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Are You Ready for Flu Season?
Good Health Habits for Preventing the Flu
The single best way to prevent the flu is to get vaccinated each year,
but good health habits and antiviral medications are other measures that can help protect against the flu.
Good Health Habits
- Avoid close contact.
Avoid close contact with people who are sick. When you are sick, keep your distance
from others to protect them from getting sick too.
- Stay home when you are sick.
If possible, stay home from work, school, and errands when you are sick.
You will help prevent others from catching your illness.
- Cover your mouth and nose.
Cover your mouth and nose with a tissue when coughing or sneezing.
It may prevent those around you from getting sick.
- Clean your hands.
Washing your hands often will help protect you from germs.
- Avoid touching your eyes, nose or mouth.
Germs are often spread when a person touches something that is contaminated with germs and then
touches his or her eyes, nose, or mouth.
- Practice other good health habits.
Get plenty of sleep, be physically active, manage your stress, drink plenty of fluids,
and eat nutritious food.
Key Facts about Influenza (Flu) Vaccine
The single best way to protect against the flu is
to get vaccinated each year.
There are two types of vaccines:
- The "flu shot" - an inactivated vaccine (containing killed virus) that is given with a needle, usually
in the arm. The flu shot is approved for use in people older than 6 months, including healthy
people and people with chronic medical conditions.
- The nasal-spray flu vaccine-a vaccine made with live, weakened flu viruses that do not cause
the flu (sometimes called LAIV for "Live Attenuated Influenza Vaccine"). LAIV is approved for use in
healthy people 5 years to 49 years of age who are not pregnant.
Each vaccine contains three influenza viruses-one A (H3N2) virus, one A (H1N1) virus, and one B virus.
The viruses in the vaccine change each year based on international surveillance and scientists' estimations
about which types and strains of viruses will circulate in a given year.
About 2 weeks after vaccination, antibodies that provide protection against influenza virus infection
develop in the body.
When to Get Vaccinated
October or November is the best time to get vaccinated, but you can still get vaccinated in December and
later. Flu season can begin as early as October and last as late as May.
Who Should Get Vaccinated
In general, anyone who wants to reduce their chances of getting the flu can get vaccinated. However, it is
recommended by ACIP that certain people should get vaccinated each year. They are either people who
are at high risk of having serious flu complications or people who live with or care for those at high risk for
serious complications. During flu seasons when vaccine supplies are limited or delayed, ACIP makes
recommendations regarding priority groups for vaccination (see
People who should get vaccinated each year are:
1. People at high risk for complications from the flu, including:
- Children aged 6 months until their 5th birthday,
- Pregnant women,
- People 50 years of age and older, and
- People of any age with certain chronic medical conditions;
- People who live in nursing homes and other long term care facilities.
2. People who live with or care for those at high risk for complications from flu, including:
- Household contacts of persons at high risk for complications from the flu (see above)
- Household contacts and out of home caregivers of children less than 6 months of age (these children are
too young to be vaccinated)
- Healthcare workers
Use of the Nasal Spray Flu Vaccine
It should be noted that vaccination with the nasal-spray flu vaccine is always an option for healthy
persons aged 5-49 years who are not pregnant.
Who Should Not Be Vaccinated
There are some people who should not be vaccinated without first consulting a physician. These include
- People who have a severe allergy to chicken eggs.
- People who have had a severe reaction to an influenza vaccination in the past.
- People who developed Guillain-Barr? syndrome (GBS) within 6 weeks of getting an influenza
vaccine previously (see
- Influenza vaccine is not approved for use in children less than 6 months of age.
- People who have a moderate or severe illness with a fever should wait to get vaccinated until their
The ability of flu vaccine to protect a person depends on the age and health status of the person getting
the vaccine, and the similarity or "match" between the virus strains in the vaccine and those in circulation.
Testing has shown that both the flu shot and the nasal-spray vaccine are effective at preventing the flu.
Vaccine Side Effects (What to Expect)
Different side effects can be associated with the flu shot and LAIV.
The flu shot: The viruses in the flu shot are killed (inactivated), so you cannot get the flu from a flu shot.
Some minor side effects that could occur are
- Soreness, redness, or swelling where the shot was given
- Fever (low grade)
If these problems occur, they begin soon after the shot and usually last 1 to 2 days. Almost all people who
receive influenza vaccine have no serious problems from it. However, on rare occasions, flu vaccination
can cause serious problems, such as severe allergic reactions. As of July 1, 2005, people who think that
they have been injured by the flu shot can file a claim for compensation from the National Vaccine Injury
Compensation Program (VICP). For more information, go to
LAIV: The viruses in the nasal-spray vaccine are weakened and do not cause severe symptoms often
associated with influenza illness. (In clinical studies, transmission of vaccine viruses to close contacts has
occurred only rarely.)
In children, side effects from LAIV can include
- runny nose
- muscle aches
In adults, side effects from LAIV can include
- runny nose
- sore throat
Antiviral Drugs and Influenza
Please note the publication "Prevention and Control of Influenza:
Recommendations of the Advisory Committee on Immunization Practices (ACIP)
(MMWR 2006 Jul 28;55(RR10):1-42)" In which ACIP recommends that neither amantadine
nor rimantadine be used for the treatment or prevention of
influenza A in the United States for the 2006-07 influenza season.
Four antiviral medications (amantadine, rimantadine, zanamavir and oseltamivir*) have been approved by
the U.S. Food and Drug Administration (FDA) for treatment of influenza. However, you will need to begin
taking the medication within 2 days after becoming sick. When used in this manner, these medications
can reduce influenza symptoms and may shorten the time you are sick by 1 or 2 days. They also may
make you less contagious. All of these medications must be prescribed by a doctor and taken for 3-5
consecutive days (5 days for oseltamivir and zanamivir). The 4 antiviral medications are effective only
against influenza viruses. They will not help symptoms associated with the common cold or many other
influenza-like illnesses caused by viruses that circulate in the winter.
All four antiviral medications (amantadine, rimantadine, and oseltamivir) also are approved by the FDA
and are commercially available for use in the United States to prevent influenza. All of these medications
are prescription drugs, and a doctor should be consulted before the drugs are used. When used for
prevention, they are about 70% to 90% effective in preventing illness in healthy adults.
All of the antiviral medications may be effective for influenza A viruses. However, only oseltamivir and
zanamivir are effective for influenza B viruses. Also, recent evidence indicates that a high proportion of
currently circulating influenza A viruses in the United States have developed resistance to amantadine and
rimantadine. Please see the January 14, 2006 Health Alert Notice for more information.
All of the antiviral medications are different in terms of who can take them, how they are given, any
dosing changes based on age or medical conditions, and side effects. Your doctor can help decide whether
you should take an antiviral drug and which one you should use.
Use of Antiviral Medications
Antiviral medications are most often used to help control influenza outbreaks in institutions, for example in
nursing homes or in hospital wards, where people at high risk for complications from influenza are in close
contact with each other. Antiviral medications also have been used on cruise ships or similar settings to
help control influenza outbreaks.
In the event of an outbreak, public health practice is to combine the use of influenza vaccine and antiviral
medications. For example, nursing home residents and staff are given vaccine during an outbreak and also
are given antiviral medications to prevent influenza until the vaccine takes effect (about 2 weeks). This
practice continues as long as influenza is occurring in that setting.
Doctors also can prescribe influenza antiviral medications to people not living in institutional settings, but
treatment must begin within 2 days of the onset of symptoms for the drugs to be effective. Although all
antiviral medications lessen symptoms and shorten the duration of illness, only one (oseltamivir) has been
shown in a study to reduce lower respiratory tract complications requiring antibiotics. They do not cure
When considering the use of antiviral medications it is important to remember that most healthy people
recover from influenza without complications.
Who Should Get Antiviral Medications
People who are at high risk of serious complications from influenza may benefit most from antiviral
medications. This includes: people 65 years of age and older, children 12-23 months of age, people with
chronic medical conditions (for example, heart or lung disease, diabetes), and pregnant women. (Note
that none of the antiviral medications is approved for use in children less than 1 year of age.) Although
CDC has provided guidelines for health-care professionals on the use of antiviral drugs, your doctor will
decide whether you should receive antiviral medications this season. The guidelines for use of influenza
antiviral medications are not intended as recommendations for use of these medications in other
situations, such as outbreaks of new strains of avian influenza.
For Treatment: If you become sick with influenza-like symptoms this season, your doctor first may give you
a test to find out whether you have influenza. (Symptoms include fever (usually high), headache,
tiredness, a sore throat and dry cough, nasal congestion, and body aches.) Your doctor also will consider a
number of factors before making a treatment decision, such as your risk for complications from influenza.
For Prevention: In the event of an influenza outbreak in a home, institution, or community, your doctor may
choose to prescribe antiviral medications to you as a preventive measure, especially if you are at high risk
for complications from influenza. Also, if you are in close contact with someone who is considered at high
risk for complications, you may be given antiviral medications to reduce the chances of passing influenza
to the high-risk person.
* Note: On November 13, 2006, FDA approved a labeling supplement for Roche Laboratories' Tamiflu
(Oseltamivir Phosphate) to include a precaution about neuropsychiatric events. The revision is based on
postmarketing reports (mostly from Japan) of self-injury and delirium with the use of Tamiflu in patients
with influenza. The reports were primarily among pediatric patients. The relative contribution of the drug
to these events is not known. However, people with the flu, particularly children, may be at an increased
risk of self-injury and confusion shortly after taking Tamiflu and should be closely monitored for signs of
unusual behavior. A healthcare professional should be contacted immediately if the patient taking Tamiflu
shows any signs of unusual behavior. For more information, please visit the for
For more information, visit www.cdc.gov/flu, or call CDC at
800-CDC-INFO (English and Spanish) or 888-232-6358 (TTY).
U.S. Department of Health and Human Services - Centers for Disease Control and Prevention
Adapted by Editorial Staff on December 2006
Last update, July 2008