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home : community : bulletin board May 29, 2016

12/11/2012 3:45:00 PM
Ask Dr. Louise
Q: My husband doesn’t get a flu vaccine because he swears, “it gives me the flu.” Can the flu vaccine actually give you the flu?
Dr.Louise Achey

My husband believes this, too. His memory of "getting the flu from the flu vaccine" is from getting the "swine flu" vaccine back in 1976. Because he remembers feeling sick soon after his immunization shot, he has avoided getting vaccinated for influenza ever since.

My very first flu shot was also from the swine flu vaccine in 1976, and like my husband, I vividly remember having muscle aches, headache and fever afterward. Like him, I avoided getting a flu shot for years, until in 1990, influenza put me flat on my back in bed for two weeks. After that, I started getting the flu shot every year, and I haven't been sick like that since.

There are two types of influenza vaccine available in the United States: inactivated vaccine and live attenuated vaccine. The most common type is the inactivated flu vaccine, which is injected. It's not alive, so it cannot infect you. When injected, the dead virus triggers your immune system to make antibodies against it.

The live vaccine works by reproducing itself and multiplying until your immune system sits up and notices, then makes antibodies against it. This is just like when you are infected with it, but the live virus has been changed (attenuated) so that it doesn't cause any disease symptoms.

Flumist® is a live attenuated vaccine made of influenza virus that has been genetically modified to prevent it from reproducing in the lungs. It only replicates in the nose, mouth and upper throat. First introduced in 2003, it is approved only for people between the ages of 2 and 49.

The main types of adverse reactions to vaccines are local, systemic and allergic. The most common type of reaction is local, the area right around the spot where you received the injection. Redness, tenderness and swelling are the most common types of local reaction, and occur in half of all vaccinations.

Allergic reactions are rare, and are not always from the actual organism. Allergic symptoms can be triggered by cell culture material such as eggs, stabilizing compounds or by the preservative, thimerosol.

Systemic reactions to ANY vaccination, not just influenza, can give us fever, malaise, muscle aches, nausea, or headache, with malaise and headache the most common ones reported. Because these reactions are similar to symptoms of common viral illnesses, it's easy to confuse these vaccine side effects with a viral illness.

Another reason we can get confused is how we refer to most viral illnesses as either having "a cold" or "the flu." We say, "I've got the flu" whenever we suffer from muscle aches with headache or fever. Or we'll say, "I have stomach flu" to describe having nausea or diarrhea. We call a lot of illnesses "the flu," but infection with influenza virus is very rare outside of the winter months.

As the United States learned the hard way during the 1976 swine flu debacle, it's important to be sure that each new influenza vaccine is not just effective, but safe. The Food and Drug Administration (FDA) and Center for Disease Control and Prevention (CDC) choose which strains of influenza to use for the upcoming flu season in late February to allow enough time to do that. They need time for the drug companies to be able to grow the vaccine and then for clinical trials to measure each formulation for immunogenic response, called "immunogenicity," and its ability to cause adverse reactions, also called "reactogenicity" before approving it for use.

In 2010, clinical trials for two adult vaccines against influenza in Western Australia found that although each formulation created adequate immunity, one vaccine had significantly more muscle aches and fever reported with it than the other one. The one with the greater "reactogenicity" was not approved for use in children.

Influenza causes over 36,000 more deaths every year in the U.S., with 90 percent occurring in Americans 65 years and older. When offered a flu shot every fall, my husband has always said, "I'll take my chances." Before this year, I've let him be. But now that my beloved is 63, I'm going to ask him to reconsider.

This year, I've decided to take the CDC Flu Vaccination Pledge: "I have already received my flu vaccine but will encourage my friends and family including my dear husband to do so, for the 2012-2013 season." More information about the CDC Flu Vaccination pledge is at

It's not too late to vaccinate!

Dr. Louise Achey, Doctor of Pharmacy is a 30-year veteran of pharmacology. Your questions and comments are always welcome at

©2012 Louise Achey

Related Links:
• Dr. Louise Achey, Doctor of Pharmacy.

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