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Dr. Bill's Commentaries

It’s Flu Shot Time   (September 18, 2011)

It's that time of year again - summer's almost over, and it's time to get your flu shot. The flu shot, officially  called the "influenza virus vaccine," is designed to protect against influenza, a potentially-fatal viral disease that can cause seasonal epidemics every autumn and winter.

For people with diabetes, this has been an annual recommendation, but there's new advice recently. The revised recommendation is about who should get a flu shot: now it's not just little kiddies, the elderly, and those of us with chronic disorders such as diabetes; now it's everyone who is six months or older. The Centers for Disease Control and Prevention (CDC) explains that this recommendation has been in place since February 24, 2010 when their Advisory Committee on Immunization Practices (ACIP) recommended "universal" flu vaccination to expand protection against the flu to more people.

While it's now recommended that everyone should get a flu shot each year, it's especially important that certain people get vaccinated because they are at high risk of having serious flu-related complications. High-risk individuals include those of us with diabetes.

There are three versions of the flu shots, all of which have the three strains of influenza viruses expected to cause illness for that particular flu season.  The CDC says that this year's version will protect against an influenza A H3N2 virus, an influenza B virus and the H1N1 virus that emerged in 2009 and caused the "swine flu" pandemic.

Besides the standard flu shot, which is injected into muscle, there's now a version that is injected into the skin itself ("intradermal"). This intradermal version uses a smaller needle and a smaller dose, and is recommended for people between ages 18 and 64.  

There's also a high-dose version that's advised for people over 65 years of age: it contain four times the amount of active stuff than what's in the regular flu shots. The additional amount of antigen is intended to create a stronger immune response. The CDC is not making a recommendation about whether this high-dose version should be recommended rather than the usual flu vaccine: "neither CDC nor ACIP is expressing a preference of one vaccine over another at this time."

There are a few folks who probably should not get the flu vaccine: Those who have had a severe allergic reaction to eggs, or have had a serious reaction to a previous flu shot, or had Guillain-Barré Syndrome after receiving influenza vaccine.

There's lots more information at the Centers for Disease Control and Prevention website, where there's a comprehensive on-line Q&A about the influenza vaccine, and a separate webpage about the high-dose version.

Be sure to get your flu shot!

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Dr. Bill Quick began writing at HealthCentral's diabetes website in November, 2006. These essays are reproduced at D-is-for-Diabetes with the permission of HealthCentral.

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