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Flu shot and flu treatment FAQs

Consumer Reports News: October 31, 2007 01:03 PM

Three years ago a flu-vaccine shortage kept many people from getting the shots. Now you’re more likely to be confused by the multiple vaccine options available, including the nasal spray recently approved even for use in toddlers, and which drugs to take if you do come down with the flu. Possible health concerns have added to the uncertainty. Here’s our advice.

Who should get vaccinated?
All adults should get a flu shot every year, especially if they’re age 50 or older, live in a long-term-care facility, are pregnant, have weakened immunity or a chronic illness, or live with or care for people in any of those groups.

Should I get the shot or the newer nasal spray?
Most people, including kids, should opt for the shot. It works as well as the spray (FluMist) and costs less. Moreover, the spray is not approved for children under age 2 or adults over 49, and its live vaccine poses unacceptable risks to pregnant women and people with weakened immunity. But consider the spray if you’re overweight, since excess fat can make it hard for the needle to reach the necessary depth, or if excessive fear of shots keeps you from getting vaccinated.

Are mercury-free shots better?
There is no convincing evidence linking the mercury-containing preservative thimerosal with autism or other health problems, though research continues. If you’re concerned, ask for a preservative-free vaccine, such as Fluzone. What about the risk of Guillain-Barré syndrome? Roughly one out of every 1 million people vaccinated may develop that neurological disorder. But the shot’s protection against illness, hospitalization, and death far outweighs the risk. Still, if you’ve had Guillain-Barré syndrome, avoid the spray vaccine and discuss with your doctor whether to get a shot.

Does it matter when you are vaccinated?
Try to get your shot by December, when the flu virus usually arrives. But the disease can peak as late as April or May, so even a January shot can help.Don’t get vaccinated while you have a moderate or severe fever, and don’t take the nasalspray vaccine if you have a cold.

What should I do if I already have the flu?
Over-the-counter pain relievers can ease the fever, chills,muscle aches, sore throat, and other symptoms associated with the flu. And if your doctor diagnoses the illness within two days of the onset of symptoms, the antiviral drugs oseltamivir (Tamiflu) and zanamivir (Relenza) can shorten its duration and possibly prevent complications.

Should I keep a supply of antiviral drugs on hand?
No. Stockpiling depletes the antiviral supply that health officials count on in case of a pandemic, and encourages needless use. Experts worry that excessive antiviral use may fuel the emergence of drug-resistant flu strains, much as the misuse of antibiotics leads to antibiotic-resistant bacteria. Research suggests that up to 18 percent of children treated with oseltamivir now harbor drug-resistant variants. And a 2006 study found that certain resistant flu strains could be passed from person to person, something researchers had considered unlikely. So get a prescription for antivirals only when you have the flu, and take the full course, since stopping early can allow germs to survive and adapt.


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