsfeld , but he was partly right when he said “You go to war with the army you have, not the army you might want or wish to have at a later time.”

It is true in medicine as well. My army is the vaccine and the data used to support it. You can conclude that neither the vaccine nor the data is perfect, and decide the vaccine is not useful.

Or you can look at the preponderance of data, with all the flaws, nuance, subtleties and qualifiers, and conclude the flu vaccine is of benefit. The vaccine decreases the probability of morbidity and mortality. It is a good thing.

http://www.sciencebasedmedicine.org/flu-vaccine-efficacy/

How does CDC present data on flu vaccine effectiveness?

CDC typically presents vaccine effectiveness (VE) as a single point estimate: for example, 60%. This point estimate represents the reduction in risk provided by the flu vaccine. CDC vaccine effectiveness studies commonly measure laboratory confirmed flu illness that results in a doctor’s visit or urgent care visit as an outcome. For this outcome, a VE point estimate of 60% means that the flu vaccine reduces a person’s risk of developing flu illness that results in a visit to the doctor’s office or urgent care provider by 60%.

In addition to the VE point estimate, CDC also provides a “confidence interval” (CI) for this point estimate, for example, 60% (95% CI: 50%-70%). The confidence interval provides a lower boundary for the VE estimate (e.g., 50%) as well as an upper boundary (e.g., 70%). One way to interpret a 95% confidence interval is that if CDC were to repeat this study 100 times, 95 times out of 100, the VE point estimate would fall within the confidence interval (i.e., on or between 50% and 70%). There is still the possibility that five times out of 100 (a 5% chance) that CDC’s point estimate of VE could fall outside of the 50%-70% confidence interval.

http://www.cdc.gov/flu/about/qa/vaccineeffect.htm

I'll take a 60% reduction in risk of influenza. I don't want to get it, nor do I want to be a vector responsible for killing some poor chemo patient, newborn, or grandmother who had the misfortune of being near me in the 24hrs before I became symptomatic.

Whilst I agree wholeheartedly that pharmaceutical companies are driven by profits and need regulation and oversight, they would stand to make a great deal more money if they did not produce vaccines. Millions of sick and crippled people = $$$.

 

[momhappy]

I'm getting mine Oct 2 and DH is getting his a couple of days later, both free at work. After having the flu when my boys were in elementary school 2 years in a row, we said "Never again". I rarely get sick, but I watch people around me at work who don't get the shot get sick often. Some every year. I love the people who won't get it because the last time they had it "they got the flu". If they did, it's not the shot, it's the fact they were exposed to the virus before the shot took effect. I've been getting the shot for 17 years and have not had the flu in that entire time, nor has DH. Influenza can be very dangerous as it creates an environment that allows secondary infections to take over. Both times I had the flu I had a secondary infection, sinus infection one time and pink eye the next. Believe me, those that were infected by the large influenza outbreak in the early 1900's (and many other years) would have done anything to have had the vaccines we have.

As for those wimps who are afraid of needles, the needle used for the influenza vaccine is sooooooo tiny that you don't even really feel it.

Guess I'm a wimp then….
It's not necessarily the needle that makes a vaccine painful - it can be any number of things (the size of the needle, the placement of the needle, the ingredients in the vaccine that is being administered, etc.). Being afraid of needles is perfectly normal - it's not like anyone here has said that they won't get a flu vaccine because they are afraid of needles. Some of us have simply said that if given a choice, we'd choose the mist over the shot.

 

[Tacori E-ring]

Got the email today. Vaccines will be offered after 10/1 so looks like I will be getting mine first week in October.

 

[VRBeauty]

Guess I'm a wimp then….
It's not necessarily the needle that makes a vaccine painful - it can be any number of things (the size of the needle, the placement of the needle, the ingredients in the vaccine that is being administered, etc.). Being afraid of needles is perfectly normal - it's not like anyone here has said that they won't get a flu vaccine because they are afraid of needles. Some of us have simply said that if given a choice, we'd choose the mist over the shot.

I don't have an aversion to needles. I donate blood regularly and nurses and phlebotomists are always happy to see me because I have "good veins." Nonetheless, someone must have screwed up an injection I got last week (not a flu shot), because the injection site on one of those good veing swelled to walnut-size and is still quite swollen a week later. So yeah, injections can go wrong. If you have an aversion to needles for some reason, using an equally good alternative delivery method is hardly "wimping out!"

 

[packrat]

As one of the "wimps" who goes for the mist rather than the shot, let's not gloss over the fact that those who chose the mist are still being vaccinated.

 

[ming]

I'm not in a high risk group but I get a shot annually. Had the flu once, about 15 years ago, and have never been so sick and wished I was dead. Horrible 10 days.

I generally wait until late October/November to roll up my sleeve so that high risk individuals can be first in line, particularly if there is some issue with distributing vaccine.

 

[Circe]

Blah ... I usually vaccinate at the first opportunity (and though I may spend a day or two feeling achey, I don't develop the 104 fever I had the one year I skipped it), but this year my toddler got a nasty cold early, and now the whole house has it. Anybody know what a safe period to wait before getting it would be? I know you're not supposed to get it while you're still sick, but do you need a buffer ...? I'm 20 weeks preggers, don't want to take any chances!

 

[pandabee]

If you're well enough to walk out in public (no serious nausea or vomiting essentially) it is okay to get your flu shot still even if you are sick.

Congrats on the upcoming new one Circe!!

 

[TooPatient]

The pharmacy has the 4 strain traditional vaccine and the flu mist available, but the flu mist is only for those 8 and under or those deathly afraid of needles. (oh.... and the mist is back ordered so may be a week or longer wait)

So...
I think I'll have "A" get the traditional ASAP since she is in close contact with lots of kids in high school
I'm waiting for the mist and hoping I don't get sick before then. (most of my classes are online so I have minimal contact with big groups and have tried to cut shopping to once a week instead of daily to reduce that kind of contact)


DH made the best argument -- If it reduces your chances of getting sick by even a small bit or if it helps you get less sick if you do get sick, it seems worth it to not lose another quarter of school. (since I've had to do health withdrawals and drop all of my classes several quarters due to illness )

 

[pandabee]

Flumist is labeled for ages 2 to 49, so I wonder if they are just trying to ration it out? That's funny though because my work usually orders a box in every year and we can never get rid of it before it expires.

 

[TooPatient]

Flumist is labeled for ages 2 to 49, so I wonder if they are just trying to ration it out? That's funny though because my work usually orders a box in every year and we can never get rid of it before it expires.

They said they have a hard time getting it as it is backordered. They get a box or two here and there, but they are usually spoken for a week or more before they arrive. People have to get on a waitlist and wait for the next order to show up.

I think the thing about under the age of 8 is that the CDC (or whatever health organization he mentioned) did a study on kids that age and found that the mist is more effective in them than standard vaccine. I asked why it would be different in older people and he said that they must have found no difference (my favorite lady was out that day, she would have known!). The thing is, I thought I had seen mention in the reading I've been doing that the age of 8 was listed because they didn't check people over that age?

 

[momhappy]

Just got my flu mist today They had to double-check stock because they were getting low on mist - thankfully, they had a few left. Our health insurance would cover the shot, but not the mist, which I thought was odd. We opted to pay the $39.99 to get the mist as opposed to the shot.

 

[VRBeauty]

I got vaccinated today - just the quick stick for me. My upper arm is a little sore - hopefully that will be gone by morning. In any event, I'm done with that for another year or so!

 

[msop04]

I got vaccinated today - just the quick stick for me. My upper arm is a little sore - hopefully that will be gone by morning. In any event, I'm done with that for another year or so!

My arm always gets really sore... like it's extremely heavy. LOL

 

[baby monster]

Got mine today. My arm is on fire

 

[missy]

Got mine today. My arm is on fire

Oh, I'm sorry baby monster.
It's funny because this year I barely felt any discomfort at all whereas in past years my arm feels a bit heavy for a day or so. Weird.

Did a doctor or nurse or pharmacist give you your shot? I wonder if that makes any difference. The NP at work usually gives me mine and it isn't bad but when a doctor gives it, ouch. And I had a pharmacist give it to me this year and no problem.

Hope your arm and everyone else who is experiencing shot discomfort feels better soon!

 

[baby monster]

Thanks for the kind words, missy. NP at my work's health center gave me the shot. It does feel worse than last year. I have been very stressed out at work so maybe that has an effect.

 

[packrat]

argh every time this thread gets moved up a little bit it reminds me we still haven't gone up for out mist. I need to make a note to call them and get appts set up.

 

[Amber St. Clare]

I got mine as soon as it was available, as I do every year.

The last time I got the flu It was so bad I actually prayed for death. I don't ever want to be that sick, when it can be prevented again.

 

[DNB]

Well, I got mine last week and DH got his today. My arm was sore for 24 hours right around the injection site. Both my DS's and my DDIL also got theirs. Youngest DS and DDIL are in Ireland and England on a belated honeymoon and deliberately got their shot a couple of weeks before they flew over. We all got them free at work, except for DDIL who works from home. Everyone I know that has gotten the shot this year had a sore arm for a day or so.

 

[distracts]

I've been horribly sick this week and was lamenting not having gotten the flu vaccine cause what I have sure feels like the flu, and like the second-worst one I've had (the worst was when I was in fifth grade - I had a 105 degree fever. I marathoned all the James Bond movies and I don't even remember most of them, that's how messed up that high of a fever makes you!). Good news from my doctor, though! They ran the test and it's not the flu! It's some other virus! So I should still get the flu vaccine!

(As for when I usually get my flu vaccine... when I remember. I go in to the pharmacy monthly to pick up my medications, and it's really easy to just get done then. But usually I don't remember until everyone I know has reminded me about it. The joys of over half the people you know being doctors...)

 

[amc80]

I will get mine at our health fair at work in a couple of weeks. I just canceled my son's appointment. He skin tests as allergic to egg yolk, even though he eats stuff with eggs in it (cooked, like baked goods) without a problem. He's never had just plain old eggs though, nor can we get him to try them. So I figure we will wait another year and hopefully have a chance to get him to eat eggs between now and then. It was a really hard decision, especially since we will have a new baby born at the peak of flu season.

 

[cflutist]

Got mine today, my arm is sore and warm right now.

 

[Tacori E-ring]

I also got mine today. Arm is a bit sore but nothing unmanageable.

 

[Hospatogi]

Just got the flu shot yesterday. It's a requirement to volunteer with my dog at the pediatric hospital we go to. I usually avoid taking the flu shot as I rarely get sick and luckily haven't had the flu in years. Since taking the shot I have had a low grade temp, slight swelling at the injection site along with some overall body aches so I feel a bit crummy. Hopefully the side effects will be gone soon however having my DH spoil me with a foot massage and take out from our favorite restaurant has made feeling sick a definite plus !

 

[NOYFB]

I get it as soon as it's available at work. I work in a hospital, and got it yesterday. My arm is very sore.

 

[SandyCheeks]

Got mine and my 3 kids at the pharmacy which insurance covered 100%. We do it very year but the pediatric office my kids go to didn't get any vaccines this year, I'm really not pleased with them. I've been following this thread and it was a motivator for me to get it done. Thank you OP!

 

[pandabee]

I will get mine at our health fair at work in a couple of weeks. I just canceled my son's appointment. He skin tests as allergic to egg yolk, even though he eats stuff with eggs in it (cooked, like baked goods) without a problem. He's never had just plain old eggs though, nor can we get him to try them. So I figure we will wait another year and hopefully have a chance to get him to eat eggs between now and then. It was a really hard decision, especially since we will have a new baby born at the peak of flu season.

If he can safely eat cooked eggs then it is recommended that he will be able to receive the flu vaccine. If you are still concerned you can call around to see if any clinic or pharmacy carries the egg free version.