2020-2021 Influenza Vaccination FAQs (injection and nasal spray)

THIS SEASON A FLU VACCINE IS MORE IMPORTANT THAN EVER!

Getting a flu vaccine is more important than ever during 2020-2021 to protect yourself, your family and your community from flu.

What is the flu (influenza)?
What is the flu (influenza)?

Influenza also called the flu, is a serious and contagious respiratory illness that is caused by the influenza virus. Symptoms can range from mild to severe, sometimes leading to pneumonia, bronchitis, ear infections, and even death.

Who is at risk?
Who is at risk?

Every year many people get sick with the flu. Some groups are at higher risk than others, including the elderly, young children, and people with certain health conditions.

Can I have flu and COVID-19 at the same time?
Can I have flu and COVID-19 at the same time?

Yes. It is possible have flu, as well as other respiratory illnesses, and COVID-19 at the same time. Some of the symptoms of flu and COVID-19 are similar, making it hard to tell the difference between them based on symptoms alone.

Who should get their flu vaccine during the COVID-19 pandemic?
Who should get their flu vaccine during the COVID-19 pandemic?

According to the Centers for Disease Control and Prevention (CDC), the best way to help prevent the flu is to get vaccinated. Given that seasonal influenza vaccines are safe and effective, all persons aged 6 months or above except those with known contraindications are recommended to receive influenza vaccine to protect themselves against seasonal influenza and its complications, as well as related hospitalisations and deaths.

Persons aged 9 years or above are recommended to receive one dose of 2020-21 influenza vaccine. To ensure adequate immunity against seasonal influenza, children under 9 years old who have never received any seasonal influenza vaccine are recommended to be given 2 doses of seasonal influenza vaccine with a minimum interval of 4 weeks in the 2020-21 season. Children who have received at least one dose of seasonal influenza vaccine in the 2019-20 season or before are recommended to receive one dose in the 2020-21 season.

When should get vaccinated?
When should get vaccinated?

September and October are good times to get vaccinated. However, as long as flu viruses are circulating, vaccination should continue, even in January or later.

What are the vaccine choices?
What are the vaccine choices?

There are two main types of influenza vaccines:

(a)       Inactivated Influenza Vaccine (Flu shot); and

(b)       Live-attenuated Influenza Vaccine (Nasal spray)

The flu shot is formulated with the viruses that have been inactivated during the manufacturing process; while the nasal spray contains viruses that are attenuated or weakened right at the beginning of the manufacturing. The inactivated viruses are validated by the medical science that they only trigger restricted growth in the body and can hardly replicate themselves to manifest into the real illness.

As opposed to the flu shot, the nasal spray simulates natural infection through the nose and may be able to induce stronger and long-lasting immune protection.

For both flu shot and nasal spray, the effectiveness will depend on whether the virus strains in the vaccine, based on the WHO recommendation, are compatible with the virus strains that are circulating in the community.

What are the pros and cons of nasal spray?
What are the pros and cons of nasal spray?

Pros:

  • The only non-invasive alternative to the flu shot without a needle
  • No pain from the injection
  • Suitable for people who are afraid of needles

Cons:

  • More restrictions on who can get
  • A little more expensive than a flu shot
  • Since it is given as a nose spray, some experts think that it may not be as effective if your child is very congested, such as if he has allergies or a cold.
What are the side effects of nasal spray?
What are the side effects of nasal spray?

The viruses in the nasal spray flu vaccine are weakened and do not cause severe symptoms often associated with flu illness. In children, side effects from the nasal spray may include:

  • Runny nose
  • Wheezing
  • Headache
  • Vomiting
  • Muscle aches
  • Fever (low grade)
  • Sore throat (in older children)

In adults, side effects from the nasal spray vaccine may include:

  • Runny nose
  • Headache
  • Cough

These problems usually are mild and short-lived.

What are the contraindications for nasal spray?
What are the contraindications for nasal spray?

Some people should not get the nasal spray flu vaccine:

  • Children younger than 2 years
  • Adults 50 years and older
  • People with a history of a severe allergic reaction to any ingredient of the vaccine or a previous dose of any influenza vaccine
  • Children 2 years through 17 years old who are receiving aspirin- or salicylate-containing medications.
  • Children 2 years through 4 years old who have asthma or who have had a history of wheezing in the past 12 months
  • People with weakened immune systems
  • People who care for severely immunocompromised persons who require a protected environment
  • People without a spleen, or with a non-functioning spleen
  • Pregnant women
  • People with an active leak between the cerebrospinal fluid and the mouth, nose, ear, or another within the skull
  • People with cochlear implants
  • People who have taken flu antiviral drugs recently
What are the precautions on the use of nasal spray?
What are the precautions on the use of nasal spray?

The following conditions are precautions to the use of the nasal spray flu vaccine:

  • Asthma in people aged 5 years and older.
  • Other underlying medical conditions that can put people at higher risk of serious flu complications.
  • Moderate or severe acute illness with or without fever.
  • Guillain-Barré Syndrome within 6 weeks following a previous dose of flu vaccine.
How effective is the nasal spray vaccine?
How effective is the nasal spray vaccine?

The American Academy of Pediatrics did not recommend the nasal spray during the 2016-17 and 2017-18 flu seasons because it didn't work as well against the A/H1N1 viral strain, but with changes in the formulation of the spray vaccine, the CDC is recommending any licensed, age-appropriate flu vaccine with no preference for any one vaccine over another in 2020-2021 flu season.

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