This is an immunization to prevent influenza infection. There are actually 2 different kinds of flu immunizations: an inactivated shot and a live, attenuated nasal mist. These immunizations have to be altered annually to anticipate the three flu strains which are projected to be the biggest threat in the coming flu season. The 2011-2012 vaccine will contain the same formulation as the 2010-2011 version, since the same 3 strains continue to be the predominant risk. As with last year's vaccine, one of these strains is the H1N1 strain which causes the swine flu. As mentioned above, even if you had the shot last flu season, you still need it again this season and every year since the immunity decreases with time.

Influenza, the "flu,"(also called the seasonal flu) is an unpleasant virus and in some cases can lead to complications, including pneumonia and death. Typical symptoms include fever, chills, aches, congestion, cough, sore throat, and possible diarrhea and vomiting. There are medications that may decrease the severity and duration of the influenza if you do get it. By immunizing yourself against the disease, you are effectively minimizing your risk of getting the virus. By receiving the vaccine, you can also prevent spreading it to others in your environment who may be at greater risk of complications. People with certain health conditions or extremes of age are at greater risk. The vaccine is modified each year, so it is important to get immunized every year.

For most people, the vaccine is a single annual shot of inactivated flu vaccine given in the deltoid muscle of the upper arm. Adults age 65 and over, who may have less immune response to vaccines, may be candidates for the single shot higher dose vaccine. Infants 6-12 months are usually injected in the upper outer thigh. Children aged 8 and under get a booster shot 1 month after the first shot if they have never had a flu shot before. Children 6 months to 8 years of age who received a single vaccine dose in their first year of immunization should receive 2 doses the following year.

There is also a nasal spray vaccine preparation called FluMist©. The FluMist© contains a live, but weakened virus.

Severe reactions, including life-threatening allergic reactions, can occur but are very rare. Rare cases of Guillain-Barré have occured, but causality has not been proven. Mild reactions can include soreness, swelling or redness at the injection site, aches, fever, nasal congestion, cough, headache, chills, sore throat, fatigue, muscle ache, fever, abdominal pain, vomiting, or diarrhea.

The influenza inactivated vaccine shot and FluMist© are not recommended for people with a fever, a history of Guillain-Barré syndrome, chicken or egg protein allergy, or a history of moderate or severe reaction to a flu shot. While pregnant women may receive the inactivated flu shot, some physicians prefer waiting until after the first 3 months of pregnancy. The inactivated flu shot is safe for breastfeeding women.

FluMist© (the nasal spray version) is not recommended for those who are pregnant (even beyond 3 months), nursing, or generally unwell, or for children or teenagers on long-term aspirin therapy. It is not recommended for children under 2 years of age or adults 50 years or older. Because FluMist© contains a live virus, it is not recommended for anyone who might be at high risk for complications from influenza. This includes people with asthma, wheezing, other chronic lung or heart disease, diabetes, kidney failure, or weakened immunity. In addition, it is preferred not to use FluMist© for anyone caring for someone with severe immune problems because of the risk of transmitting the live vaccine virus to that individual.

While the vaccine is optional for healthy people ages 19 to 49 years, the influenza inactivated shot is recommended for people in this age range with certain health issues including: compromised immunity, HIV, diabetes, heart disease, chronic lung disease, chronic alcoholism, lack of speen, chronic liver disease, and chronic kidney disease. It is also recommended for women who will be pregnant during flu season, health-care personnel, and other individuals if they are caring for people at increased risk for influenza and its complications. Health-care personnel may receive either type of flu vaccine, but again, FluMist© should be avoided in people caring for immune compromised individuals.

Individuals with prior severe reactions to this vaccine may not be able to receive another dose. Check with your doctor regarding this issue and for any other contraindications for this vaccine. Also check with your doctor to find out what other ingredients may be in the vaccine, its container, or any diluent in case of allergies or other concerns. Immunization is usually postponed for individuals with a moderate or severe acute illness. Remember that this immunization can only protect against the flu strains covered by the vaccine, not against others strains and other respiratory illnesses.

As mentioned above, this flu season (2011-2012), the flu vaccine will again offer protection against H1N1 (swine flu), so there is no need to get a separate H1N1 vaccine as was recommended in 2009.

• >/= 50 years old
• Chronic heart, kidney, lung, liver, diabetes, cancer, HIV or blood disease
• Immune problems
• Chronic steroids
• Expecting to be 2nd or 3rd trimester pregnancy during flu season
• Long-term aspirin therapy in children 6 months-18 years
• Children 6-9 months
• Persons who cannot handle respiratory secretions such as those with certain brain or spinal cord injuries
• Residents of nursing homes, dormitories, or other crowded facilities

• Fluzone® (approved for individuals ages 6 months and over)
• Fluzone High-Dose® (approved for adults age 65 years and over)
• Fluvirin® (approved for individuals ages 4 and over)
• Fluarix® (approved for individuals ages 3 and over)
• Afluria® (approved for individuals >/= 9 years)
• FluLaval^TM (approved for individuals ages 18 and over)
• Agriflu® (approved for individuals >/= 18 years; not available 2011-12 season)
• Flumist© (live attenuated nasal mist version; approved for individuals ages 2 to 49)