Flu season is here and the best way to protect against flu is to get a flu vaccine. Annual flu vaccination is recommended for everyone 6 months of age or older.

What is flu?

Flu, also known as influenza, is a contagious illness caused by the influenza virus which infects the nose, throat, and lungs. Symptoms include fever, chills, cough, sore throat, runny or stuffy nose, headache, muscle aches, and fatigue. Flu also can cause pneumonia.  Other illnesses can have similar symptoms and be mistaken for flu. If flu is suspected, your doctor may be able to order a test that can detect the flu virus in the nose or throat.

Can flu cause serious illness?

Yes!  Flu can lead to very serious complications, including pneumonia, and even death. For example, from 2009 to 2010 in the United States, 275,000 hospitalizations and 12,500 deaths were estimated to have occurred due to flu. While serious complications from flu are more common among certain people–children younger than 5 years of age, adults age 50 or older, pregnant women, and people with certain chronic medical conditions, complications also can occur in otherwise healthy individuals of any age.

How do I protect myself and my family from flu?

The most important step in protecting against flu is to get a flu vaccine every year. Getting a flu vaccine may also protect your family and others around you. How? If you don’t get vaccinated and become infected with flu, you can spread the virus to others who may be at high risk for serious illness or death from flu, such as a baby, a child, a pregnant woman, grandparents, or a friend. Also helpful in preventing the spread of flu is washing your hands frequently, or using an alcohol-based hand rub, as well as covering your nose and mouth with a tissue when you cough or sneeze.

Is the flu vaccine safe?

Yes! The most commonly administered flu vaccine is the “flu shot.” It is made of killed virus, so you cannot get the flu from it. The most common side effect from the flu shot is soreness where the shot was given, which typically lasts only one or two days. The risk of serious problems from the flu shot, such as a severe allergic reaction, is extremely small. Of course, even if you get the flu shot, you still can catch a non-flu virus or bacteria that may cause symptoms that mimic flu.

Where can I get the flu vaccine and how long does it take to develop immunity?

See your doctor or go to other locations where the flu vaccine is being offered. It typically takes about two weeks for your body to develop an immune response after getting the flu vaccine, so get vaccinated now to protect yourself and your family. Remember, flu activity in the United States usually peaks in January or February and can continue to occur as late as May.

Exceptions include people with egg allergies, people who have had a severe reaction to a flu vaccine in the past, and infants younger than six months.

“Though it’s never too late to get the flu shot, the earlier people get the vaccine, the better,” said Anat R. Feingold, MD, Head of Cooper’s Division of Pediatric Infectious Disease. “Immunity will last well through the entire season,” she said.

The official flu season is September through March, but the flu tends to peak in December, January, and February.

Dr. Feingold noted that data from last year showed that children were disproportionately affected by the H1N1 flu. “It’s not always a mild illness,” Dr. Feingold said, “and we need to protect (vaccinate) every child we can because that’s how we help protect the rest of the population, especially those who cannot be vaccinated or respond well to the vaccine.”

Pregnant women are another high-risk group for whom immunization is particularly important.

According to Richard L. Fischer, MD, Head of Cooper’s Division of Maternal-Fetal Medicine, “Pregnant women are far more susceptible to pneumonia and respiratory distress than non-pregnant women. Plus, studies show that by immunizing the mother, it creates antibodies that cross the placenta and protect the newborn child from infection during the first months of life,” he said.

Three-In-One Flu Vaccine

The 2010-2011 flu vaccine will protect against three viruses: an influenza A H3N2 virus, an influenza B virus and the 2009 H1N1 virus that caused so much illness last season. This three-in-one vaccine will be available as both a nasal spray, which contains the attenuated (weakened) virus, and as an injection (a shot), which contains the inactivated virus.

“It’s important for people to realize that neither form of the vaccine – the nasal spray or the injection – gives people the flu,” Dr. Feingold said.

Dr. Fischer noted that the nasal spray is not recommended for women who are pregnant. “Pregnant women should receive the vaccine only by injection,” he said.

Both Drs. Feingold and Fischer stressed that there is no risk of acquiring the flu from being immunized.

Availability of this season’s flu vaccine is predicted to be excellent.

Related Links

• Pediatric Infectious Disease
• Maternal-Fetal Medicine

Most people with 2009 H1N1 have had mild illness and have not needed medical care and the same is true of seasonal flu. However, the flu can be serious, especially for young children (risk is highest in children younger than 2 years) and children of any age who have certain chronic medical conditions. These conditions include asthma or other lung problems, diabetes, weakened immune systems, kidney disease, heart problems and neurological and neuromuscular disorders. Children with these conditions can have more severe illness from any flu, including from the 2009 H1N1 flu virus.

If your child is 5 years or older and otherwise healthy and gets flu-like symptoms, including a fever and/or cough, consult your doctor as needed. Make sure your child gets plenty of rest and drinks enough fluids.

If your child is younger than 5 (and especially younger than 2), or you have a  child of any age with a medical condition like asthma, diabetes, or a neurologic problem, and develops flu-like symptoms, ask a doctor if your child should be examined. This is because younger children (especially children younger than 2), and children who have chronic medical conditions, may be at higher risk of serious complications from flu infection, including 2009 H1N1 flu. Talk to your doctor early if you are worried about your child’s illness.

Call the doctor or take your child to a doctor right away if your child seems very sick with any of these symptoms:

• Fast breathing or trouble breathing.
• Bluish or gray skin color.
• Not drinking enough fluids.
• Severe or persistent vomiting.
• Not waking up or not interacting.
• Being so irritable that the child does not want to be held.
• Flu-like symptoms improve but then return with fever and worse cough.
• Has other conditions (like heart or lung disease, diabetes, or asthma) and develops flu symptoms, including a fever and/or cough.

Remember that the flu spreads through sneezes and coughs of someone with the flu, or if you touch an object with the flu viruses on it and then touch your mouth or eyes. Using good hygiene can help you and your child to stay healthy.

If you would like further information about protecting your child from H1N1, please click here to view the CDC’s Seasonal and 2009 H1N1 Flu: A Guide for Parents.

Related Links

• Children’s Regional Hospital at Cooper
• H1N1 Influenza Immunization Schedules and Information
• Seasonal and 2009 H1N1 Flu: A Guide for Parents
  

According to the Centers for Disease Control and Prevention (CDC), the H1N1 flu has hit pregnant women especially hard. About 700 cases have been confirmed in pregnant women since late April, about 100 pregnant women have required admission to intensive care units, and 28 pregnant women have died from the H1N1 flu, the CDC reported earlier this month.

“Because pregnant women who get influenza have a greater chance for serious complications, it is important they receive both the 2009 H1N1 flu shot and the seasonal flu shot.  Receiving these vaccines is the best way pregnant women can protect themselves – and their newborns – against the flu,” said Rosalie Pepe, M.D., infectious disease specialist at Cooper University Hospital.

Research has found that women who get a flu shot during pregnancy get sick with the flu less often than pregnant women who do not get a flu shot. The same holds true for their newborns. Babies born to mothers who get a flu shot during pregnancy get sick with the flu less often than babies born to mothers who did not get a flu shot during pregnancy.

A woman can receive both the seasonal flu shot and the H1N1 flu shot at any time during pregnancy. But, pregnant women should get the vaccines by injection – a “flu shot” – not by nasal spray. The nasal spray vaccine is not approved for pregnant women.

The injectable vaccine is made with inactivated flu virus. It is given with a needle, usually in the arm. The nasal spray vaccine is made with live, weakened flu virus and should be used only in healthy people ages 2 to 49 years old, and women who are not pregnant.

Following delivery, new mothers can safely get either the injectable or nasal spray vaccine, even if they are breastfeeding. In fact, vaccinated mothers who are nursing can pass on vaccine antibodies to their infants and reduce their babies’ chances of getting sick with the flu. This is especially important for infants less than 6 months old, who have no other way of receiving vaccine antibodies because they are too young to be vaccinated.

Dr. Pepe reminds pregnant women to get both a seasonal flu shot and a H1N1 flu shot as early as possible.

“You will need both shots this year to fully protect yourself and your baby against the flu. Both shots are absolutely safe and recommended for pregnant women and nursing mothers,” she said.

Additional H1N1 Flu Resources from Cooper University Hospital

• H1N1 Influenza and Seasonal Flu Information and Resources – Cooperhealth.org
  Visit our H1N1 resource page for information to help you and your family prepare for this year’s flu season. We will be updating this page as new information becomes available.
• Health eTalk Web Chat: Your Questions about H1N1 Pandemic Flu – Cooperhealth.org/etalk
  Join Rosalie Pepe, M.D., of Cooper University Hospital’s Division of Infectious Diseases, as she answers your questions live on Cooperhealth.org.  No question is too big or too small, as she’ll help you sort through the rumors and debunk the myths.

As of September 21, 2009, the CDC is recommending that all children and young adults from 6 months through 24 years of age be immunized.  Children from 6 months through 18 years of age because cases of 2009 H1N1 influenza have been seen in children who are in close contact with each other in school and day care settings, which increases the likelihood of disease spread. Young adults 19 through 24 years of age because many cases of 2009 H1N1 influenza have been seen in these healthy young adults. They often live, work, and study in close proximity and they are a frequently mobile population.

There are other important vaccines which children should receive as they grow up. Immunizations have helped children stay healthy for more than 50 years. Yet many parents still question their safety because of misinformation they receive. That’s why it’s important to turn to a reliable and trusted source, including your pediatrician, for information.

Immunizations are safe and they work. In fact, serious side effects are no more common than those from other types of medication. Vaccinations have reduced the number of infections from vaccine-preventable diseases by more than 90 percent! Millions of children have been protected against serious illnesses because they were immunized. Most childhood vaccines are 90 percent to 99 percent effective in preventing disease. And if a vaccinated child does get the disease, the symptoms are usually milder with less serious side effects or complications than in a child who hasn’t been vaccinated.

Here is a list of the recommended immunizations for children from newborns to 18 years of age.

Recommended Immunizations for Children Newborn to 6 years old:

1. Hepatitis B vaccine (HepB). (Minimum age: birth)
2. Rotavirus vaccine (RV). (Minimum age: 6 weeks)
3. Diphtheria and tetanus toxoids and acellular pertussis vaccine (DTaP). (Minimum age: 6 weeks)
4. Haemophilus influenzae type b conjugate vaccine (Hib). (Minimum age: 6 weeks)
5. Pneumococcal vaccine. (Minimum age: 6 weeks for pneumococcal conjugate vaccine [PCV]; 2 years for pneumococcal polysaccharide vaccine [PPSV])
6. Inactivated poliovirus vaccine (IPV). (Minimum age: 2 months)
7. Influenza vaccine. (Minimum age: 6 months for trivalent inactivated influenza vaccine [TIV]; 2 years for live, attenuated influenza vaccine [LAIV])
8. Measles, mumps, and rubella vaccine (MMR). (Minimum age: 12 months)
9. Varicella vaccine. (Minimum age: 12 months)
10. Hepatitis A vaccine (HepA). (Minimum age: 12 months)
11. Meningococcal vaccine. (Minimum age: 2 years for meningococcal conjugate vaccine [MCV] and for meningococcal polysaccharide vaccine [MPSV])

Recommended Immunizations for Ages 7 Through 18 Years:

1. Tetanus and diphtheria toxoids and acellular pertussis vaccine (Tdap). (Minimum age: 10 years for BOOSTRIX® and 11 years for ADACEL®)
2. Human papillomavirus vaccine (HPV). (Females minimum age: 9 years)
3. Meningococcal conjugate vaccine (MCV).
4. Influenza vaccine.
5. Pneumococcal polysaccharide vaccine (PPSV).  (for children with certain underlying medical conditions)
6. Hepatitis A vaccine (HepA).
7. Hepatitis B vaccine (HepB).
8. Inactivated poliovirus vaccine (IPV).
9. Measles, mumps, and rubella vaccine (MMR).
10. Varicella vaccine. (For ages 7 through 18 years without evidence of immunity)

To download a chart with the schedules of these recommended immunizations, visit www.aap.org/healthtopics/immunizations.cfm.

With the nation’s focus on the development of a vaccine for the H1N1 pandemic flu expected to be available later in October, health officials are concerned that families might choose to wait to get vaccinated against the seasonal flu.

Each year, as many as 60 million Americans get the flu, and the resulting complications cause more than 200,000 hospitalizations annually, according to the CDC.

Also, children between the ages of 2 and 17 reportedly are twice as likely as adults to get seasonal flu and frequently require medical care.

While protection against the H1N1 influenza virus might be just around the corner and foremost on our minds, safeguards against seasonal flu viruses still are necessary and are available now.

“We may be thinking about the need for an H1N1 vaccination, but we can’t forget the importance of getting vaccinated first for the seasonal flu,” said Anat R. Feingold, M.D., Head of Cooper’s Division of Pediatric Infectious Diseases.

An expert in pediatric infectious disease, Dr. Feingold took part in last month’s “Don’t Play With the Flu” national health-awareness campaign  led by MedImmune, the biologics business for Astra Zeneca PLC, in partnership with Women’s Professional Soccer and the American Youth Soccer Organization. The high-profile campaign kicked off in New York City with a one-of-a-kind soccer clinic led by soccer legends Mia Hamm and Brandi Chastain.

“It is very important to increase seasonal flu vaccination rates for eligible children and families,” Dr. Feingold said. “Along with all the things that parents know are important for helping keep their kids healthy, like washing hands and getting enough sleep, influenza vaccination should be at the top of the list. It’s a smart defense to help protect our kids – and ourselves – from seasonal flu,” she said.

See your healthcare provider to get the flu vaccine, or seek out other locations where the vaccine is being offered.

This year’s seasonal flu vaccine protects against three, new influenza virus strains that research indicates will cause the most illness during the 2009-2010 flu season. They are:

• A/Brisbane/59/2007(H1N1)-like virus.
• A/Brisbane/10/2007 (H3N2)-like virus.
• B/Brisbane 60/2008-like antigens.

According to the CDC, the vaccine can protect you from getting sick from these three viruses, or it can make your illness milder if you get a related but different influenza virus strain.

In general, anyone who wants to reduce the chance of getting seasonal flu can get vaccinated. However, it is recommended by the CDC and the Advisory Committee on Immunization Practices that certain people should get vaccinated each year. Most of these people are recommended for vaccination because they are at high risk of having serious flu complications or they live with or care for people at high risk for serious complications.

People recommended for seasonal influenza vaccination during the 2009-2010 season are:

• Children aged 6 months up to their 19th birthday.
• Pregnant women.
• People 50 years of age and older.
• People of any age with certain chronic medical conditions.
• People who live in nursing homes and other long-term care facilities.
• People who live with or care for those at high risk for complications from flu, including healthcare workers; household contacts of persons at high risk for complications from the flu; and household contacts and out-of-home caregivers of children less than 6 months of age. (Children less than 6 months of age are too young to be vaccinated.)

Each year, influenza kills more people in the U.S. than all other vaccine-preventable diseases combined. For the 2008-2009 flu season, the U.S. Centers for Disease Control and Prevention and the American Academy of Pediatrics have expanded the recommendation for flu vaccination to include all children ages six months to 18 years.

The Children’s Regional Hospital at Cooper is pleased to bring parents this information about the new guidelines for children and the importance of flu vaccines. Please make an appointment with your pediatrician and take your children to be vaccinated. There are a small number of children who should not be vaccinated and you should discuss this possibility with your family’s doctor.

If you need a pediatrician, please call our Physician Referral Staff at 1-800-8-COOPER (1-800-826-6737) who will assist you in getting an appointment.

The American Academy of Pediatrics (AAP) recommends annual influenza immunization for the following groups:

• All children, both healthy and with high-risk conditions, ages 6 months through 18 years
• Household contacts and out-of-home care providers of:
  • Children with high-risk conditions
  • Healthy children younger than 5 years of age
  • Health care professionals
• Pregnant women

The recommended age range of children for annual flu immunization has been expanded to include all children 6 months through 18 years of age. This means vaccinating:

• All children at higher risk for influenza complications (eg, those with chronic medical conditions or immunosuppression).
• All healthy children 6 months up to 5 years of age.
• All children 5 through 18 years of age, if feasible, in the 2008-2009 influenza season, but parents should definitely plan on this for next year.

This expansion targets all school-aged children, who are at a significantly higher risk of needing medical care for the flu compared with healthy adults. Additionally, reducing the flu transmission among school-aged children will in turn reduce transmission of influenza to family and community members.

On occasion there are reactions to the vaccine that go beyond soreness at the injection site. The most common symptom besides soreness is fever. Fever usually occurs within 24 hours after immunization and affects approximately 10% to 35% of children younger than 2 years; the frequency of fever after injection is much lower in older children and adults. Mild systemic symptoms, such as nausea, lethargy, headache, muscle aches, and chills, also can occur with this year’s injection.

Because viruses for both vaccines are grown in eggs, neither should be administered to anyone with known allergic reactions (ie, hives, angioedema, allergic asthma, and systemic anaphylaxis) to chicken and egg proteins. Less severe or local symptoms of allergy to eggs or feathers should not deter administration of influenza vaccine.