You want some time for it to start working, so that you can be sure that you are protected.
So while some folks talk about getting a flu vaccine too early, you do want to make sure that you get it in time to get protection before flu is active in your area. Still, it is never too late to get a flu vaccine. It is better to get a flu vaccine late in the flu season than to skip it all together.
What about younger kids getting their flu vaccine for the first time and who need 2 doses? When do they start getting protection?
“The first dose “primes” the immune system; the second dose provides immune protection.”
Study Looks at Flu Vaccine Dosing in Children
Although they likely have some protection after that first dose, the best protection will begin 10 to 14 days after their second dose.
A yearly flu vaccine is the best way to protect yourself and your family against the flu.
But why do you need to get a flu vaccine each and every year?
Why Do You Need to Get a Flu Vaccine Each Year?
Hopefully we will one day have a universal flu vaccine that covers all flu strains and offers longer lasting protection.
Most folks know we don’t have that flu vaccine yet…
“A flu vaccine is needed every season for two reasons. First, the body’s immune response from vaccination declines over time, so an annual vaccine is needed for optimal protection. Second, because flu viruses are constantly changing, the formulation of the flu vaccine is reviewed each year and updated as needed to keep up with changing flu viruses. For the best protection, everyone 6 months and older should get vaccinated annually.”
So because the protection from the flu vaccine wanes or wears off relatively quickly, even if the flu vaccine strains don’t change from one year to the next, you should get a new flu vaccine.
How long does the protection from the flu vaccine last?
“An analysis from the 2011–12 through 2013–14 seasons noted protection ranging from 54% to 67% during days 0 through 180 postvaccination.”
Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 Influenza Season
The flu vaccines takes about two weeks to become effective and should then last for at least six months – long enough to get you through the average flu season.
“A number of observational studies and a post hoc analysis from a randomized controlled trial have reported decreases in vaccine effectiveness (VE) within a single influenza season, with increasing time postvaccination. Waning effects have not been observed consistently across age groups, virus subtypes, and seasons; and observed declines in protection could be at least in part attributable to bias, unmeasured confounding, or the late season emergence of antigenic drift variants that are less well-matched to the vaccine strain. Some studies suggest this occurs to a greater degree with A(H3N2) viruses than with A(H1N1) or B viruses . This effect might also vary with recipient age; in some studies waning was more pronounced among older adults and younger children. Rates of decline in VE have also varied.”
Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 Influenza Season
That means it should last past the peak of the average flu season, which is typically between December and March.
And in most young, healthy people, the protection likely lasts even longer.
Still, there is some concern that the protection from the flu vaccine can wear off during a flu season, especially if you are very young, very old, or have chronic medical problems, and you get your flu vaccine early and you get exposed late – in April or May.
Of course, that’s not a good reason to delay getting a flu vaccine though, as waiting too long might leave you unprotected if flu peaks early, in October or November.
What to Know About Why You Need the Flu Vaccine Every Year
Since the flu vaccine strains can change and protection doesn’t last from season to season, get a flu vaccine each year. It’s the best way to protect yourself and your family against the flu.
Wearing a surgical mask is very common when people are sick and want to avoid spreading their germs to others. They are also commonly worn when people are healthy and are just afraid of getting sick.
Why Do Some Folks Wear a Mask During Flu Season?
Is that why you see some folks wearing masks during flu season?
Maybe, but some folks actually have to wear a mask during flu season.
Well, they have to because they decide they don’t want to get a flu vaccine, but still want to keep their job that could put others at risk if they got sick with the flu. So basically, it is unvaccinated health care personal and others who work around sick and vulnerable people who might have to wear a mask when they are at work.
Why don’t they just get vaccinated and protected against the flu?
That’s a good question…
Some other questions to consider as you think about flu vaccine mandates include:
Do unvaccinated health care workers pose a risk to others in the course of their jobs? Of course they do. Health care personal are at high risk to get the flu, since they are often around people who are sick with the flu, and are at higher risk to get the flu if they are unvaccinated.
Does wearing a mask protect anyone? – Yes, they actually do and recent studies have concluded that “surgical face masks worn by infected persons are potentially an effective means of limiting the spread of influenza.”
Does getting a flu shot prevent you from catching the flu? – Flu shots aren’t the most effective vaccine we have, but they are the best way to avoid catching the flu, being 10 to 60% effective since 2004.
Does getting a flu shot prevent you from spreading the flu to others? Yes, and several studies have shown lower rates of nosocomial cases among hospitalized patients as more health care personal get vaccinated!
Does getting a flu shot just cause you to have milder symptoms? The flu vaccine does has many benefits besides preventing the flu, but it is certainly not limited to just causing milder symptoms.
Does wearing a mask violate your HIPAA rights? No. Unless you announce it, no one knows why you are wearing a face mask. Maybe you have herpes or a cold or are just afraid of getting sick. And the Health Insurance Portability and Accountability Act only protects patients, not employees.
So why don’t all health care personal get a flu vaccine each year?
And while some people seem to be against the idea of mandates for health care workers getting flu shots, most think it is a great idea.
“I support this requirement. I think it is a good idea. Ethically, it makes total sense. First, every doctor, nurse, and HCW knows that they are supposed to put patient interests ahead of their own interests. Whatever you think about flu shots, it is good for patients that their healthcare providers are vaccinated against the flu, particularly among patients who cannot themselves be vaccinated, such as some of the elderly, babies, people with immune diseases, and people who just received transplants or are getting cancer treatment. Vaccination does not help them. They are all immunosuppressed.”
Art Caplan on The Law: Get a Flu Shot or Wear a Mask, Healthcare Workers!
In fact, most think that there is both an ethical and a legal rationale for flu vaccine mandates for health care workers.
“Doctors and other healthcare providers have an ethical obligation to make decisions and take actions that protect patients from preventable harm. 5 Many patients are highly vulnerable to flu, so choosing not to be vaccinated is choosing to do harm—a choice that has no place in healthcare.”
Doctors choosing not to be vaccinated is choosing to do harm
It is hard to imagine that some doctors and nurses not only skip getting vaccinated, putting others at risk, but then don’t even want to wear a mask.
For most the folks, the real question isn’t if they should get a flu shot, but when.
When Should I Get My Flu Shot?
The original flu shot recommendations were based on the fact that flu vaccine became available for distribution in September, but was not completed until December or January. And that high-risk folks should get vaccinated “to avoid missed opportunities for vaccination” if flu vaccine was available in September and they were already at a doctor’s appointment or in the hospital.
But for most people, the original recommendation was really that “the optimal time for vaccination efforts is usually during October–November.”
“Persons and institutions planning substantial organized vaccination campaigns (e.g., health departments, occupational health clinics, and community vaccinators) should consider scheduling these events after at least mid-October because the availability of vaccine in any location cannot be ensured consistently in early fall. Scheduling campaigns after mid- October will minimize the need for cancellations because vaccine is unavailable.”
Prevention and Control of Influenza Recommendations of the Advisory Committee on Immunization Practices (2006)
What was the problem with this strategy?
Early flu seasons.
And trying to vaccinate over 100 million people in such a short time.
While it might work fine if flu season doesn’t hit until January or February, waiting until mid-October could leave a lot of folks unvaccinated if you had an early flu season that was peaking in November or December.
Fortunately, we don’t have to rush to get people vaccinated so quickly anymore. For one thing, manufacturers have gotten much better at distributing flu vaccine and are able to get a lot of the doses out at the very beginning of flu season. And with more manufacturers, we are seeing fewer delays and shortages of flu vaccine than we used to.
That’s why the recommendation on the timing of flu vaccination has changed over the years.
“In general, health-care providers should begin offering vaccination soon after vaccine becomes available and if possible by October. To avoid missed opportunities for vaccination, providers should offer vaccination during routine health-care visits or during hospitalizations whenever vaccine is available.”
Prevention and Control of Influenza Recommendations of the Advisory Committee on Immunization Practices (2010)
That nice, simple message has changed yet again though.
To balance the concerns that getting a flu shot too early might leave you unprotected at the end of a late flu season, but getting a flu shot too late might leave you unprotected at the beginning of an early flu season, the latest recommendations from the CDC on the timing of flu vaccination aren’t so clear cut:
Balancing considerations regarding the unpredictability of timing of onset of the influenza season and concerns that vaccine-induced immunity might wane over the course of a season, it is recommended that vaccination should be offered by the end of October.
Community vaccination programs should balance maximizing likelihood of persistence of vaccine-induced protection through the season with avoiding missed opportunities to vaccinate or vaccinating after onset of influenza circulation occurs.
Revaccination later in the season of persons who have already been fully vaccinated is not recommended.
Vaccination should continue to be offered as long as influenza viruses are circulating and unexpired vaccine is available.
To avoid missed opportunities for vaccination, providers should offer vaccination during routine health care visits and hospitalizations.
Optimally, vaccination should occur before onset of influenza activity in the community.
Although vaccination by the end of October is recommended, vaccine administered in December or later, even if influenza activity has already begun, is likely to be beneficial in the majority of influenza seasons.
What’s the problem with these recommendations?
If everyone waits until the end of October to get vaccinated, then you might have a hard time getting a flu vaccine. And you might get stuck if you try and time your flu shot with the onset of flu activity. Unless you have a crystal ball, you don’t know when flu season is going to start.
Still, it is important to note that the CDC doesn’t actually say to wait until the end of October. They say to get vaccinated by the end of October. Getting your kids vaccinated as soon as you can is the best way to make sure that happens.
Could getting a flu shot early leave your kids unprotected at the very end of flu season?
Maybe, but that’s typically when flu activity is low. And we have that same type of low flu activity in early October, well before flu season peaks.
So just remember that your child could end up unvaccinated and unprotected if you mistime their flu vaccine.
What to Know About the Best Time to Get a Flu Vaccine
Experts say to get vaccinated by the end of October. Getting your kids vaccinated as soon as you can is the best way to make sure that happens.
encouraging your kids to not touch their eyes, nose, or mouth, or to bite their nails or put things in their mouth, like their pencil or pen
cleaning and disinfecting surfaces that your child will likely touch
encouraging others to stay home from school or work when they have the flu until they are fever free for at least 24 hours, although they might be contagious for even longer
While these techniques might not work, they are certainly better than doing nothing and simply letting your kids catch the flu.
What to Do If Your Child Is Exposed to the Flu
If your kids do anything outside the home, even if they don’t go to daycare or school, there might come a time during a long flu season when they get exposed to someone with the flu.
What do you do?
“Prevention (prophylaxis) is a term used when someone who does not have flu symptoms is given Tamiflu to help stop them from getting the flu because they are exposed to or come into close contact with someone (for example live with or take care of someone) who has the flu.”
FDA on Tamiflu: Consumer Questions and Answers
In addition to watching for classic flu symptoms to develop over the next one to four days, if your child is unvaccinated or it is a year during which the flu vaccine is not very effective, if your child is in a high risk group for severe complications from the flu (under age two to five years or any age with chronic medical problems), then you might ask your pediatrician about:
a once a day dose of Tamiflu (Oseltamivir), which is recommended as a preventative in infants as young as three months old
a once a day dose of Relenza (Zanamivir), which is recommended as a preventative in children as young as five years old, unless they have respiratory problems, like asthma
But that doesn’t mean that everyone should take these flu medicines every time they are exposed to someone with the flu. If these medicines are overused, flu viruses will develop resistance and they won’t work, just like happened to some of the older anti-viral flu medicines, amantadine and rimantadine.
Still, if your child with diabetes, uncontrolled asthma, muscular dystrophy, or healthy four month old is closely exposed to someone with the flu, then taking Tamiflu to prevent a potentially severe case of the flu is likely a good idea.
What to Do If Your Child Gets the Flu
And if your child gets the flu?
Believe it or not, most healthy school age kids with the flu don’t need to be seen by their pediatrician.
“When treatment is started within two days of becoming sick with flu symptoms, antiviral drugs can lessen symptoms and shorten the time you are sick by about one day. They may reduce the risk of complications such as ear infections in children, and pneumonia and hospitalizations in adults. For people at high risk of serious flu complications, early treatment with an antiviral drug can mean the difference between having milder illness instead of more severe illness that might require a hospital stay.”
CDC on What You Should Know About Flu Antiviral Drugs
You should see your pediatrician or other health care provider at the first sign of flu symptoms if they are at high risk for serious complications of the flu and they might benefit from Tamiflu, which includes those under two to five years old and children with any chronic medical problems.
And of course, seek medical attention if your child with the flu is showing signs of a severe case of the flu, such as trouble breathing, dehydration, or being inconsolable, etc.
You should also seek medical attention if your child with the flu was getting better, but then starts to get worse again, with a return of fever, worsening cough, or severe headache, etc.
When in doubt, call your pediatrician!
What to Know About Protecting Kids from the Flu
In addition to avoiding people who are sick with the flu, see your pediatrician as soon as possible if your younger, high risk child is gets sick after being exposed to someone with the flu.