Remember There’s Flu too!

A boy with the flu holds thermometer in his mouth.

Most pediatricians in the country are seeing more positive COVID cases in their offices due to the delta variant and the start of the new school year. With every cough, sore throat, and stuffy nose, we think Could this be COVID?

We had an unusually mild influenza season last winter, as we did with other viruses that normally rear their ugly heads in the cold. It became clear in our office at Families First and nationally that masks and social distancing work. As our kids are back in school without mask mandates, this influenza season is set up to be a rough one. Unlike COVID, we already have a tool for all of our patients over the age of 6 months to fight and promise a milder illness- the flu shot!

What is influenza?

Influenza (the flu) is a contagious respiratory illness caused by 2 different types of influenza viruses- type A and type B. Just like COVID-19, influenza viruses have caused pandemics, namely the Influenza Pandemic of 1918. The influenza season starts in the fall and continues into winter with a peak between December and February.

Influenza is often confused with ‘the stomach bug’ when we say ‘flu’. Influenza is different from what pediatricians and doctors call gastroenteritis- a term we use for vomiting and diarrhea. The ‘flu’ has many symptoms, including fever, cough, rhinitis (runny nose), headache, and myalgia (muscle aches). As you can see, many of these symptoms overlap with COVID, which will make diagnosis especially tricky this year.

Patients with influenza are the most contagious during the first 3-4 days of illness, but may transmit the virus a day before they even know they are sick, and even 5-7 days later. Children younger than 2 are considered high risk for flu-related complications, including pneumonia, dehydration, and worsening of underlying conditions. Eighty percent of pediatric flu deaths occur in children who are not fully vaccinated against influenza, underscoring the importance of flu vaccination in preventing/fighting severe infection.

What is the flu shot?

According to the CDC, all flu vaccinations will be quadrivalent this year. Quadrivalent means that there are four components; once given, your body will be protected against 4 different strains of influenza- 2 A and 2 B. There are two types of flu vaccinations: the ‘shot’, which is formulated from an inactivated virus, and the ‘mist’, which is a live attenuated (weakened) virus. Flumist is only available for children aged 2 to 49 years, whereas the flu shot is available for children aged 6 months and older. An added twist is that if you are under 8 when you receive your first flu vaccination, you need two flu vaccinations in the same year, typically given at least 1 month apart.

Can the flu vaccine give me the flu?

I am often asked, ‘Can the flu vaccine give me the flu?’ The answer is a resounding no. There are two possible scenarios that may make people think this. The first is that some people receive their flu vaccination and have an ‘immune’ response- they get fever, sore throat, headache, nausea, and fatigue. Although this mimics the symptoms of influenza, it only lasts for a few days and is very mild, unlike influenza, which will cause a higher fever and last for a week. The second is that we give the influenza shot during what pediatricians call ‘respiratory season,’ and the patient has actually acquired an entirely different virus.

Can I still get the flu if I got a flu shot?

Lastly, I am also asked- ‘can I still get influenza if I have had the influenza vaccine?’ The answer to this question is yes. Just like with COVID vaccination, we can still get influenza even after getting the influenza vaccination, but the chances of getting the illness are much lower, and the illness will be much milder.

How can we prevent influenza?

There are three actions that we can take to prevent influenza, and they are: 1. The vaccine, 2. Prevention by washing hands, staying home if ill, avoiding close contact with those who are ill, avoiding touching your eyes/nose/mouth, and covering your nose and mouth if you sneeze (a mask would do this!). 3. Certain antiviral medications (talk to your doctor for more information on this).

The influenza vaccination is typically available at the end of September, and Families First Pediatrics holds vaccine clinics for the whole family- how convenient! We will continue to give flu vaccinations throughout the whole respiratory season, but the optimal time to get your flu shot is by the end of October, so your body can build antibodies to fight Influenza in time for the season.

The good news is, if you are older than 12 and still need your COVID vaccination, we can give them together, and you no longer have to wait 14 days in between.

If there ever was a year to get the flu vaccination, this is it. Please protect yourself and your loved ones!

Tiffany Thomas, M.D.

Tiffany Thomas, M.D.

Dr Zak Zarbok performs a well-child checkup on a smiling patient

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