Misconceptions about Seasonal Flu and Flu Vaccines

Misconceptions about Flu Vaccines

Can a flu shot give you the flu?

No, a flu shot cannot cause flu illness. Flu vaccines given with a needle are currently made in two ways: the vaccine is made either with a) flu vaccine viruses that have been ‘inactivated’ and are therefore not infectious, or b) with no flu vaccine viruses at all (which is the case for recombinant influenza vaccine). The most common side effects from the influenza shot are soreness, redness, tenderness or swelling where the shot was given. Low-grade fever, headache and muscle aches also may occur.

In randomized, blinded studies, where some people get inactivated flu shots and others get salt-water shots, the only differences in symptoms was increased soreness in the arm and redness at the injection site among people who got the flu shot. There were no differences in terms of body aches, fever, cough, runny nose or sore throat.

• Carolyn Bridges et al. (2000). Effectiveness and cost-benefit of influenza vaccination of healthy working adults: A randomized controlled trial.
• Kristin Nichol et al. (1995). The effectiveness of vaccination against influenza in healthy working adults. New England Journal of Medicine. 333(14): 889-893.

Are any of the available flu vaccines recommended over the others?

Is it better to get the flu than the flu vaccine?

No. Flu can be a serious disease, particularly among young children, older adults, and people with certain chronic health conditions, such as asthma, heart disease or diabetes. Any flu infection can carry a risk of serious complications, hospitalization or death, even among otherwise healthy children and adults. Therefore, getting vaccinated is a safer choice than risking illness to obtain immune protection.

Do I really need a flu vaccine every year?

Yes. CDC recommends a yearly flu vaccine for just about everyone 6 months and older, even when the viruses the vaccine protects against have not changed from the previous season. The reason for this is that a person’s immune protection from vaccination declines over time, so an annual vaccination is needed to get the “optimal” or best protection against the flu.

Why do some people not feel well after getting the seasonal flu vaccine?

Some people report having mild reactions to flu vaccination. The most common reaction to the flu shot in adults has been soreness, redness or swelling at the spot where the shot was given. This usually lasts less than two days. This initial soreness is most likely the result of the body’s early immune response reacting to a foreign substance entering the body. Other reactions following the flu shot are usually mild and can include a low grade fever and aches. If these reactions occur, they usually begin soon after the shot and last 1-2 days. The most common reactions people have to flu vaccine are considerably less severe than the symptoms caused by actual flu illness.

What about serious reactions to flu vaccine?

Serious allergic reactions to flu vaccines are very rare. If they do occur, it is usually within a few minutes to a few hours after the vaccination. While these reactions can be life-threatening, effective treatments are available.

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What about people who get a seasonal flu vaccine and still get sick with flu symptoms?

There are several reasons why someone might get a flu symptoms, even after they have been vaccinated against flu.

1. One reason is that some people can become ill from other respiratory viruses besides flu such as rhinoviruses, which are associated with the common cold, cause symptoms similar to flu, and also spread and cause illness during the flu season. The flu vaccine only protects against influenza, not other illnesses.
2. Another explanation is that it is possible to be exposed to influenza viruses, which cause the flu, shortly before getting vaccinated or during the two-week period after vaccination that it takes the body to develop immune protection. This exposure may result in a person becoming ill with flu before protection from the vaccine takes effect.
3. A third reason why some people may experience flu like symptoms despite getting vaccinated is that they may have been exposed to a flu virus that is very different from the viruses the vaccine is designed to protect against. The ability of a flu vaccine to protect a person depends largely on the similarity or “match” between the viruses selected to make the vaccine and those spreading and causing illness. There are many different flu viruses that spread and cause illness among people. For more information, see Influenza (Flu) Viruses.
4. The final explanation for experiencing flu symptoms after vaccination is that the flu vaccine can vary in how well it works and some people who get vaccinated may still get sick.

Can vaccinating someone twice provide added immunity?

In adults, studies have not shown a benefit from getting more than one dose of vaccine during the same influenza season, even among elderly persons with weakened immune systems. Except for some children, only one dose of flu vaccine is recommended each season.

Is it true that getting a flu vaccine can make you more susceptible to other respiratory viruses?

There was one study (published in 2012) that suggested that influenza vaccination might make people more susceptible to other respiratory infections. After that study was published, many experts looked into this issue further and conducted additional studies to see if the findings could be replicated. No other studies have found this effect. For example, this article [99 KB, 5 pages] in Clinical Infectious Diseases (published in 2013). It’s not clear why this finding was detected in the one study, but the preponderance of evidence suggests that this is not a common or regular occurrence and that influenza vaccination does not, in fact, make people more susceptible to other respiratory infections.

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Misconceptions about Flu Vaccine Effectiveness

Influenza vaccine effectiveness (VE) can vary from year to year and among different age and risk groups. For more information about vaccine effectiveness, visit How Well Does the Seasonal Flu Vaccine Work. For information specific to this season, visit About the Current Flu Season.

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Misconceptions about the Timing of Seasonal Influenza Vaccination

Should I wait to get vaccinated so that my immunity lasts through the end of the season?

CDC and the Advisory Committee on Immunization Practices (ACIP) recommend that flu vaccinations begin by the end of October, if possible. However, as long as flu viruses are circulating, it is not too late to get vaccinated, even in January or later. While seasonal flu outbreaks can happen as early as October, most of the time flu activity peaks between December and February, although activity can last as late as May. Since it takes about two weeks after vaccination for antibodies to develop in the body that protect against flu virus infection, it is best that people get vaccinated in time to be protected before flu viruses begin spreading in their community. Although immunity obtained from flu vaccination can vary by person, previously published studies suggest that immunity lasts through a full flu season for most people.

There is some evidence, however, that immunity may decline more quickly in older people. For older adults, two vaccine options are available. One of these options is a “high-dose” vaccine, which is designed specifically for people 65 and older. This vaccine contains a higher dose of antigen (the part of the vaccine that prompts the body to make antibody), which is intended to create a stronger immune response in this age group. For more information, see Fluzone® High-Dose Seasonal Influenza Vaccine Questions and Answers. Another option licensed is an adjuvanted flu vaccine (FLUAD™). FLUAD™ is a trivalent vaccine made with MF59 adjuvant for use in persons aged 65 years and older. (FLUAD™ is the first adjuvanted influenza vaccine marketed in the United States.) For more information, see FLUAD™ Flu Vaccine with Adjuvant.

How long you are immune or your “duration of immunity” is discussed in the ACIP recommendations. While delaying getting of vaccine until later in the fall may lead to higher levels of immunity during winter months, this should be balanced against possible risks, such as missed opportunities to receive vaccine and difficulties associated with vaccinating a large number of people within a shorter time period.

Is it too late to get vaccinated after Thanksgiving (or the end of November)?

No. Vaccination can still be beneficial as long as flu viruses are circulating. CDC recommends that providers begin to offer flu vaccination by the end of October, if possible, but if you have not been vaccinated by Thanksgiving (or the end of November), it can still be protective to get vaccinated in December or later. Flu is unpredictable and seasons can vary. Seasonal flu disease usually peaks between December and March most years, but disease can occur as late as May.

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Misconceptions about Physician Consent for Vaccination

Do pregnant women or people with pre-existing medical conditions need special permission or written consent from their doctor to receive the flu vaccine?

No. There is no recommendation for pregnant women or people with pre-existing medical conditions to seek special permission or secure written consent from their doctor for vaccination if they get vaccinated at a worksite clinic, pharmacy or other location outside of their physician’s office. With rare exception, CDC recommends an annual flu vaccine for everyone 6 months and older, including pregnant women and people with medical conditions.

A variety of influenza vaccine products are available (Table 1). Vaccine providers should be aware of the approved age indications of the vaccine they are using and of any contraindications or precautions. Providers also should appropriately screen all people getting vaccinated for allergies to vaccine components or other contraindications. People who have previously had a severe allergic reaction to influenza vaccine or any of its ingredients should generally not be vaccinated.

There are some people who should not get a flu vaccine without first speaking with their doctor.

These include:

• People who have a moderate-to-severe illness with or without a fever (they should wait until they recover to get vaccinated), and
• People with a history of Guillain-Barré Syndrome (a severe paralytic illness, also called GBS) that occurred after receiving influenza vaccine and who are not at risk for severe illness from influenza should generally not receive vaccine. Tell your doctor if you ever had Guillain-Barré Syndrome. Your doctor will help you decide whether the vaccine is recommended for you.

Pregnant women or people with pre-existing medical conditions who get vaccinated should get the flu shot.

If a person is vaccinated by someone other than their primary health care provider, the vaccinating provider should ensure that the patient and, if possible, the patient’s medical provider have documentation of vaccination.

For a complete list of people who should not get the vaccine before speaking with their doctor, please review the influenza Vaccine Information Statement for the flu shot.

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Misconceptions about “Stomach Flu”

Is the “stomach flu” really the flu?

No. Many people use the term “stomach flu” to describe illnesses with nausea, vomiting or diarrhea. These symptoms can be caused by many different viruses, bacteria or even parasites. While vomiting, diarrhea, and being nauseous or “sick to your stomach” can sometimes be related to the flu — more commonly in children than adults — these problems are rarely the main symptoms of influenza. The flu is a respiratory disease and not a stomach or intestinal disease.

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