- Dr. Lewis First
Flu season is officially upon us. Medical experts can't predict how serious it will be this year or exactly when it will affect Vermonters. But the U.S. Centers for Disease Control and Prevention and the American Academy of Pediatrics agree that one of the best protections against this serious respiratory ailment is for everyone over 6 months of age through adulthood to get vaccinated, assuming they haven't had a rare severe allergic reaction to a prior influenza vaccine.
This month, Dr. Lewis First, chief of pediatrics at the University of Vermont Children's Hospital, takes a shot at addressing some of the concerns parents may have about the flu vaccine and explains why its benefits far outweigh the risks.
KIDS VT: How does influenza differ from a standard cold?
LEWIS FIRST: There are at least 200 different viruses that cause the common cold, but the cold symptoms you get due to the influenza virus are bad ones to experience. With a simple viral cold, you may get a low-grade fever and perhaps a mild cough and runny nose for a few days. But when you get the flu, it usually involves a significant fever, chills, body shakes, headaches, fatigue and a dry, hacking cough that can last for weeks.
KVT: Is the flu more dangerous in children than adults?
LF: It tends to be dangerous in small infants who have not been protected against it and don't have the reserves in their immune system to fend it off. Certainly, when you combine flu with an underlying disease — diabetes, asthma, pneumonia, cancer — you've really got a battle, as those patients' immune systems are often already compromised even before flu infects that child or adult. Flu also poses a risk to pregnant women, as well as people over age 65.
KVT: The nasal flu spray isn't available this year. Why not?
LF: There used to be two types of vaccines. The nasal spray contained a live strain of flu that was very tame and could help build up the body's immunity to the full-blown virus should it infect a person's body. But the strains of flu we're expecting this year are not susceptible to that type of vaccine. Therefore, everyone should get the injectable recombinant (inactivated) vaccine, which contains killed parts of the virus, not the live virus itself. Everyone who can should get a flu shot, and the sooner the better.
KVT: Why is getting a flu shot so important?
LF: Because there's no question that, even if you come down with the flu, having received the vaccine will make it a much milder case that will last days rather than weeks. If you contract a strain of the flu that's not in the vaccine, you'll still have some protection since there's overlap between the strains in the vaccine and those that aren't. Flu is a big deal! It can take parents out of work, and kids out of school, for weeks. Don't think of it as just a bad cold. It can even be life-threatening, to children and adults.
KVT: Can the vaccine itself cause adverse reactions?
LF: First of all, the flu shot made up of inactivated parts of the virus doesn't cause the flu but does help build immunity to the real virus. The most common side effects of this vaccine are mild soreness at the injection site, a low-grade fever for a day, which is rare, and maybe a mild headache, which is even rarer. We now know that even people who have an egg allergy can usually tolerate this vaccine, even though some brands of the vaccine contain small amounts of egg protein. Unless there's a strong family history of allergic reactions to the vaccine — only about one in a million people — the CDC recommends that everyone get a flu shot.
KVT: What do you tell parents who are skeptical about the vaccine's effectiveness?
LF: Some people argue that the vaccine doesn't always work. Yes, people can still contract influenza if they've received the vaccine, but it's rare. And when it occurs, data show that the flu you get will be much milder. It's also less likely to spread around the community. If you contract the flu, you will be contagious from the day before your symptoms appear until they're gone. So since you're only going to be ill for a few days rather than several weeks, you won't be as contagious if you've been vaccinated. Finally, there's no data showing that this vaccine, or other vaccines, cause autism.
KVT: If kids do contract the flu, or even a milder illness, how important is it for parents to monitor their temperature?
LF: It's unimportant to follow the temperature in a child over several months of age with the flu, but very important to look at your child at any age for their ability to breathe comfortably and stay hydrated with this illness. If your child feels warm and is irritable, you can treat the fever with acetaminophen or ibuprofen. But the absolute temperature of your child is less important than making sure your child is not getting dehydrated or short of breath due to influenza.
KVT: Anything else parents can do to prevent their kids from getting the flu?
LF: I cannot overstress the benefits of hand washing. It's not the substitute for a flu vaccine, but, combined with the vaccine, it can prevent your child from getting exposed to the flu or many other infections that can spread during the winter season. It's important to teach children how to cough or sneeze into their sleeves and not into their hands, to wash their hands before meals, after using the bathroom and after being in close contact with other children, such as during recess and gym class. All those practices will go a long way to minimizing the transmission of germs and reducing the risk that your child will get sick from flu or other infections this fall and winter.