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2018-11-24
Category: Prevention and Wellness
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Influenza Flu Season 2018-2019 - Frequently Asked Flu Questions

First off, who should get the flu vaccine?

Almost everyone should get the flu shot each Flu Season. The Centers for Disease Control and Prevention recommends a yearly flu vaccine for everyone 6 months of age and older as the first and most important step in protecting against influenza. Different flu shots are approved for people of different ages, but there are flu shots that are approved for use in people as young as 6 months of age and up. This includes children, pregnant women, and our senior population, especially if you have a chronic illness.

Bottom line: Your best chance of avoiding the flu this flu season is to get your flu vaccine.

You should get a flu vaccine before flu begins spreading in your community. It takes about two weeks after vaccination for antibodies that protect against flu to develop in the body, so make plans to get vaccinated early in fall, before flu season begins. CDC recommends that people get a flu vaccine by the end of October. Getting vaccinated later, however, can still be beneficial and vaccination should continue to be offered throughout flu season, even into January or later.

Children who need two doses of vaccine to be protected should start the vaccination process sooner, because the two doses must be given at least four weeks apart.


Two big things we hear every year in the flu season – the flu vaccine isn’t effective and the shot can give you the flu. Are these true?

Effectiveness rates can fluctuate from year to year based on the strain of flu that circulating. In general, the flu vaccine is about 60 percent effective. In some years, it has been up to 90 percent effective at preventing the flu.

No, the shot will not give you the flu. That is a common myth. Sometimes people experience flu-like symptoms after receiving the vaccine because they are having a reaction to the vaccine. They may experience muscle aches or fatigue for a day or two as their body produces protective antibodies to fight the flu. The flu vaccine also takes about two weeks to become effective. Some people have unlucky timing and get the flu during this time. More often than not, people catch other illnesses such as a cold, which may produce flu-like symptoms.

What else should I do to prevent catching the flu?

The single best way to prevent seasonal flu is to get vaccinated each flu season, but good health habits like washing your hands often can help stop the spread of germs and prevent illnesses like the cold and flu.

The proper way to wash your hands is to wet them with clean, running water (warm or cold) and apply soap. Lather your hands by rubbing them together. Be sure to lather the backs of your hands, between your fingers, and under your nails. Scrub your hands for at least 20 seconds. If you need a timer, hum the “Happy Birthday” song from beginning to end twice. Rinse your hands well and dry them using a clean towel or air dry them.

If soap and water are unavailable, use an alcohol-based hand sanitizer that contains at least 60 percent alcohol to clean hands.

Other good health habits include covering your cough; avoiding close contact with people who are sick; staying home when you are sick; and practicing a healthy lifestyle by getting plenty of sleep, being physically active, drinking plenty of fluids and eating nutritious food.

Where can someone get the flu shot during flu season 2018?

Our First Response Doctor on Call – General Physician can answer any questions about the flu shot and come to your home to get you and your loved ones vaccinated in the comfort of your home. For appointment call our 24 Hour Customer Service Helpline at 050 5050 387

What is Influenza (Flu)?

Flu is a contagious respiratory illness caused by influenza viruses that infect the nose, throat, and sometimes the lungs. It can cause mild to severe illness, and at times can lead to death. The best way to prevent flu is by getting a flu vaccine each flu season.

Flu Symptoms

Flu can cause mild to severe illness, and at times can lead to death. Flu is different from a cold. Flu usually comes on suddenly. People who have flu often feel some or all of these symptoms:

  • fever*
  • cough
  • sore throat
  • runny or stuffy nose
  • body aches
  • headache
  • chills
  • fatigue
  • sometimes diarrhea and vomiting

*It’s important to note that not everyone with flu will have a fever.

How Flu Spreads

Most experts believe that flu viruses spread mainly by tiny droplets made when people with flu cough, sneeze or talk. These droplets can land in the mouths or noses of people who are nearby. Less often, a person might get flu by touching a surface or object that has flu virus on it and then touching their own mouth, nose or possibly their eyes.

Period of Contagiousness

You may be able to pass on flu to someone else before you know you are sick, as well as while you are sick.

  • People with flu are most contagious in the first 3-4 days after their illness begins.
  • Some otherwise healthy adults may be able to infect others beginning 1 day before symptoms develop and up to 5 to 7 days after becoming sick.
  • Some people, especially young children and people with weakened immune systems, might be able to infect others with flu viruses for an even longer time.

Onset of Symptoms

The time from when a person is exposed and infected with flu to when symptoms begin is about 2 days, but can range from about 1 to 4 days.

Complications of Flu

Complications of flu can include bacterial pneumonia, ear infections, sinus infections and worsening of chronic medical conditions, such as congestive heart failure, asthma, or diabetes.

People at High Risk from Flu

Anyone can get flu (even healthy people), and serious problems related to flu can happen at any age, but some people are at high risk of developing serious flu-related complications if they get sick. This includes people 65 years and older, people of any age with certain chronic medical conditions (such as asthma, diabetes, or heart disease), pregnant women, and children younger than 5 years.

Preventing Seasonal Flu

The first and most important step in preventing flu is to get a flu vaccine each flu season. Flu vaccine has been shown to reduce flu related illnesses and the risk of serious flu complications that can result in hospitalization or even death. CDC also recommends everyday preventive actions (like staying away from people who are sick, covering coughs and sneezes and frequent handwashing) to help slow the spread of germs that cause respiratory (nose, throat, and lungs) illnesses, like flu.

Diagnosing Flu

It is very difficult to distinguish flu from other viral or bacterial respiratory illnesses based on symptoms alone. There are tests available to diagnose flu.

Treating Flu

There are influenza antiviral drugs that can be used to treat flu illness.

What’s new this flu season 2018-2019 ?

A few things are new this season:

  • Flu vaccines have been updated to better match circulating viruses [the B/Victoria component was changed and the influenza A(H3N2) component was updated].
  • For the 2018-2019 season, the nasal spray flu vaccine (live attenuated influenza vaccine or “LAIV”) is again a recommended option for influenza vaccination of persons for whom it is otherwise appropriate. The nasal spray is approved for use in non-pregnant individuals, 2 to 49 years old. There is a precaution against the use of LAIV for people with certain underlying medical conditions. All LAIV will be quadrivalent (four-component).
  • Most regular-dose egg-based flu shots will be quadrivalent.
  • All recombinant vaccine will be quadrivalent. (No trivalent recombinant vaccine will be available this season.)
  • Cell-grown flu vaccine will be quadrivalent. For this vaccine, the influenza A(H3N2) and both influenza B reference viruses will be cell-derived, and the influenza A(H1N1) will be egg-derived. All these reference viruses will be grown in cells to produce the components of Flucelvax.
  • No intradermal flu vaccine will be available.
  • The age recommendation for “Fluarix Quadrivalent” was changed from 3 years and older to 6 months and older after the annual recommendations were published last season to be consistent with Food and Drug Administration (FDA)-approved labeling.
  • The age recommendation for Afluria Quadrivalent was changed from 18 years and older to 5 years and older after the annual recommendations were published last season to be consistent with Food and Drug Administration (FDA)-approved labeling.
  • Baloxavir marboxil (trade name Xofluza®) is a new influenza single-dose antiviral drug approved October 24, 2018 by the Food and Drug Administration (FDA). Baloxavir is approved for the treatment of acute uncomplicated flu in people 12 years and older who have had flu symptoms for less than 48 hours. More information is available in the FDA press release.

What flu vaccines are recommended this flu season?

For the 2018-2019 flu season, providers may choose to administer any licensed, age-appropriate flu vaccine (IIV, RIV4, or LAIV4).

Options this season include:

  • Standard dose flu shots. These are given into the muscle. They are usually given with a needle, but two (Afluria and Afluria Quadrivalent) can be given to some people (those 18 to 64 years old) with a jet injector.
  • High-dose shots for older people.
  • Shots made with adjuvant for older people.
  • Live attenuated influenza vaccine (LAIV) – or the nasal spray vaccine – is also an option for use during the 2018-2019 season for persons whom it is otherwise appropriate.

What viruses will the 2018-2019 flu vaccines protect against?

There are many different flu viruses and they are constantly changing. Flu vaccines protect against the three or four viruses (depending on vaccine) that research suggests will be most common. For 2018-2019, trivalent (three-component) vaccines are recommended to contain:

  • A/Michigan/45/2015 (H1N1)pdm09-like virus
  • A/Singapore/INFIMH-16-0019/2016 A(H3N2)-like virus (updated)
  • B/Colorado/06/2017-like (Victoria lineage) virus (updated)

Quadrivalent (four-component) vaccines, which protect against a second lineage of B viruses, are recommended to contain:

  • the three recommended viruses above, plus B/Phuket/3073/2013-like (Yamagata lineage) virus

Can I get a flu vaccine if I am allergic to eggs?

The recommendations for people with egg allergies are the same as last season.

  • People who have experienced only hives after exposure to egg can get any licensed flu vaccine that is otherwise appropriate for their age and health.
  • People who have symptoms other than hives after exposure to eggs, such as angioedema, respiratory distress, lightheadedness, or recurrent emesis; or who have needed epinephrine or another emergency medical intervention, can also get any licensed flu vaccine that is otherwise appropriate for their age and health, but the vaccine should be given in a medical setting and be supervised by a health care provider who is able to recognize and manage severe allergic conditions. (Settings include hospitals, clinics, health departments, and physician offices). People with egg allergies no longer have to wait 30 minutes after receiving their vaccine.

What sort of flu season is expected this year?

It is not possible to predict what this flu season will be like. While flu spreads every year, the timing, severity, and length of the season varies from one season to another.

Will new flu viruses circulate this flu season?

Flu viruses are constantly changing so it’s not unusual for new flu viruses to appear each year.

When will flu activity begin and when will it peak?

The timing of flu is unpredictable and can vary in different parts of the country and from season to season. Seasonal flu viruses can be detected year-round; however, seasonal flu activity often begins as early as October and November and can continue to occur as late as May. Flu activity most commonly peaks in the United States between December and February.

Protective Actions

What should I do to protect myself from flu this season?

CDC recommends a yearly flu vaccine for everyone 6 months of age and older as the first and most important step in protecting against this serious disease.

In addition to getting a seasonal flu vaccine, you can take everyday preventive actions like staying away from sick people and washing your hands to reduce the spread of germs. If you are sick with flu, stay home from work or school to prevent spreading flu to others. In addition, there are prescription medications called antiviral drugs that can be used to treat influenza illness.

What should I do to protect my loved ones from flu this season?

Encourage your loved ones to get vaccinated. Vaccination is especially important for people at high risk for developing flu complications, and their close contacts. Also, if you have a loved one who is at high risk of flu complications and they develop flu symptoms, encourage them to get a medical evaluation for possible treatment with flu antiviral drugs. These drugs work best if given within 48 hours of when symptoms start. CDC recommends that people who are at high risk for serious flu complications and who get flu symptoms during flu season be treated with flu antiviral drugs as quickly as possible without waiting for confirmatory testing. People who are not at high risk for serious flu complications may also be treated with flu antiviral drugs, especially if treatment can begin within 48 hours.

Do some children require two doses of flu vaccine?

Yes. Some children 6 months through 8 years of age will require two doses of flu vaccine for adequate protection from flu. Children in this age group who are getting vaccinated for the first time will need two doses of flu vaccine, spaced at least 4 weeks apart. Children who have only received one dose in their lifetime also need two doses. Your child’s doctor or other health care professional can tell you if your child needs two doses of flu vaccine.

What can I do to protect children who are too young to get vaccinated?

Children younger than 6 months old are at high risk of serious flu complications, but are too young to get a flu vaccine. Because of this, safeguarding them from flu is especially important. If you live with or care for an infant younger than 6 months old, you should get a flu vaccine to help protect them from flu. Everyone else who is around the baby also should be vaccinated. Also, studies have shown that flu vaccination of the mother during pregnancy can protect the baby after birth from flu infection for several months.

In addition to getting vaccinated, you and your loved ones can take everyday preventive actions like staying away from sick people and washing your hands to reduce the spread of germs. If you are sick with flu, stay home from work or school to prevent spreading flu to others.

How long does a flu vaccine protect me from getting flu?

Multiple studies conducted over different seasons and across flu vaccine types and influenza virus subtypes have shown that the body’s immunity to influenza viruses (acquired either through natural infection or vaccination) declines over time. The decline in antibodies is influenced by several factors, including the antigen used in the vaccine, the age of the person being vaccinated, and the person’s general health (for example, certain chronic health conditions may have an impact on immunity). Older people and others with weakened immune systems may not generate the same amount of antibodies after vaccination; further, their antibody levels may drop more quickly when compared to young, healthy people.

Getting vaccinated each flu season provides the best protection against flu throughout flu season. It’s important to get a flu vaccine every season, even if you got vaccinated the season before and the viruses in the flu vaccine have not changed for the current season.

Can I get vaccinated and still get the flu?

Yes. It’s possible to get sick with flu even if you have been vaccinated (although you won’t know for sure unless you get a flu test). This is possible for the following reasons:

  • You may be exposed to a flu virus shortly before getting vaccinated or during the period that it takes the body to gain protection after getting vaccinated. This exposure may result in you becoming ill with flu before the vaccine begins to protect you. (Antibodies that provide protection develop in the body about 2 weeks after vaccination.)
  • You may be exposed to a flu virus that is not included in the seasonal flu vaccine. There are many different flu viruses that circulate every year. A flu vaccine is made to protect against the three or four flu viruses that research suggests will be most common.
  • Unfortunately, some people can become infected with a flu virus a flu vaccine is designed to protect against, despite getting vaccinated. Protection provided by flu vaccination can vary widely, based in part on health and age factors of the person getting vaccinated. In general, a flu vaccine works best among healthy younger adults and older children. Some older people and people with certain chronic illnesses may develop less immunity after vaccination. Flu vaccination is not a perfect tool, but it is the best way to protect against flu infection.

Flu Vaccine Effectiveness

How effective will flu vaccines be this flu season?

Influenza vaccine effectiveness (VE) can vary from season to season and among different age and risk groups and even by vaccine type. How well the vaccine works can depend in part on the match between the vaccine viruses used to produce vaccine and circulating viruses that season. It’s not possible to predict in advance what flu viruses will predominate.

Vaccine effectiveness estimates are also provided when they become available. While vaccine effectiveness can vary, recent studies show vaccine reduces the risk of flu illness by about 40% to 60% among the overall population during seasons when most circulating flu viruses are like the vaccine viruses. Similar reductions against hospitalization have been observed too.

Will this season’s flu vaccine be a good match for circulating viruses?

It’s not possible to predict with certainty if a flu vaccine will be a good match for circulating flu viruses. A flu vaccine is made to protect against the flu viruses that research and surveillance indicate will likely be most common during the season. However, experts must pick which flu viruses to include in a flu vaccine many months in advance in order for flu vaccines to be produced and delivered on time. Also flu viruses change constantly (called “drift”). They can change from one season to the next or they can even change within the course of one flu season. Another factor that can impact vaccine effectiveness, especially against influenza A(H3N2) viruses, are changes that can occur in vaccine viruses as they are grown in eggs, which is the production method for most current flu vaccines. Because of these factors, there is always the possibility of a less than optimal match between circulating flu viruses and the viruses in a flu vaccine.

Can a flu vaccine provide protection even if the flu vaccine is not a “good” match?

Yes, antibodies made in response to vaccination with one flu virus can sometimes provide protection against different but related flu viruses. A less than ideal match may result in reduced vaccine effectiveness against the flu virus that is different from what is in the flu vaccine, but it might still provide some protection against flu illness.

In addition, it’s important to remember that a flu vaccine contains three or four flu viruses (depending on the type of vaccine you receive) so that even when there is a less than ideal match or lower effectiveness against one virus, a flu vaccine may protect against the other flu viruses.

If You Get Sick

What happens in the body when someone has flu?

Influenza viruses usually infect the respiratory tract (i.e., the airways of the nose, throat and lungs). As the infection progresses, the body’s immune system responds to fight the virus. This results in inflammation that can trigger respiratory symptoms such as cough and sore throat. The immune system response can also trigger fever and cause muscle or body aches. When infected persons cough, sneeze, or talk, they can spread influenza viruses in respiratory droplets to people who are nearby. People might also get flu by touching a contaminated surface or object that has flu virus on it and then touching their own mouth or nose.

Most people who become sick will recover in a few days to less than two weeks, but some people may become more severely ill. Following flu infection, moderate complications such as secondary ear and sinus infections can occur. Pneumonia is a serious flu complication that can result from either influenza virus infection alone or from co-infection of flu virus and bacteria. Other possible serious complications triggered by flu can include inflammation of the heart (myocarditis), brain (encephalitis) or muscle (myositis, rhabdomyolysis) tissues, and multi-organ failure (for example, respiratory and kidney failure). Severe complications can happen to anyone, but may be more likely to happen to people who have certain chronic medical conditions, or in elderly persons.

What should I do if I get sick with flu?

Most people with flu have mild illness and do not need medical care or antiviral drugs. If you get sick with flu symptoms, in most cases, you should stay home and avoid contact with other people except to get medical care.

If, however, you have symptoms of flu and are at high risk of flu complications, or are very sick or concerned about your illness, contact your health care provider. There are drugs your doctor may prescribe for treating flu called antivirals. These drugs can make you better faster and may also prevent serious complications.

Antiviral drugs are prescription drugs that can be used to treat flu illness. People at high risk of serious flu complications recommended for prompt antiviral treatment include children younger than 2 years of age (although all children younger than 5 years are considered at higher risk for complications from influenza, the highest risk is for those younger than 2 years of age), adults 65 years of age and older, pregnant women, people with certain long-term medical conditions, and residents of nursing homes and other long-term care facilities). Antiviral treatment as early as possible is also recommended for people who are very sick with flu (such as those with complicated, progressive illness or people hospitalized because of flu). Other people can be treated with antivirals at their health care professional’s discretion. Treating high risk people or people who are very sick with flu with antiviral drugs is very important. Studies show that prompt treatment with antiviral drugs can prevent serious flu complications. Prompt treatment can mean the difference between having a milder illness versus very serious illness that could result in a hospital stay.

Treatment with antivirals works best when begun within 48 hours of getting sick, but can still be beneficial when given later in the course of illness. Antiviral drugs are effective across all age and risk groups. Studies show that antiviral drugs are under-prescribed for people who are at high risk of complications who get flu. Four FDA-approved antiviral medications are recommended for use during the 2018-2019 flu season: oseltamivir (available in generic versions and under the trade name Tamiflu®), zanamivir (Relenza®), peramivir (Rapivab®), and baloxavir marboxil (Xofluza®).