By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

READER SHOULD GET FLU SHOT, TIMING DEPENDS ON RISK GROUP

Question: Last year I wasn’t able to get a flu shot because of the vaccine shortage. As it turned out, it didn’t matter because I didn’t get the flu. How important do you think it is for me to get a flu shot this year?

Answer: I'll start by explaining a bit about influenza, commonly referred to as, simply, "flu," before I answer your question. Flu is a viral illness that occurs year-round but can become epidemic during the winter months. While there is no scientific proof, it is widely accepted that the incidence of flu peaks in the winter because we huddle together in buildings during the cold months and cough on one another. In the United States, flu is most common from October through April.

Flu is usually spread from person to person by inhaling fine droplets of moisture that contain the unwanted virus. The infected moisture droplets that spread the flu to you and me get into the air every time a flu sufferer coughs or sneezes.

The virus invades the body by attacking cells in the mucus lining of the nose, throat, and respiratory track. Once into these cells, it alters their metabolic machinery so that new virus particles are manufactured. Our body's attempts to fight these invading germs produce the typical flu symptoms of fever, runny nose, sore throat, cough and muscle aches.

This year, in order to increase supply, the government approved several new vaccine manufacturers. However, the delivery dates for vaccines and the total supply volume is still a bit uncertain. To be on the safe side, in case there is another shortage, the Centers for Disease Control is recommending that priority be given to certain high risk groups early in the flu season. These include those 65 and older, children between 6 months and 2 years of age, pregnant woman, people in long-term care facilities, physicians and other health-care workers with direct-patient contact, and those providing care to infants 6 months and younger.

Also, people between 2 and 65 years of age who have what doctors call “comorbid conditions” should receive flu vaccine now. A comorbid condition is a chronic illness, such as diabetes, asthma, emphysema, COPD and coronary artery disease, to name a few.

So whether you should get a flu shot in this “first wave” will depend on whether you fall into one of these high-risk groups. If you’re not sure, ask your family physician.

By the end of October, the government officials feel they will have a better handle on the actual supply of flu vaccine for the 2005-2006 season. Where you live determines when influenza vaccinations are given. The farther north you live, the earlier the flu shots start.

After October 24, 2005, flu shots should be made available to everyone, unless there is an unanticipated supply disruption. Unless your physician tells you otherwise, I would recommend that you get a flu shot this year. You were lucky last year. Why press your luck again?

These recommendations do not apply to the nasal spray flu vaccine -- the live, attenuated influenza vaccine (LAIV). This may be administered at any time to non-pregnant, healthy people aged 5 to 49 years. You might want to ask your doctor about this option, too.

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.