Thursday March 28th, 2024 5:29AM

Sensitive patients have multiple flu vaccine options to prevent a "twin-demic"

Getting a jab of the flu vaccine isn’t that bad – for most of the population. But for those who are unsure of getting an annual flu shot due to negative reactions in the past, there are options to protect yourself as we head into the holidays.

“Flu vaccines are our first defense and best defense against the flu virus,” said District 2 Public Health Services spokesman Dave Palmer. “They’ve been around for a while and now they’re very effective at stopping the flu.”

First, know that roughly 81% of flu vaccines are made using egg proteins, according to Palmer, and 99% of the vaccines using egg protein will be quadrivalent. Quadrivalent vaccines protect against four different flu viruses. This is the most common flu vaccine and are approved for everyone six months old and older. There are four standard dose brands, one High-Dose for those over 65 years old as well as a standard dose of an Adjuvanted vaccine which is come in both quadrivalent form and trivalent, which protects again three types of flu. (More on flu shot types)

The standard flu shot is a virus raised in a hen’s egg, duplicated, and the virus killed and the antigen purified to create the vaccine, Palmer said, so it cannot give you the flu. You may have other reactions called an immunoresponse, which just means your immune system is at work. (More on immunoresponse)

If you react poorly to the “everyday” vaccine, Palmer said there are other options. The first is cell-based, called Flucelvax, also by Seqirus. It was approved by the Centers for Disease Control to combat the flu in 2016, Palmer said. These viruses are grown in cells instead of eggs and transitioned to the vaccine manufacturer to be cultivated and processed in a mammal cell.

Another type is the recombinant vaccine. Palmer said this type of vaccine, approved in 2013 by the CDC, is both egg-free and cell-free. That means the vaccine uses an antigen process that kicks the immune system into gear, targets the virus and uses DNA. The antigen is combined with baculovirus to help transport cultivated DNA instructions, which are basically marching orders for antigen soldiers to instruct the other cells to produce the antigen.

If it’s the needle that creates a nervous reaction, there is a nasal spray option as well. It is quadrivalent, so it is egg-based and protects the patient from four types of flu. The nasal spray does have some limits, though. Palmer said pregnant women are advised against getting the nasal spray, as are those over 50 years old, and those with certain medical conditions.

The coronavirus pandemic has encouraged many people to get the flu shot that normally wouldn’t to avoid a “twin-demic.” But Palmer said even if the vaccine isn’t as successful, it still can help.

“Flu vaccines are our first defense and best defense against the flu virus,” said Palmer. “They’ve been around for a while and now they’re very effective at stopping the flu. Even if people don’t get total protection from the flu shot, if they only get 20, 30, or 40% of the immunity they would normally get, it’s still a lot better than zero immunity.”

With coronavirus numbers increasing, Dr. Zachary Taylor, District 2 Director, said there are two reasons to fight both the flu and COVID-19. The first, no one wants to have the flu and COVID-19 at the same time, and the second, is the strain on medical care.

"Typically during influenza season we have increased hospitalizations. We are also seeing increased hospitalizations with coronavirus," said Taylor. "So we don't want to overload our medical system, this year especially."

So how can a patient tell if they are having a serious reaction to the flu vaccine and need to try something else?

“The flu shot can give you some side effects, some of those are soreness at the injection site, you could develop a little bit of a fever or a runny nose. In general, feelings of just not feeling well like the on set of a cold. If you get those, it means the flu vaccine is working because it has triggered a response in your body and you’re actually developing immunity when that happens.

Those with a history of fainting can rest assured that fainting or feeling faint is also normal. Anything more severe should result in a call to where you got your shot, or your doctor’s office, local walk-in clinic or District 2 Public Health.

If your reaction is severe or unlike what’s mentioned above, such as swelling under the skin, hives or a rash, difficulty breathing, wheezing, or swelling of the throat, it is likely a sign of a severe allergic reaction (anaphylaxis.) Palmer said this is a rare reaction, even for patients who have a history of egg allergies. He said it is key to know what kind of vaccine, what brand and which type was injected so responding doctors can best assess the reaction.

Palmer encouraged anyone who has previous had a sever reaction to the flu vaccine to see an allergist and determine exactly which element might have cause the reaction. Palmer suggests asking your healthcare provider what specific vaccine you had and what components were in it (cell, egg, recombinant) and making a list of your symptoms, reaction and treatment.

Lastly, if you are unable to tolerate a flu vaccine, or do not want to take one for whatever reason, Taylor said following your COVID-19 guidelines will protect you as well.

“Most people can get the flu vaccine… but if they can’t, we encourage people to follow the hygiene protocols of washing their hands, covering coughs and sneezes, if they’re sick, stay home, and stay away from people who may be sick and have symptoms like coughing or sneezing,” said Palmer. “Continue to wear those masks and social distance, stay six feet away from people and that can help prevent flu germs as well.”

QUICK FACTS
TYPES OF FLU VACCINES: Egg-based, Nasal Spray, Cell-based, Recombinant
EGG TYPES:
Quadrivalent (most common, 6 months+) – Alfuria, Fluarix, FluLaval, Fluzone 
High-Dose (65 years+ only) - Fluzone
Adjuvanted (65 years+ only) – Fluad, Quadrivalent and Trivalent
NASAL SPRAY:
For 2020-2021, all nasal sprays are quadrivalent (2 years – 49 years; non-pregnant; ask about medical conditions)
CELL TYPES:
Flucelvax (4 years+)
RECOMBINANT:
Flublok (18 years+)
Some vaccines also come in a high dose for those 65 years old or older.
REACTIONS
OK: red, sore injection site; muscle aches, low grade headache, low grade fever, nausea and fatigue (for the nasal spray, patients may also experience runny nose, wheezing and vomiting.)
NOT OK: swelling under the skin or hives/rash; difficulty breathing due to wheezing or throat swelling, low blood pressure and shock. These symptoms typically appear quickly. Call a doctor.
PREVENTION
Flu vaccine
Wear a mask
Social Distance
Sneeze, cough into elbow or shoulder
GET A SHOT
Call your doctor or allergist
Visit a pharmacy
Contact Public Health for events or scheduling

LEARN MORE AT THE CDC WEBSITE

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  • Associated Tags: COVID-19, District 2 Department of Public Health, flu shot
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