When flu vaccination season comes each year, do you get vaccinated?

Here’s why I’m asking. Before coming to Daily Health News, I was a medical writer and editor who developed information for doctors to keep them in the know. One of my specialties was infectious diseases. Because I read nearly every relevant new study, attended medical meetings and was constantly interacting with the field’s experts, I prided myself on being at least as informed as doctors on this topic. I had several friends who also thought they were better informed than doctors, but not because they studied the latest medical research. They had read lots of blog posts and chat-room comments about vaccines—and they were convinced that vaccines are ineffective at best, poisonous at worst and intended only to make big money for the medical establishment. Discussing the science relating to vaccination with them was a no-win situation for me. They were invested in their beliefs (as was I).

I was and still am a strong advocate of vaccination for most people—whether it be for the mumps and measles, hepatitis or the seasonal flu. With flu season upon us again, I find myself telling friends and family who are on the fence about getting vaccinated that they should just do it. It could save their lives, considering that, depending on the season, 3,000 to 49,000 Americans die each year because of the flu.

What’s your take on flu shots? Are you dutiful about it, or do you take your chances and tough it out? Is it all about you, or do you consider the impact of viral illnesses and vaccination on the world at large? Are you afraid that you’ll have a serious adverse reaction to the vaccine? Let’s flesh out these concerns about the flu and the vaccine and see who should and who shouldn’t get vaccinated…


To hear the latest take from the aforementioned “establishment,” I called Fiona Havers, MD, a medical epidemiologist at the National Center for Immunization and Respiratory Diseases at the Centers for Disease Control and Prevention (CDC) in Atlanta.

“Commonly held misconceptions, according to research from the CDC, are that the vaccine is not safe, has dangerous side effects and gives you the flu,” she said. “Other people believe that the vaccine doesn’t work or that an annual flu shot is just not necessary,” she added.

So, are those all actually “misconceptions,” as Dr. Havers asserts?

The truth is, serious allergic reactions to flu vaccine can occur—but the truth also is that these reactions are extremely rare. What causes these rare reactions is not always known. The cause can be an allergic reaction to a preservative added to the vaccine to extend its shelf life, an antibiotic added to inhibit bacterial contamination or the material (eggs for most flu vaccines) that the virus for the vaccine is grown in. To help prevent severe allergic reactions, doctors are trained to examine and question patients to decide whether they may react badly to the vaccine and to have antidotes on hand should a bad reaction occur.

Another truth: Despite what many people think, an association between an uncommon neurologic disease called Guillain-Barré syndrome and currently available flu vaccines is unlikely. In Guillain-Barré syndrome, the immune system attacks the neuromuscular system, causing muscle weakness. The syndrome tends to develop after a person has had a respiratory infection or the flu. Most people recover, but some can have permanent nerve damage or even die, usually from breathing difficulties.

Although a bona-fide association was seen between Guillain-Barré syndrome and the swine flu vaccine of 1976, scientists are now questioning whether a link exists beyond that one year’s vaccine. The latest research shows that a person is 17 times more likely to acquire Guillain-Barré syndrome after having the flu than after getting the flu vaccine.

As for whether the flu vaccine can give you the flu, the evidence strongly says no. Although it’s true that people who get vaccinated can still get the flu—no one ever claimed that the vaccine is 100% effective—it isn’t the vaccine that makes these people sick. Their immune systems might not be strong enough (even after vaccination) to fight off a flu virus they become exposed to—in which case they come down with a milder version of the flu than they would otherwise. Or else they may become infected with a flu strain that differs from that in the vaccine they received. With the introduction of a quadrivalent vaccine (which protects against four different flu strains) and a new high-dose trivalent vaccine (which packs stronger protection against three different flu strains), getting the flu after vaccination is becoming less and less likely.

Yes, you might have a sore arm after getting the flu shot, but what is that compared with days or weeks of being sick and possibly being hospitalized if you catch the flu?

As for fears about mercury-laced vaccines, most currently available vaccines either do not contain the mercury-containing preservative thimerosal or are available in two versions—one with and one without thimerosal.

The amount of thimerosal used in vaccines has been proved to be safe in people of all ages—including people with thimerosal allergies, who are simply more likely to have a sore arm after vaccination. Despite what many people think (and despite many heartbreaking personal anecdotes from parents whose children are autistic), there is no scientific evidence of a correlation between thimerosal in vaccines and autism or any health problem besides injection-site soreness. In any case, thimerosal-free vaccines have been made available to ease public concerns. You can request one from your doctor.

Because a shot in the arm might be traumatic, a nasal-spray vaccine, called FluMist, is also available, but it’s not for everyone. You have to be healthy, not pregnant, have no respiratory problems (or allergies) and be between two and 49 years old. It’s particularly effective in children and is mainly being made for them, Dr. Havers told me. Eligibility is limited to the very healthy, young, and allergy-free because FluMist is the last-standing activated flu vaccine out there. Activated vaccines are made from live virus strains and are associated with more side effects—both mild (sore arms and mild, short-term flu-like symptoms) and severe (allergy-associated anaphylaxis, with estimated incidence of one in 500,000 vaccinations)—than inactivated vaccines.


Dr. Havers and the CDC recommend that virtually everyone older than six months get the flu vaccine. Still, if you’ve had a bad allergic response to the flu vaccine in the past, discuss with your doctor whether any of the current vaccines would be safe for you—or if you need to avoid the vaccine altogether.

Also, because nearly all flu vaccines contain a small amount of egg as an ingredient, people with egg allergies need to proceed with caution when it comes to flu vaccines. They can’t just walk into a local pharmacy for any free flu shot—but they may be able to be safely vaccinated depending on the severity of the allergy. Vaccination is, therefore, something that a person with an egg allergy needs to carefully discuss with his or her physician.

There is good news for some people with egg allergies, though. An egg-free vaccine called Flublok was recently approved by the FDA for people with egg allergies who are between the ages of 18 and 49. If you have an egg allergy, this is the vaccine to ask your doctor about. If it is right for you, the doctor may have it on hand or may have to order it for you.

Finally, what if you come down with bronchitis or a “stomach flu” (which is usually not caused by the seasonal flu but another cause) just when you’ve decided to run out to get your flu shot? You should postpone getting vaccinated until you feel better. “People who are moderately or severely ill, with or without fever, should wait until they recover before getting the flu vaccine,” said Dr. Havers, adding that mild illness, such as a mild head cold or sore throat, is not a deterrent to vaccination.

Many different types of flu vaccines are now available. You can view a list of those approved for this year’s flu season at the CDC website.The list includes information on precautions and whether and how much mercury and egg are in each vaccine.

If you are on the fence about getting a flu shot because of safety concerns about mercury content in a vaccine, an egg allergy or other personal medical condition or anything else, my suggestion is that you print out the CDC list and talk to your doctor about which flu vaccine is best for you.