Flu Information You Need to Know
Flu FAQ. Learn the basics, including who should get the flu shot and when to seek medical attention for sickness.

Who should get a flu shot?
The Centers for Disease Control and Prevention (CDC) recommends routine influenza vaccination for all people ages 6 months and older. This year’s vaccine actually offers three vaccines in one to cover what is anticipated this flu season, A/H1N1 (pandemic) influenza, and two other influenza viruses — Influenza A/H3N2 and Influenza B.

What is different this year regarding the flu shot?
This year's flu shot will immunize you from A/H1N1 (pandemic) influenza, and two other influenza viruses — Influenza A/H3N2 and Influenza B.

Who can get this year’s flu shot?
Everyone 6 months of age and older except:

• People who have a severe allergy to eggs
• People who have had a severe reaction to an influenza vaccination in the past
• People who developed Guillian-Barré syndrome (GBS) within 6 weeks of getting an influenza vaccine previously
• Children younger than 6 months of age

Do I need to get any other flu shots this year?
No, this year’s flu shot will immunize you from A/H1N1 (pandemic) influenza, and two other influenza viruses — Influenza A/H3N2 and Influenza B.

Last year there was a lot of focus on children and pregnant women getting the H1N1 vaccine — is that the same this year?
The flu shot is recommended for everyone over the age of 6 months. Everyone is encouraged to receive the vaccination because it is the best way to avoid getting the flu.

Is it safe for pregnant women to receive this year’s vaccine?
Yes. It is especially important that pregnant women get vaccinated. They are at a high risk of having serious flu-related complications.

Are there any priority groups of people who should get the vaccine?
No, but there are people who are considered high risk and should get the vaccine this year, including

• Pregnant women
• Children 6 months and older
• People 50 years of age or older
• People of any age with certain chronic medical conditions
• People who live in a nursing home or any other long-term care facilities
• Health care workers
• It is strongly recommended that everyone get the flu shot because it is the best way to avoid getting the flu.

Why are there three vaccines in one this year?
The viruses used in making seasonal flu vaccines are chosen each year based on information collected over the previous year about which influenza viruses are spreading and what vaccine viruses would offer the best protection against circulating viruses.

What causes the flu?
Influenza (the flu) is a respiratory infection caused by the influenza virus.

When does flu season start?
People usually get influenza in winter. However, the flu season is variable. Some areas of the world have influenza all year round. In the northern hemisphere, it can start as early as October and last through May. It’s good to keep this in mind when you are traveling internationally too. The flu season usually peaks in February. It’s always best to get the flu shot early.

What is the difference between the flu and a cold?
Many symptoms of a cold and the flu are similar. Both the common cold and the flu are caused by viruses and are respiratory illnesses. It is often hard to tell the difference. Symptoms such as a runny or stuffy nose are more common with a cold.

However, symptoms of the flu are often worse and can hit suddenly, causing a person to become weaker. Symptoms such as fever, body aches, fatigue, and a dry cough are more common with the flu. The dry cough and fatigue from the flu can last two to three weeks.

It should be noted that there is no such thing as the ‘stomach flu.’ Nausea, vomiting and diarrhea can be seen with the flu or related to the flu (most particularly in children), but it is not a main symptom of the flu. Again, cold and flu are respiratory illnesses, not intestinal illnesses.

How do I know if I have the flu?
The flu occurs most often during the winter and easily spreads from person to person. Most people who get the flu feel sick for a week or two and then recover. The symptoms of the flu include:

• Runny or stuffy nose
• Sore throat
• Body aches
• Headache
• Temperature above 100°F
• Dry cough, which can last two or more weeks
• Nausea, vomiting, and diarrhea, although these are more common in children than adults

How long do flu symptoms last?
Most people who get the flu feel sick for a week or two and recover, with the fever going down within two to three days. However, sometimes the flu can lead to infections that are more serious.

When should I call my doctor?
You can check in with your doctor when you first get the flu. Your doctor may prescribe medications to help relieve some of your flu symptoms and/or lessen the duration of the flu. These medications must be taken very early on to be effective. However, it is very important to make an appointment if you are at high risk for flu complications or have a chronic illness, such as heart disease or asthma.

Also, if any of the following warning signs exist, seek immediate medical attention:

For children:

• Trouble breathing
• Blue/gray color to the skin
• Flu symptoms that go away and then return
• High fever and excessive coughing
• Excessive vomiting
• Little or no drinking
• Listlessness
• Irritability

For adults:

• Trouble breathing
• Excessive vomiting
• Pain in the chest or abdomen
• Dizziness and/or confusion
• Flu symptoms that go away and return
• High fever and excessive coughing

Are there any questions I should ask the doctor during my visit?
If you are a parent, you may want to ask the doctor:

1. What over-the-counter medications will help my child?
2. What are the side effects of medications (prescription or over-the-counter) my child will have to take?
3. What warning signs would require a return visit? (This may include an extremely high fever, symptoms that do not get better within a certain period, and new symptoms that come on suddenly.)
4. Do I need to change my child’s diet?
5. How will I know if any complications have developed?
6. For an adult, questions might include information on any prescription medications and side effects, how long to wait if symptoms do not seem to be getting better, and when to call or return to the office if necessary.

How long will I be contagious?
This depends on your age and health. When you are exposed to the flu virus, it can take from one to four days before you may ‘feel’ sick and start having symptoms. Adults are contagious up to one day before symptoms appear and up to five days after. For children, it is up to seven days. In other words, you can spread the flu virus before you even know that you are sick.

How can I stay healthy?

• Cover your cough/sneeze
• Wash your hands often or use hand sanitizer
• Avoid touching eyes, nose, or mouth after coughing/sneezing
• If you’re sick, stay home
• If you have flu-like symptoms and visited areas where influenza cases have been confirmed, or if you’ve been exposed to someone with influenza, contact your doctor

How is influenza treated?
Some strains of influenza are susceptible to antiviral drugs. The CDC currently recommends the use of the antiviral drugs oseltamivir or zanamivir for the treatment and/or prevention of influenza infection. Use of these drugs should be prioritized for hospitalized patients and those patients who are at greatest risk for complications of influenza.

Antiviral drugs may lessen severity or shorten duration of illness and must be started within 24 hours of symptoms. They may also prevent serious flu complications.

What can I do to reduce the length of the flu?
If you are seriously ill, your healthcare provider might order an antiviral drug for you. If taken within 48 hours of the beginning of the flu, they can make you feel better more quickly. Otherwise, you should rest and drink plenty of fluids. You might also want to take over-the-counter medications to help symptoms such as muscle aches or sneezing.

When can my child go back to school, and when can I go back to work?
You should wait 24 hours after your temperature has gone down, or your child’s temperature has returned to normal levels without medicine before going back to work or sending your child back to school. If coughing and sneezing persist, make sure you cover your mouth and nose, and wash your hands frequently or use hand sanitizer.

Can people die from the flu?
Most people who become ill from the flu do not die, but infection with the influenza virus can lead to death. Severe and even fatal complications from the flu — such as pneumonia — are more likely for people with chronic diseases (including asthma, diabetes, and heart disease). In addition, the conditions themselves might worsen during a bout with the flu.

I’ve heard about a higher-strength flu shot. Who should have that?
Fluzone High-Dose is approved for use in people 65 years of age and older. As with all flu vaccines, Fluzone High-Dose is not recommended for people with a severe allergy to chicken eggs, or people who have had a severe reaction to a flu vaccine in the past. Visit the CDC’s Questions & Answers: Fluzone High–Dose Seasonal Influenza Vaccine site for more information.

Fluzone High-Dose vaccine is a flu shot, made up of the 3 flu strains most likely to cause illness for a particular flu season. Fluzone High-Dose vaccines contain 4 times the amount of active ingredients contained in regular flu shots. The higher dose vaccine is intended to create a stronger immune response in the person getting the vaccine.

Human immune defenses become weaker with age, which places older people at greater risk of severe illness from influenza. Also, aging decreases the body’s ability to have a good immune response after getting influenza vaccine. A higher dose of antigen in the vaccine is supposed to give older people a better immune response and therefore better protection against flu.

Does the other vaccine protect those 65 and older or do we have to get this version?
Yes, the other vaccine does protect those 65 and older. This version is another option that has been made available, which has a higher concentration. But again, those who are 65 years or older are protected by the regular flu vaccine being offered this year.

Why are there two versions of the flu vaccine available for those 65 and older?
Our understanding is that it was created as another option to offer those aged 65 and older with a stronger concentration to fend off flu but this will likely need to be studied over several flu seasons to make a conclusion. The regular flu vaccine will also protect those 65 and older from the flu.

Is one better than the other?
We understand the Fluzone High-Dose vaccines contain 4 times the amount of active ingredients contained in regular flu shots. The higher dose vaccine is intended to create a stronger immune response in a person getting the vaccine.

It is being offered by the government because as people age their immune defenses become weaker, placing older people at greater risk of severe illness from influenza. A higher dose of antigen in the vaccine is supposed to give older people a better immune response and therefore better protection against flu.

But again, it’s important to know the regular flu vaccine will protect people ages 65 and older from the flu.

What can be done to protect children from flu complications and death?
Vaccination remains the best method for preventing flu and its potentially severe complications in children. September through November is the best time to get vaccinated, but getting vaccinated in December or even later can still be beneficial, since most flu activity occurs in January or later in most years. Though it varies, the flu season can last as late as May and sporadic cases of flu occur year round.

Children 6 months of age and older should be vaccinated. Children younger than 6 months of age are at high risk of influenza complications, but are too young to get a flu vaccine. The best way to protect these children is to vaccinate their household members and out-of-home caregivers.

How many doses of this year’s vaccine does my child need?
Children receiving flu vaccine for the first time need to receive two doses their first year, with the first dose ideally given in September. For inactivated vaccine (the flu shot), the second dose is given four or more weeks after the first dose. The flu shot is approved for children 6 months of age and older.

For live, attenuated flu vaccine (nasal spray vaccine), the second dose can be administered four or more weeks after the first dose. The nasal spray vaccine is approved for healthy children 5 years of age and older.

Children with asthma or other conditions should get the flu shot instead of the nasal spray.

What if my child got the flu shot and the H1N1 vaccine last year — what do they need to get this year?
Flu viruses change from year to year, which means two things. First, you can get the flu more than once during your lifetime. The immunity doesn't always provide protection when a new strain is circulating. Second, a vaccine to protect against flu viruses circulating last year may not protect against the newer viruses. That is why the influenza vaccine is updated to include current viruses every year.

Another reason to get flu vaccine every year is that after you get vaccinated your immunity declines over time and may be too low to provide protection after a year.

What if my child has never had a flu shot?
Parents of children between the ages of 6 months and 8 years should consult with their pediatrician about what flu vaccinations their child should receive. Children 9 and older should receive the seasonal flu vaccination.

What if my child received the season flu vaccine last year, but not the H1N1 vaccine — how many doses will they need?
All children 6 months through 8 years of age are recommended to receive 2 doses of 2010-11 flu vaccine unless they have received:

• At least 1 dose of 2009 H1N1 vaccine last flu season, and
• At least 1 dose of seasonal vaccine prior to the 2009-2010 flu season or 2 doses of seasonal flu vaccine last flu season.
  

For more information, visit clevelandclinic.org/flu