What is the flu vaccine?
The flu vaccine is a weakened or dead form of the virus that
causes influenza or “the flu”.1 The vaccine is either given as an
intramuscular (IM) or intradermal shot or via the intranasal route. The IM
vaccine is indicated for people aged 6 months and older, whereas, the
intradermal vaccine may be given to those aged 18 to 64. The intranasal
inhalation is indicated for healthy individuals 2 to 49 years old. Vaccination
against the flu and strategies to prevent the flu are the main tools to fight
the flu.2
On July 18th, the Food and Drug Administration
(FDA) approved the formulation of flu vaccine that will be available in autumn
2011 for the 2011-2012 influenza season.3 This formulation contains
3 strains of the influenza virus that the FDA, Centers for Disease Control and
Prevention (CDC), World Health Organization (WHO), and other public health
entities have determined will be those most likely to cause flu in the upcoming
flu season. These strains are:
● A/California/7/09
(H1N1)-like virus (pandemic (H1N1) 2009 influenza virus)
● A/Perth/16/2009
(H3N2)-like virus
● B/Brisbane/60/2008-like
virus
Additionally, a new formulation of the flu vaccine became
available this year.3 The Fluzone Intradermal vaccine produced by
Sanofi Pasteur Inc. was approved in May for individuals aged 18 to 64 for
intradermal (into the skin rather than into the muscle) administration.3,4
The Fluzone Intradermal vaccine is associated with more injection site
reactions, such as itchiness, swelling, and redness, than the IM vaccine;
however, the intradermal shot is associated with less pain after
administration.4
Who should get vaccinated and when?
Currently, the CDC recommends that all people older than 6
months get vaccinated against the flu as soon as the vaccine for the upcoming
flu season is available.2 Typically, the vaccine for the upcoming
flu season is available in September or October, but the timing of availability
does vary from location to location.
Where can I get the flu shot?
As the importance of vaccination for protection against the
flu has become more apparent, the number of sites at which you can receive the
flu shot has increased. The flu shot is available at two UIC Pharmacy locations; University Village
Pharmacy/UVP, 722 W. Maxwell St. suite 206 and at Wood St. Pharmacy, 840 S. Wood
St. /Pharmacy. The flu shots are offered for only $20. You can also get your flu shot at your doctor’s office. Some
community and employee health fairs may also offer the vaccine.
What are symptoms of flu?
A large percent of the United States population, between 5%
and 20% every year, gets sick with the flu, so you or someone you know will
likely get the flu in your lifetime.3 While most people recover from
the flu without any medical assistance, the flu and related complications are
responsible for approximately 3,000 to 49,000 deaths every year, so it is
important that you are able to recognize the common signs and symptoms of the
flu. These include:
● Nausea
and vomiting, especially in children5
● Fever
● Muscle
ache
● Headache
● Cough
● Sore
throat
● Runny
nose
Who is at an increased risk
for complications of the flu?
●
Pregnant women5
●
Those older than 50
●
Those living in a nursing home or other long term care
setting
●
Individuals with chronic cardiovascular disorders
●
Individuals with a chronic disease of the lungs
●
Children and adolescents being regularly treated with
aspirin
●
Those at an increased risk for aspiration due to any
medical condition
●
Those who have been hospitalized or have required
regular checkups with their doctor because of
○
Diabetes
○
Kidney disease
○
Blood diseases
○
A weakened or compromised immune system
○
HIV
●
Anyone between 6 and 59 months old
What are warning signs that someone may need more
advanced medical care for the flu?
Oftentimes advanced medical care is not necessary for people
sick with the flu; however, in some cases the CDC recommends that medical care
should be sought if you or a person you are caring for develops any of the
following signs or symptoms:6
● In
children
○ Rapid
breathing
○ Blue
skin coloration
○ Reduced
consumption of fluids
○ Not
waking up
○ Not
wanting to be held as a result of irritability
○ Improvement
in flu symptoms that then worsen with return of cough
○ Fever
with a rash
● In
infants
○ All
of the above stated for children, plus
○ Inability
to eat
○ Trouble
breathing
○ Less
wet diapers than normal
○ Crying
that does not result in tears
● In
adults
○ Difficulty
breathing or shortness of breath
○ Pain
or pressure in the chest or abdomen
○ Dizziness
that occurs suddenly
○ Confusion
○ Severe
or persistent vomiting
○ Improvement
in flu symptoms that then worsen with return of cough
What treatments can be used to help with the flu?
Non-drug treatments:
● Get
plenty of sleep5
● Avoid
strenuous activity whenever possible
● Stay
well hydrated, drinking around eight 8 oz glasses of water daily, so that you
rarely feel thirsty
● Warm
drinks or soup may help soothe a sore throat
Drug
treatments: antivirals zanamivir (Relenza) and oseltamivir (Tamiflu)
● What
should I know about these antivirals?5
○ Both
zanamivir and oseltamivir are in a class of antivirals called neuraminidase
inhibitors
○ Zanamivir
■
Available as an inhalable powder
■
May be used in children aged 7 years and up
■
May only be used in people without breathing problems
or heart disease
○ Oseltamivir
■
Available as an oral capsule and suspension
■
May be used in children aged 1 year and up
● Who
should use these drugs?7
○ Patients
severely ill with the flu
○ People
with certain diseases at a higher risk for complications related to the flu
● What
are some common side effects of these medications?
○ Oseltamivir
■
Nausea
■
Vomiting
○ Zanamivir
■
Dizziness
■
Runny or stuffy nose
■
Cough
■
Headache
● These
medications are most effective if used in the first 2 days of flu symptoms
● Both
of these medications may be used in pregnant women; however, oseltamivir is
preferred to treat pregnant women with the flu
How can I help stop the spread of the flu?
● Wash
your hands with soap and water regularly2
● Cover
your sneeze or cough in a tissue and dispose of the tissue after it has been
used
● Stay
home from work or school while you are sick, at least 24 hours after you no
longer have a fever
● Do
not touch your face with your hands
References
1. Hayney MS. Vaccines, toxoids, and other immunobiologics
In: Dipiro JT, Talbert RL, Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy:
A Pathophysiologic Approach. 7th ed. New York, NY: McGraw-Hill;
2008:2041-2063.
2. Centers for Disease Control and Prevention. CDC says
“take 3” actions to fight the flu. www.cdc.gov/flu/protect/preventing.htm.
Accessed July 19, 2011.
3. Food and Drug Administration. FDA approves vaccines for
2011-2012 influenza season.
www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm263319.htm. Accessed July
19, 2011.
4. Fluzone [package insert].Swiftwater, PA: Sanofi Pasteur
Inc; 2011.
5. Hermsen ED, Rupp ME. Influenza In: Dipiro JT, Talbert RL,
Yee GC, Matzke GR, Wells BG, Posey LM, eds. Pharmacotherapy: A
Pathophysiologic Approach. 7th ed. New York, NY: McGraw-Hill;
2008:1791-1799.
6. Centers for Disease Control and Prevention. The flu: what
to do if you get sick. www.cdc.gov/flu/takingcare.htm. Accessed July 19, 2011.
7. Centers for Disease Control and Prevention. What you
should know about flu antiviral drugs.
www.cdc.gov/flu/antivirals/whatyoushould.htm. Accessed July 26, 2011.
Written by:
Kristian Campbell, Pharm.D. candidate, Class of 2013
UIC College of Pharmacy
UIC Pharmacy
UIC Pharmacy
