search feedback link archive home

Parathyroid hormone may help battle osteoporosis

Doctors control spread of antibiotic-resistant bug

Healthier cattle feed benefits animals and people

Younger than 55? Alcohol risks outweigh benefits

Women have poorer body image than men

Finding disease genes may not be so difficult

Drug users need regular medical, drug abuse care

Study links child's depression with later obesity

RAND: US faces healthcare 'quality deficit'

Exercise keeps women's minds in shape



Waiting for the Promised Miracle: Diabetics Look with Hope Toward Islet Cell Transplants

Pain, Pain, Go Away ...: New Standards Should Reduce Suffering For Those With Chronic Pain

Tuberculosis Is Back, and Deadlier Than Ever

Mending the Heart

Introducing Jonathan Freedhoff, M.D.


November 17, 1999
Flu Shots for Whom?
By Elizabeth Smoots, M.D.

Illustration: Flu shots

It usually begins quite suddenly with fever, aches, sore throat, dry cough, and fatigue. After a week or two of feeling totally wiped out, you feel your symptoms slowly subside -- until next year. Every winter, many of us come down with influenza, commonly called the flu.

Fortunately, the flu shot can help prevent all that -- if you get one. And many people across the nation are doing just that, waiting their turn in lines at medical clinics, drugstores, supermarkets, and the workplace.

The Institute of Medicine recently placed flu vaccines on its list of most effective therapies for the twenty-first century. The shots not only help prevent the flu but also decrease the severity of illness when it does occur. A study published in the New England Journal of Medicine showed that flu vaccination of healthy, working adults can reduce sick leave by 43 percent. The vaccination is more than 70 percent effective in preventing influenza in healthy children, young adults, and seniors. The shots can also help ward off the most feared flu complication -- pneumonia -- plus some of the 20,000 flu-related deaths that occur in the United States each year.

Despite these health benefits, many people don't get immunized. Less than 30 percent of younger people at high risk for flu complications -- and only about 65 percent of those over age 65 -- receive the vaccine. This fall, the American Academy of Family Physicians began recommending routine influenza vaccinations for all people aged 50 years and older.

So who, exactly, needs a flu shot?

The Advisory Committee on Immunization Practices of the U.S. Public Health Service recommends the following people get an annual flu vaccine: *+

  • Any person who wishes to reduce the likelihood of becoming ill with influenza
  • All adults who are 65 years of age or older (or aged 50 or older, according to new recommendations from the American Academy of Family Physicians)
  • Adults and children with chronic medical problems such as diabetes, asthma, and other disorders of the heart, lungs, kidneys, blood, or immune system (including those caused by drugs or human immunodeficiency virus)
  • Children or teens taking long-term aspirin therapy (raises the risk of Reye's syndrome after influenza)
  • Women who will be in their second or third trimester of pregnancy -- or those with a chronic disease who will be in any stage of pregnancy -- during flu season
  • All health care workers and other providers of key community services
  • Caregivers or household members (including children) of people in high-risk groups
  • Residents and staff of nursing homes and other chronic-care facilities; students and other people in institutional settings, including dormitories
  • People who travel to areas where influenza activity exists, and people who travel in large groups

*As long as there are no contraindications to the vaccine (see below)

+Children must be at least 6 months old.

How often and when?

It's best to get your yearly immunization before the start of flu season -- which generally spans from about December until March -- for several reasons. Each vaccine contains three types of influenza viruses that scientists predict will be most prevalent in the upcoming season. Because these viruses change constantly, the flu shot must be updated annually. Also, studies show that the vaccine's protective effect wanes after a number of months. October through November is the best time to get your shot. Your protection against influenza usually starts one to two weeks after the injection.

Flu shots are generally quite safe, according to experts. Since they contain killed viruses, you can't contract influenza from a shot. The vaccine, however, doesn't protect you from colds or other viral illnesses. Side effects may occasionally occur, including local soreness, fever, fatigue, or aches. In 1976, the swine flu vaccine was associated with a severe paralytic illness called Guillain-Barré syndrome (GBS). Influenza vaccines since then, however, have not been clearly linked to GBS. Consult with your provider before getting a vaccine if you have a history of GBS or are acutely ill, running a fever, or allergic to eggs or other components of the influenza vaccine.