Protect Yourself and Your Loved Ones
VDH and CDC recommend yearly influenza vaccination as the first and most important step in protecting yourself and your loved ones from influenza illness. Annual seasonal flu vaccination is the best way to reduce the chances that you will get the flu and lessen the chance that you will spread it to others. When more people get vaccinated against the flu, less flu illness can spread through the community.
Influenza Vaccine Recommendations
All people 6 months of age and older are recommended to receive an influenza vaccination each year. Depending on the vaccine types available to you, the 2019-2020 vaccine will protect against either three or four different influenza viruses.
Vaccination is especially important for certain people who are at “high risk” of serious complications from seasonal flu. People at high risk include adults age 65 years and older, children younger than five years of age, pregnant women, and people of any age with certain chronic medical conditions.
In addition, people who live with or care for persons who are at increased risk of developing serious complications should be vaccinated. This includes household contacts and caregivers of young children (especially infants less than 6 months of age) and people with certain medical conditions such as asthma, diabetes, and chronic lung disease.
The best time to get vaccinated is before the end of October. Protection from the vaccine occurs within two weeks of vaccination. If you don’t get it before the end of October, you can still get vaccinated through the fall, winter, or spring since seasonal flu activity can last through May.
Children aged 6 months through 8 years of age who have never received a seasonal flu vaccine need two doses of vaccine spaced at least 4 weeks apart. For individuals 9 years of age and older, only one dose of vaccine is needed each flu season, regardless of vaccine timing.
- Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2019–20 Influenza Season
- All persons aged 6 months and older should be vaccinated annually.
- Vaccination of persons at high risk is especially important to decrease their risk of severe flu illness.
- People at high risk of serious flu complications include young children, pregnant women, people with chronic health conditions like asthma, diabetes or heart and lung disease, and people 65 years and older.
- Vaccination also is important for healthcare workers, and other people who live with or care for people at high risk to keep from spreading flu to those at high risk.
- Children younger than 6 months are at high risk of serious flu illness, but are too young to be vaccinated. People who care for them should be vaccinated instead.
- People who have ever had a severe (life-threatening) allergic reaction to influenza vaccine should not be vaccinated. Talk to your doctor BEFORE vaccination if you have any of the below:
- Severe allergic reaction to eggs – (e.g., anaphylaxis) after receiving a previous dose of influenza vaccine or an influenza vaccine component. You may be advised to not get vaccinated or receive a different formulation. Make sure your healthcare provider knows about any allergic reactions. Most, but not all, types of flu vaccine contain a small amount of egg proteins.
- Moderate or severe illness with or without fever
- History of Guillain-Barré Syndrome (a severe paralytic illness, also called GBS) within 6 weeks of a previous influenza vaccination. If you are not at risk for severe illness from influenza, flu vaccine is generally not recommended. Tell your doctor if you have ever had GBS. They will help you decide if the flu vaccine is right for you.
- NOTE: Since the 2017-2018 influenza season, ACIP has recommended the following for those with a history of egg allergy:
- Those who have experienced only hives after exposure to egg should receive any licensed and recommended influenza vaccine that is otherwise appropriate.
- Those who report having had reactions to egg involving symptoms other than hives (such as angioedema, respiratory distress, lightheadedness, or recurrent emesis; or who required epinephrine or another emergency medical intervention) may also receive any licensed and recommended influenza vaccine but it should be administered in an inpatient or outpatient medical setting.
- Vaccination Recommendations for Healthcare Personnel
Where to Get Vaccinated
Flu vaccines are offered in many locations, including doctor’s offices, clinics, health departments, pharmacies, and college/university health centers. Even if you don’t have a regular doctor or nurse, you can get a flu vaccine somewhere else, such as at a health department or pharmacy. Individuals who lack health insurance should contact their local health department to inquire about flu vaccination clinics.
Visit the HealthMap Vaccine Finder to locate where you can get a flu shot.
Types of Influenza Vaccine Available
The three types of vaccine are inactivated influenza vaccine (IIV), recombinant influenza vaccine (RIV4), and live attenuated influenza vaccine (LAIV4), also known as the nasal-spray flu vaccine.
- The inactivated vaccine is made with ‘killed’ virus and given with a needle, usually in the arm. Depending on the formation, this flu shot is approved for use in people 6 months of age or older, including healthy people and people with chronic medical conditions. The majority of IIV viruses are grown in chicken eggs before being inactivated. There is one formulation approved for the 2019-20 season that is grown in mammalian cells before being inactivated.
- The recombinant vaccine only includes a specific protein from the influenza virus (hemagglutinin) grown as part of another virus in insect cells. This process includes no eggs.
- The nasal spray flu vaccine (LAIV4) is made with live, weakened flu viruses and is given as a nasal spray. The viruses in the nasal spray vaccine do not cause the flu. The nasal spray vaccine is approved for use in healthy people 2 through 49 years of age who are not pregnant.
A number of different manufacturers produce influenza vaccines for the U.S. market. Talk with your healthcare provider to determine which vaccine may be best for you. Most of the flu vaccines offered for the 2019-20 season are quadrivalent, meaning they protect against four influenza viruses. Some seasonal flu vaccines, called trivalent, are formulated to protect against three flu viruses. For many vaccine recipients, more than one type or brand of vaccine may be appropriate. Where more than one type of vaccine is appropriate and available, VDH and CDC make no preferential recommendation for use of any influenza vaccine product over another.
- Vaccines approved for the 2019-20 Season (CDC) – table of available vaccine products. Includes age indication, presence of thimerosal, and method of administration, as well as other relevant information.
2019-20 Influenza Vaccine Composition
While there are many types of flu viruses, flu vaccine protects against the three or four types of flu viruses that are most likely to be circulating during the current flu season.
The 2019-20 trivalent influenza vaccines protect against the following three viruses:
- an A/Brisbane/02/2018 (H1N1)pdm09-like virus;
- an A/Kansas/14/2017 (H3N2)-like virus;
- a B/Colorado/06/2017-like virus (Victoria lineage).
The quadrivalent vaccines protect against four viruses: the three viruses above, as well as a B/Phuket/3073/2013-like virus (Yamagata Lineage), for a total of two influenza A viruses and two influenza B viruses.
Resources for Healthcare Professionals
Handouts for Patients and Staff
- Influenza Vaccine Information Statements (VIS) – large print and foreign language versions are also available here
- Influenza Handouts (IAC) – influenza-specific educational materials for healthcare professionals and their patients including information on cocooning, guidelines for determining number of doses needed, screening checklists for contraindications, templates for standing orders, and more from the Immunization Action Coalition
- Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2019–20 Influenza Season – comprehensive vaccine recommendations
- Guidelines for Administering Seasonal Influenza Vaccine to Minors (VDH) – visit the Division of Immunization homepage for the latest protocol and standing orders.
- The Pink Book: Influenza (CDC) – chapter from CDC’s Epidemiology and Prevention of Vaccine-Preventable Diseases textbook
- Red Book Online Influenza Resource Page (AAP) – information for healthcare professionals from the American Academy of Pediatrics
- Vaccine Adverse Events Reporting System (VAERS) – online reporting of possible vaccine adverse events
Talking About Influenza Vaccination
Influenza Vaccination Coverage
- FluVaxView (CDC) – estimates of annual influenza vaccination coverage for the United States utilizing data from several nationally representative surveys.
Other Prevention Strategies
Keep Your Hands Clean
- Clean hands are another important factor in preventing the spread of disease, including influenza.
- Hand hygiene is a general term that refers to a method of removing germs from the hands so they cannot be spread to anyone else. The two most common types of hand hygiene are hand washing with soap and water and using an alcohol-based hand rub.
- Soap and water should be used when hands are visibly dirty, contaminated, or soiled, after using the restroom, and before eating or preparing food.
- Alcohol-based hand rubs are products that kill germs on the hands. They are fast-acting, convenient, and generally can be used for all situations other than the ones described above. Be sure to use hand rubs that contain 60-95% ethanol or isopropanol (types of alcohol).
- Avoid touching your eyes, nose, or mouth. Germs spread this way.
Practice Good Respiratory Hygiene and Cough Etiquette
- Cover your mouth and nose with a tissue when coughing or sneezing.
- Promptly throw away tissues after they are used.
- If a tissue is not available, cover your cough/sneeze with your elbow or sleeve, not your hand.
- Wash your hands after coughing or sneezing.
- If you are sick, maintain a safe distance (at least 3 feet) from others or wear a surgical mask, if you are able to tolerate it, especially if you are at a doctor’s office or a location with others who may be at high risk for getting the flu.
Stay Home if You’re Sick
- If you’re sick, avoid contact with other people unless you are seeking medical care. Don’t share glassware, silverware, or personal items with healthy people in your household.
- Don’t return to work, school, or other activities until you are fever-free for at least 24 hours without the use of fever-reducing medication.
- When you go back to work or school, continue to cover your coughs and sneezes and keep your hands clean.
Use Antiviral Drugs if Recommended by Your Doctor
- If you have the flu or have been exposed to the flu, your doctor may prescribe an antiviral drug for you to take. These are most effective when given early in the illness.
- When used for treatment, antiviral drugs can lesson symptoms and shorten the time you are sick by 1 or 2 days. They can also prevent serious flu complications, like pneumonia, especially in the elderly, people with weakened immune systems, or those with high risk medical conditions such as asthma or heart disease.
- Antiviral drugs are different than antibiotics, which fight against bacterial infections. Antibiotics are not effective against influenza. For more information on the appropriate use of antibiotics, see CDC’s Get Smart website.
Keep Your Environment Clean
- If taking care of yourself or a sick person at home, make sure that you clean and disinfect surfaces and objects (such as kitchen counters, bedside tables, children’s toys, and surfaces in the bathroom) that may become contaminated with the influenza virus, especially if you have others at home who are not sick.
- Wipe these surfaces down with an approved household disinfectant according to directions on the product label.
- Clean linens, eating utensils, and dishes used by the sick person thoroughly before reusing. You do not need to wash items separately. Wash linens (such as bed sheets and towels) with laundry soap and tumble dry on a hot setting. Avoid “hugging” laundry to your body before washing it to prevent contaminating yourself.
- “Cover Your Cough” poster
- Frequently asked questions about respiratory hygiene/cough etiquette
- Hand hygiene websites:
- Nonpharmaceutical interventions (CDC)
- Seasonal flu educational materials (CDC)