Influenza Vaccination: Prevent the Flu with Vaccination

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 2017-2018 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 as soon as the vaccine is available, which is often as early as August. Protection from the vaccine occurs within two weeks of vaccination and lasts throughout the flu season. If you don’t get it right away, you can still get vaccinated through the fall, winter, or spring since flu season usually peaks in January or February but often continues 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. This flu season, other children in this age group may need two doses as well. For individuals 9 years of age and older, only one dose of vaccine is needed each flu season regardless of how early the vaccine is given.

Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP) – United States, 2017-18 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:
- Contraindications
  - 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.
- Precautions
  - 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. He or she will help you decide if the flu vaccine is right for you.
  - NOTE: For the 2017-2018 influenza season, ACIP recommends 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

Types of Influenza Vaccine Available

There are two primary types of vaccine, inactivated influenza vaccine (IIV), also known as the “flu shot”, and live attenuated influenza vaccine (LAIV), also known as the nasal-spray flu vaccine.

The “flu shot” is an inactivated vaccine (made with killed virus) that is given with a needle, usually in the arm. The flu shot is approved for use in people 6 months of age or older, including healthy people and people with chronic medical conditions.
The nasal spray flu vaccine 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.
- Note: The Advisory Committee on Immunization Practices (ACIP) continues the recommendation that the intranasal live attenuated influenza vaccine (LAIV), commonly known as “Flu Mist”, should not be used during the upcoming season.

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 vaccine offered for the 2017-2018 season will be quadrivalent (protects against four influenza viruses). Some seasonal flu vaccines will be formulated to protect against three flu viruses (trivalent flu vaccines). 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 2017-2018 Season (CDC) – table of available vaccine products. Includes age indication, presence of latex, and method of administration, as well as other relevant information.

2017-2018 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 2017-2018 trivalent influenza vaccines protect against the following three viruses:

an A/Michigan/45/2015 (H1N1)pdm09-like virus;
an A/Hong Kong/4801/2014 (H3N2)-like virus;
a B/Brisbane/60/2008-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.

Questions and Answers about Influenza Vaccine

Influenza Vaccination 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

Clinical Resources

Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP) – United States, 2017-18 – comprehensive vaccine recommendations including dosing algorithm for children 6 months through 8 years of age and vaccination recommendations for persons with egg allergies
Guidelines for Administering Seasonal Influenza Vaccine to Minors (VDH) – visit the Division of Immunization homepage for the latest protocol and standing orders.
Journal Articles on Influenza Vaccine (IAC) – abstracts and citations for dozens of current immunization-related publications
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
Surveillance of Healthcare Worker Influenza Vaccination Rates (VDH) – information about Centers for Medicare and Medicaid Services (CMS) requirements for healthcare facility reporting of summary-level healthcare personnel influenza vaccination rates to the National Healthcare Safety Network
Vaccine Adverse Events Reporting System (VAERS) – online reporting of possible vaccine adverse events

Talking About Influenza Vaccination

Influenza Prevention and Vaccination (HHS) – information on vaccination, vaccine safety and vaccine production from the U.S. Department of Health and Human Services
A Look at Influenza Vaccine (CHOP) – information from the Vaccine Education Center and the Children’s Hospital of Philadelphia
National Influenza Vaccine Summit (NIVS) – array of resources intended to encourage and facilitate seasonal influenza vaccination activities and programs
Preventing Seasonal Influenza with Vaccination (CDC) – variety of vaccination resources from CDC

Influenza Vaccination Videos and Podcasts

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.

Influenza Vaccination Coverage

FluVaxView (CDC) – estimates of annual influenza vaccination coverage for the United States utilizing data from several nationally representative surveys.