Flu & pneumonia shots

A recent study from the University of Minnesota has garnered significant media attention regarding the efficacy of the flu vaccine. Aurora Health Care and other health experts agree on the most important findings of this study:

• The flu shot is our best defense against the seasonal flu for individuals and our communities.
• The health care and research communities need to continue researching for more effective antigens to fight the seasonal flu.

This study does not change the fact that the CDC says as many as 49,000 Americans die from the seasonal flu each year. To lower the flu's death toll, a flu shot is the most effective step to protect ourselves and our loved ones from this disease.

- Bruce Van Cleave, M.D., chief medical officer, Aurora Health Care

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Common Questions and Answers

Why is it important to get a flu shot?

In the United States, More than 36,000 deaths and 200,000 hospitalizations are caused by the flu each year. Influenza (flu) is a serious disease that can cause:

• Fever
• Cough
• Chills
• Sore throat
• Headache
• Muscle aches

What is the difference between a cold and the flu? See chart*

The flu and the common cold are both respiratory illnesses, but they are caused by different viruses. Because these two types of illnesses have similar flu-like symptoms, it can be difficult to tell the difference between them based on symptoms alone. In general, the flu is worse than the common cold, and symptoms such as fever, body aches, extreme tiredness, and dry cough are more common and intense. Colds are usually milder than the flu. People with colds are more likely to have a runny or stuffy nose. Colds generally do not result in serious health problems, such as pneumonia, bacterial infections, or hospitalizations.

How long can flu viruses live on hard surfaces such as door knobs, telephones, etc.?

For 2 - 8 hours.

How does the flu spread?

It usually spreads from person to person in respiratory droplets when people who are infected cough or sneeze. People occasionally may become infected by touching something with influenza virus on it and then touching their mouth, nose, or eyes. Healthy adults may be able to infect others 1 day before getting symptoms and up to 5 days after getting sick. Therefore, it is possible to give somone the flu before you know you are sick as well as while you are sick.

When is the best time to get a flu shot?

We advise getting flu shots as early as possible so you have full immunity before the regular flu season arrives. It takes about two weeks for the flu shot to help you develop immunity.

When is the normal flu season in Wisconsin?

The peak for flu is usually January. We usually see the first flu cases sometime in November or December, and the season runs through March.

Who should get the flu shot?

Annual flu vaccination is now recommended every year for every one over 6 months of age. While everyone should get a flu vaccination each flu season, it's especially important that the following groups get vaccinated either because they are at high risk of having serious flu-related complications or because they live with or care for people at high risk for developing flu-related complications:

• Anyone age 50 or older
• All children
• Pregnant women
• Anyone with long-term health problems
• Residents of nursing homes and other chronic-care facilities
• People who live with or care for those at high risk for complications from flu, including:
  • Healthcare workers
  • Household contacts and caregivers of people 50 years and older or anyone with medical conditions that put them at higher risk for severe complications from influenza
  • Household contacts and out of home caregivers of children less than 6 months of age (these children are too young to be vaccinated)

Why do people need to be vaccinated every year?

Flu strains change from year to year, so it is necessary to be vaccinated annually. The CDC tracks which flu strains are causing illness all year long and includes the strains in the vaccine that they think will be most common in the upcoming year.

Can you get the flu from the flu shot?

No, that's a myth. All the viruses in the vaccine have been killed, so people cannot get the flu from a flu shot.

What do you say to people who say, "I never get sick so I don't need to get a flu shot"?

Getting a flu shot not only protects you, but if you live with or know anyone who has asthma, diabetes or any other chronic illness, getting a flu shot helps to prevent the spread of influenza to them.

What about the nasal-spray flu vaccine we've heard about?

FluMist is a needle-free flu vaccine - a gentle nasal mist delivered into the nose, where the flu virus usually enters the body. Just a quick spray in each nostril. FluMist is a live weakened influenza virus vaccine. It is approved for healthy individuals between the ages of 2 and 49. Pregnant women should get the traditional flu shot or a thimerosal free flu shot - not FluMist.

Are there any things people can do to avoid the flu?

• Get a flu shot every year
• Eat a healthy, well-balanced diet
• Drink plenty of liquids and get plenty of sleep
• If you are sick, stay home to avoid passing anything on to others
• Cover your nose and mouth when you cough and sneeze
• Cough or sneeze into the crook of your arm rather than your hand
• Wash your hands frequently, especially after blowing your nose or coughing or sneezing. Discard used tissue immediately into the garbage can.

We know not as many people as we would like get immunized. What can people do if they get the flu?

If you get the flu, get plenty of rest, drink a lot of liquids, and avoid using alcohol and tobacco. Also, you can take medications such as acetaminophen (e.g., Tylenol®) to relieve the fever and muscle aches associated with the flu. Never give aspirin to children or teenagers who have flu-like symptoms, particularly fever.

Who should get a pneumonia shot?

(Pneumococcal Polysaccharide, Pneumovax, 23-Valent, PPSV)

• All adults 65 years of age or older.
• Anyone age 18 through 64 with any of the following conditions:
  1. Cigarette smoker
  2. Chronic cardiovascular disease (i.e. CAD, CHF, cardiomyopathy)
  3. Chronic pulmonary disease (i.e. COPD, emphysema OR asthma)
  4. Diabetes, alcoholism, chronic liver disease (cirrhosis) or cerebrospinal fluid leaks
  5. Functional or anatomic asplenia (i.e. sickle cell, splenectomy)
  6. Immunocompromising conditions (i.e. HIV, congenital immunodeficiency, hematologic and solid tumors)
  7. Immunosuppressive therapy (i.e. radiation therapy, long-term corticosteroids)
  8. Organ or bone marrow transplantation
  9. Chronic renal failure or nephrotic syndrome
  10. Candidate for or recipient of cochlear implant

Who should get a second (and final) dose of PPSV?

Anyone who 5 or more years have elapsed since the previous dose and the patient meets one of the following criteria:

1. ANY patient 65 and older who received PPSV vaccination before age 65
2. Patient is at highest risk of pneumococcal infection (categories 5 through 9 above)

Is it a Cold, Flu or Pertussis?

Colds, flu and Pertussis are highly contagious and, in the initial stages, might seem alike.
Check the following table for a comparison of the symptoms for each illness.

Rapid Reference: Flu versus Cold versus Pertussis
(source: City of Milwaukee Health Department)

Symptom		Influenza (Flu)	Cold (Viral URI)	Pertussis
Fever		Usually present & high (102-104°F or 39-40°C); typically lasts 3-4 days	Uncommon	Uncommon If present, typically low-grade
Headache		Very common	Uncommon	Uncommon
Aches and pains, muscle aches, chest discomfort		Common, Often severe	Slight to Moderate	Uncommon
Fatigue and weakness		Moderate - severe; can last up to 14-21 days	Mild	Mild to moderate
Extreme exhaustion		Very common early in illness	Extremely Rare	Rare
Stuffy or runny nose		Sometimes	Common	Common, early in the disease
Sneezing		Sometimes	Common	Common, early in the disease
Sore throat		Sometimes	Common	Uncommon
C O U G H	Character	Non-productive ("dry") cough is typical; nocturnal cough rare	Hacking cough, often productive; nocturnal cough rare; usually responds to cough medications	Variable character; fits / paroxysms and nocturnal cough are common; generally not responsive to cough medications
	Severity	Moderate	Mild to Moderate	Variable; can be mild in adults and very severe in infants and young children
	Duration	Typically 3-7 days; occasionally to 14 days	Typically 3-7 days	Persistent cough, almost always > 1week, usually 2-6 weeks, sometimes 10+ weeks
	Paroxysms	Uncommon	Rare	Common
Infectious Period		1-2 d before symptom onset to 5-10 days after	Variable; typically 4-7 days after symptom onset; can be longer	From start of catarrhal phase (before cough) to 21 days after cough onset*

*or until taking 5 days of appropriate anti-pertussis antibiotics, or until a nasopharyngeal pertussis PCR is negative, whichever occurs first