Certain flu vaccines are not recommended for all ages

It is time for your 2013-2014 flu vaccine.  However, do take your doctor’s advice before vaccination. Certain flu vaccines are not recommended for all ages. For example, CDC recommends that one brand of inactivated flu vaccine called Affluria, should not be given to children 8 years of age or younger. A related vaccine was related with fever and fever – related seizures in young children in Australia. More about side effects below.  Young children who get inactivated flu vaccine and pneumococcal vaccine (PCV13) at the same time may be at increased risk for seizures caused by fever. Ask your doctor for more information. Tell your doctor if a child who is getting flu vaccine has ever had a seizure. You may also read “Why am I feeling fatigued after taking the flu vaccine?”

Avoid Pain Reliever with Flu Vaccine
Although your first reaction would be to take a fever or pain reliever along with the flu vaccine – you may want to avoid this action. Common pain relievers dilute the effect of the vaccine. Click here to read the views of the University of Rocherster Medical Center. Quote

“What we’ve been saying all along, and continue to stress, is that it’s probably not a good idea to take common, over-the-counter pain relievers for minor discomfort associated with vaccination,” Phipps said. “We have studied this question using virus particles, live virus, and different kinds of pain relievers, in human blood samples and in mice — and all of our research shows that pain relievers interfere with the effect of the vaccine.”

Unquote.

Egg and/or latex allergy?
What if you have an egg and/or latex allergy? Consult your doctor. The answer is in this previous article.  However, there is a major update for individuals with egg allergy waiting to be vaccinated – Flublok.  In 2013, FDA has approved Flublok, for 18-49 year old, which is not developed in eggs but in insects. Hence, Flublok may be suitable for adults (but not children, teens and seniors) with egg and/or latex allergy.  Traditionally, the flu vaccine has been developed in eggs.  To learn more you may read a previous article, “Tracking the history of the development of the flu vaccine”, by clicking here.  The ability to develop the flu vaccine in insects instead of eggs is heralded as a boon to egg allergic individuals.  However, since it has been newly introduced in 2013, it remains to be clinically tested in individuals other than adults and hence, is not yet FDA approved in children, teens and seniors, since their immune system is different than a typical healthy adult.

A Flu Virus

Please, discuss with your doctor.  It is highly recommended to take the flu vaccine to avoid hospitalization and other secondary complications from a flu infection.  It is highly contagious.  Certain age groups are more susceptible than others.  The Centers of Disease Control of USA reports a total of 12,343 hospitalizations that occurred from October 1, 2012 through April 30, 2013, which translates to a cumulative rate of 44.3 influenza-associated hospitalizations per 100,000 people in the United States. The total number of influenza-associated pediatric deaths reported to CDC for 2012-2013 was 146 in USA. While the vast majority of the tested virus samples (>99%) showed susceptibility to the antiviral drugs oseltamivir and zanamivir, some varieties showed resistance. Watch an animated video of how the flu virus enters, and multiplies inside the human body.

Why do I feel fatigued after my flu vaccine?
The vaccine composition is changed every year. The WHO meets twice a year to discuss the varieties of flu strains causing flu infections and hopes to include the most “popular” strains in the flu vaccine composition (see below for for the 2013-2014 composition). However, the vaccine can accomodate a maximum of three to four flu strains. There might be a new flu strain that emerges later in the year. There might be a fifth or sixth flu strain also causing infections. The flu vaccine assists an individual in easing the “suffering from symptom” period. Therefore, a person who has the vaccine can still get the flu from a flu strain not included in the vaccine but the symptoms will be weaker. This is because the flu strains differ from each other very slightly and most of their characteristic proteins are included in the vaccine, hence “teaching” the body’s immune system to be ready to fight the flu infection.

There can be a slight fever and other side effects (see below) after the flu vaccine.  The symptoms would start right away and last 2 to 3 days. This might happen if the flu vaccine composition includes one or more flu strains that were not included in the previous year’s vaccine composition. If the individual has never been exposed to 1 or more of the flu strains in the vaccine, the immune system might react with symptoms like the flu. It is the immune system getting ready. The individual does not get flu from the inactivated flu vaccine and the live flu vaccine is too weakened to cause the flu. You may also read “Why am I feeling fatigued after taking the flu vaccine?”

Related Articles:
The compostion of the 2013 – 2014 trivalent and quadrivalent flu vaccine for the Northern Hemisphere
Tracking the seasonal flu, The History of the Flu Vaccine and The Flu Vaccine of 2011

Now is the time for your 2013 – 2014 flu vaccine

The 2013- 2014 flu season is here for the Northern Hemisphere. Los Angeles has reported it’s first flu case early September (Click here). New York city residents are surprised that flu season has already arrived and reaching people before their scheduled flu vaccination date. The first Los Angeles case is an H1N1 which is in this year’s flu vaccine combination to protect those vaccinated this season. The New York city strain has yet to be reported.  Fortunately, the flu vaccine of 2013 – 2014 has either three flu strains (trivalent) or the newly introduced four flu strains (quadrivalent) described more in detail below.  If you live in the Northern Hemisphere, you might want to begin flu vaccination plans much earlier this flu season, since the flu has already arrived atleast in two major USA cities and it is only early September. However, in Australia and countries of the Southern Hemisphere, the peak of the 2012 – 2013 flu season is expected to have just ended in August 2013, since the seasons are opposite.

This is what the flu virus looks like

Why should you take the flu vaccine?
The reason one has to take the vaccine every year is because the vaccine only provides immunity for about a year. Unlike the natural infection which gives you lifetime immunity, a flu vaccine does not. Even if in certain years the vaccine flu strain composition is exactly the same as in the previous year. The individual is  advised to take the flu vaccine annually. The answer is explained in detail in this previous article.

However, do take your doctor’s advice before vaccination. Certain flu vaccines are not recommended for all ages. For example, CDC recommends that one brand of inactivated flu vaccine called Affluria, should not be given to children 8 years of age or younger. A related vaccine was related with fever and fever – related seizures in young children in Australia. More about side effects below.  Young children who get inactivated flu vaccine and pneumococcal vaccine (PCV13) at the same time may be at increased risk for seizures caused by fever. Ask your doctor for more information. Tell your doctor if a child who is getting flu vaccine has ever had a seizure.addition,

Egg and/or latex allergy?
What if you have an egg and/or latex allergy? Consult your doctor. The answer is in this previous article.  However, there is a major update for individuals with egg allergy waiting to be vaccinated – Flublok.  In 2013, FDA has approved Flublok, for 18-49 year old, which is not developed in eggs but in insects. Hence, Flublok may be suitable for adults (but not children, teens and seniors) with egg and/or latex allergy.  Traditionally, the flu vaccine has been developed in eggs.  To learn more you may read a previous article, “Tracking the history of the development of the flu vaccine”, by clicking here.  The ability to develop the flu vaccine in insects instead of eggs is heralded as a boon to egg allergic individuals.  However, since it has been newly introduced in 2013, it remains to be clinically tested in individuals other than adults and hence, is not yet FDA approved in children, teens and seniors, since their immune system is different than a typical healthy adult.

Please, discuss with your doctor.  It is highly recommended to take the flu vaccine to avoid hospitalization and other secondary complications from a flu infection.  It is highly contagious.  Certain age groups are more susceptible than others.  The Centers of Disease Control of USA reports a total of 12,343 hospitalizations that occurred from October 1, 2012 through April 30, 2013, which translates to a cumulative rate of 44.3 influenza-associated hospitalizations per 100,000 people in the United States. The total number of influenza-associated pediatric deaths reported to CDC for 2012-2013 was 146 in USA. While the vast majority of the tested virus samples (>99%) showed susceptibility to the antiviral drugs oseltamivir and zanamivir, some varieties showed resistance. Watch an animated video of how the flu virus enters, and multiplies inside the human body.

Why do I feel fatigued after my flu vaccine?
The vaccine composition is changed every year. The WHO meets twice a year to discuss the varieties of flu strains causing flu infections and hopes to include the most “popular” strains in the flu vaccine composition (see below for for the 2013-2014 composition). However, the vaccine can accomodate a maximum of three to four flu strains. There might be a new flu strain that emerges later in the year. There might be a fifth or sixth flu strain also causing infections. The flu vaccine assists an individual in easing the “suffering from symptom” period. Therefore, a person who has the vaccine can still get the flu from a flu strain not included in the vaccine but the symptoms will be weaker. This is because the flu strains differ from each other very slightly and most of their characteristic proteins are included in the vaccine, hence “teaching” the body’s immune system to be ready to fight the flu infection.

There can be a slight fever and other side effects (see below) after the flu vaccine.  The symptoms would start right away and last 2 to 3 days. This might happen if the flu vaccine composition includes one or more flu strains that were not included in the previous year’s vaccine composition. If the individual has never been exposed to 1 or more of the flu strains in the vaccine, the immune system might react with symptoms like the flu. It is the immune system getting ready. The individual does not get flu from the inactivated flu vaccine and the live flu vaccine is too weakened to cause the flu. You may also read “Why am I feeling fatigued after taking the flu vaccine?”

The New Quadrivalent Flu Vaccine: Until recently, the vaccine compositions have only had three different kinds (trivalent) of circulating flu varieties. This year, the vaccine choices include those with four different kinds (quadrivalent) of circulating flu varieties, approved by the WHO (see quote below). Do be aware of your vaccine choices in 2013 to 2014 – trivalent or quadrivalent and discuss with your care provider. The FDA approved companies in 2013 manufacturing the new quadrivalent flu vaccine are:

1) GlaxoSmithKline – Fluarix
2) AstraZeneca – MedImmune
3) Sanofi Aventis – Fluzone approved in June 2013 for children 6 months or older, adolescents and adults.

One method of delivery of Flu Vaccine

One method of delivery of flu vaccine

The 2013-2014 Influenza/Flu virus compostion
The compostion of the 2013 – 2014 trivalent and quadrivalent flu vaccine for the Northern Hemisphere:

The World Health Organization has met in Geneva Switzerland in February 2013 to decide upon the composition of the Influenza or flu vaccine composition of the upcoming 2013-2014 flu season. Read more.

Influenza/flu vaccine Adverse Effects

The CDC site has the following safety information. In addition to including three to four different flu varieties in the vaccine composition (trivalent or quadrivalent), the flu vaccine may be either inactivated or live. If inactivated, it can never cause the flu because it does not contain a live virus. However, inactivated flu vaccine could be associated with Guillain-Barré Syndrome (GBS), no more than 1 or 2 cases per million people. If the flu vaccine is live, it is made from a weakened virus and does not cause flu. Both may cause allergic reactions in less than one in million doses. Quote
Influenza (inactivated) vaccine side-effects
What are the risks from inactivated influenza vaccine?

With a vaccine, like any medicine, there is a chance of side effects. These are usually mild and go away on their own.

Serious side effects are also possible, but are very rare. Inactivated flu vaccine does not contain live flu virus, so getting flu from this vaccine is not possible.

Brief fainting spells and related symptoms (such as jerking movements) can happen after any medical procedure, including vaccination. Sitting or lying down for about 15 minutes after a vaccination can help prevent fainting and injuries caused by falls. Tell your doctor if you feel dizzy or light-headed, or have vision changes or ringing in the ears.

Mild Problems

soreness, redness, or swelling where the shot was given
hoarseness; sore, red or itchy eyes; cough
fever
aches
headache
itching
fatigue
If these problems occur, they usually begin soon after the shot and last 1 or 2 days.

Moderate Problems

Young children who get inactivated flu vaccine and pneumococcal vaccine (PCV13) at the same time may be at increased risk for seizures caused by fever. Ask your doctor for more information. Tell your doctor if a child who is getting flu vaccine has ever had a seizure.

Severe Problems

A severe allergic reaction could occur after any vaccine (estimated less than 1 in a million doses).
There is a small possibility that inactivated flu vaccine could be associated with Guillain-Barré Syndrome (GBS), no more than 1 or 2 cases per million people vaccinated. This is much lower than the risk of severe complications from flu, which can be prevented by flu vaccine.
The safety of vaccines is always being monitored. For more information, visit: Vaccine Safety Monitoring and Vaccine Safety Activities.

One brand of inactivated flu vaccine, called Afluria, should not be given to children 8 years of age or younger, except in special circumstances. A related vaccine was associated with fevers and fever-related seizures in young children in Australia. Your doctor can give you more information.

This information was taken directly from the Inactivated Influenza VIS
(This information taken from Inactivated Influenza VIS dated 7/26/2013. If the actual VIS is more recent than this date, the information on this page needs to be updated.)

Influenza (live) vaccine side-effects
What are the risks from LAIV?

With a vaccine, like any medicine, there is a chance of side effects. These are usually mild and go away on their own.

Serious side effects are also possible, but are very rare. LAIV is made from weakened virus and does not cause flu.

Mild Problems
Some children and adolescents 2-17 years of age have reported:

runny nose, nasal congestion or cough
fever
headache and muscle aches
wheezing
abdominal pain or occasional vomiting or diarrhea
Some adults 18-49 years of age have reported:

runny nose or nasal congestion
sore throat
cough, chills, tiredness/weakness
headache
Severe Problems

A severe allergic reaction could occur after any vaccine (estimated less than 1 in a million doses).

The safety of vaccines is always being monitored. For more information, visit: Vaccine Safety Monitoring and Vaccine Safety Activities.

This information was taken directly from the LAIV VIS
(This information taken from Live Influenza VIS dated 7/2/12. If the actual VIS is more recent than this date, the information on this page needs to be updated.)

 

The WHO headquarters in Geneva, Switzerland

A meeting in action at the WHO headquarters in Geneva, Switzerland

World Health Organization (WHO) headquartered in Geneva, Switzerland recommends the flu vaccine composition each year for the Northern Hemisphere and the Southern Hemisphere.

Related Article:
Review by Anne Sealey: A Cruel Wind: Pandemic Flu in America, 1918-1920; Author Dorothy A. Pettit and Janice Bailie (Timberlane Books, 2008): The book has an excellent chapter on the biological detail of the flu virus, a historical narrative of the 1918 pandemic, and an intimate portrait of political life and social environment during the pandemic. It includes plenty of charts for statistical support.

The compostion of the 2013 – 2014 trivalent and quadrivalent flu vaccine for the Northern Hemisphere

The compostion of the 2013 – 2014 trivalent and quadrivalent flu vaccine for the Northern Hemisphere:

The World Health Organization has met in Geneva Switzerland in February 2013 to decide upon the composition of the Influenza or flu vaccine composition of the upcoming 2013-2014 flu season. A quote from their decision is below:
quote

Recommended composition of influenza virus vaccines for use in the 2013-14 northern hemisphere influenza season

21 February 2013
It is recommended that trivalent vaccines contain the following:

an A/California/7/2009 (H1N1)pdm09-like virusa;
an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011b*;
a B/Massachusetts/2/2012-like virus.

It is recommended that quadrivalent vaccines containing two influenza B viruses contain the above three viruses and a B/Brisbane/60/2008-like virusc.

a A/Christchurch/16/2010 is an A/California/7/2009-like virus;
b A/Texas/50/2012 is an A(H3N2) virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011;
c B/Brisbane/33/2008 is a B/Brisbane/60/2008-like virus.

* It is recommended that A/Texas/50/2012 is used as the A(H3N2) vaccine component because of antigenic changes in earlier A/Victoria/361/2011-like vaccine viruses (such as IVR-165) resulting from adaptation to propagation in eggs.

For more information

Recommended composition of influenza virus vaccines for use in the 2013-14 influenza season – full report
pdf, 229kb

Unquote
You may also want to read our follow up article, “Now is the time for your 2013 – 2014 flu vaccine“.

The Flu Virus

The 2013-2014 flu vaccine composition differs from the 2012-2013 and from the 2011-2012 flu vaccine composition. See below.

The Northern Hemisphere’s 2012-2013 seasonal influenza vaccine be made from the following three vaccine viruses:

• an A/California/7/2009 (H1N1)pdm09-like virus;
• an A/Victoria/361/2011 (H3N2)-like virus;
• a B/Wisconsin/1/2010-like virus (from the B/Yamagata lineage of viruses).

While the H1N1 virus used to make the 2012-2013 flu vaccine is the same virus that was included in the 2011-2012 vaccine, the recommended influenza H3N2 and B vaccine viruses are different from those in the 2011-2012 influenza vaccine for the Northern Hemisphere.

The Northern Hemisphere’s 2011-2012 seasonal influenza vaccine contain the following three flu viruses:

• an A/California/7/2009 (H1N1)-like virus;
• an A/Perth/16/2009 (H3N2)-like virus;
• a B/Brisbane/60/2008-like virus.

Related Articles:
Now is the time for the 2013-2014 flu vaccine
The History of the Flu Vaccine Development
Flu vaccine and Egg Allergy
The world’s top influenza (Flu) research laboratories decided to institute a self-imposed moratorium
Why am I feeling fatigued after the flu vaccine?

Should my baby get the flu vaccine?

The CDC says that infants younger than 6 months cannot get the flu vaccine. In this case, the role of the caregiver is important and hence, they must remain healthy and may wish to follow the CDC recommendations on precautions and advie for caregivers of children younger than 2 years old below. An excerpt:
Children Younger Than 6 Months at Higher Risk

Children younger than 6 months are at higher risk of serious flu complications, but are too young to get a flu vaccine. Because children younger than 6 months cannot get a vaccine, but are at high risk for serious flu-related complications, safeguarding them from influenza is especially important. This fact sheet provides advice to help caregivers (for example, parents, teachers, babysitters, nannies) protect children younger than 6 months from the flu.

Unquote.

For information on Egg free vaccines you may wish to click here.

CDC advice for caregivers of children below 2 years of age:
1. Take time to get the flu vaccine
2. Take everyday preventive steps – washing your hands often, covering mouth, keep baby 6 feet away from sick people, keep hands (and germs) away from face
3. Talk to doctor about antiviral drugs: which are most effective in first two days of illness

The CDC advises ensuring the infants cold or flu does not progress into pneumonia. Actively seek out advice on how to prevent flu from progressing into pneumonia.

Here is a study by pediatricians that shows that most babies begin to get sick with flu after they are 6 months old.  The mother’s ability to fight the flu virus is transmitted to the child while pregnant and does offer the new born to six month child a healthier start to life. However, a third of the new borns under six months did get the flu in this study. The Centers of Disease Control of USA (CDC) recommends that all infants above 6 months be vaccinated annually against the flu. You may click here to read the CDC recommendation on December 2012.

You may want to discuss with your pediatrician if your child is more than six months old. Maternal immunity transferred to the infant may postpone the need to immunize the infant. However, since two – thirds of the infants over 6 months in this 1997 study did get the flu, the discussion with the pediatrician becomes important. Also, the infant is getting a number of other immunizations and the expert discussion will allow you to avoid an unnecessary vaccine.

If the flu season is particularly harsh like in early 2013, then it might be advisable to not delay the discussion on immunizing your child over 6 months of age. The CDC does not recommend getting a child under 6 months getting the flu vaccine.

To read the scientific research article entitled “Influenza virus infections in infants” published in the Pediatric Infection Disease Journal click you may want to click here. It was published in 1997 but the results still apply.

The authors of this study are:
GLEZEN, W. PAUL MD; TABER, LARRY H. MD; FRANK, ARTHUR L. MD*; GRUBER, WILLIAM C. MD†; PIEDRA, PEDRO A. MD

Prevent the fluids from collecting in the ear and causing a ear infection.

Related Article
History of the flu vaccine
Egg free vaccine

Should I get the flu vaccine this year?

Although, the 2011-2012 combination in the flu vaccine, is the same as the 2010-2011, an effective way you can protect yourself against a flu virus infection is through vaccination.

The Flu Virus

However, current vaccination approaches rely on achieving a good match between circulating flu virus strains and the isolates included in the vaccine formulation.  The recommendation is made by the World Health Organization  collaborating centers. Such a match is often difficult due to a combination of factors, one being that the recommendations are made six months prior to the initiation of the flu season, and the flu viruses are constantly undergoing change.

What if the formulation of the vaccine this year is the same as the previous year? The US Centers for Disease Control (CDC) advice that for optimal protection it is safest to get vaccinated against the flu every year. The CDC recommends all people above six months get vaccinated annually; especially the young and the elderly and gives information specific to the 2011-2012 season, including the vaccine formulation, which is exactly the same as the 2010-2011 combination, but is different from the 2009-2010 and earlier combinations. Some non-vaccinated people got quite ill and weak for a very long time in the fall of 2009 from what could have been the H1N1 flu. The vaccinated people apparently were protected or only had mild flu-like symptoms and lost little productive time.

Get vaccinated annually: A Boston.com article by a Globe staff, Deborah Kotz, gives a simple explanation why one needs to get immunized annually in spite of the same combination of strains in the vaccine. If you are naturally infected by the flu virus, your body can retain that immune memory for a life-time. On the other hand, when you are vaccinated by the same flu virus, your body’s immune memory becomes weaker over time, and we do not know currently whether you will have an appropriate immune response if infected next year.

According the CDC, certain people should get advice on whether they should get vaccinated; especially those with egg allergy or latex allergy.

If you have an egg allergy:

A Scientist Cultivating the Flu vaccine in Live Eggs - A labor intensive effort

When you have to make a decision about getting a flu vaccine, which is the vaccine currently grown only in egg in most countries, then you should seriously consider medical supervision because you may have options. They are rather limited in the USA versus Europe and I have detailed current strategies in a previous article on flu vaccination and egg allergy.  The options in Europe are quite different from those currently available in the USA. You may also read “Next generation of flu vaccines coming of age: Cell – based technology may replace egg – based flu vaccines“, by Teddi Dineley Johnson.

What is the combination in the 2011-2012 flu Vaccine? There is an international effort to create that single, life-time flu vaccine, but until then the vaccine combination will need to be reassessed every year. The 2011-2012 combination in the flu vaccine, which is the same as the 2010-2011,  is:

A/Cal/7/2009 (H1N1) – like

A/Perth/16/2009 (H3N2) – like

B/Brisbane/60/2008 – like antigens

If you have a latex allergy: There is both the traditional injection version and a new, intradermal version vaccine available this year.  If you have a latex allergy you may want to take advice and choose a latex free version. The package insert says that the dermal version prefilled syringe tip caps (Fluzone) may contain natural rubber latex to which you may have an allergic reaction if you are allergic to latex. The intradermal version is specially designed to not hurt at all, unlike a needle in the arm version, which many find painful. Either way, your choice of vaccination this year will have the same combination of flu virus.

Flu vaccination and egg allergy

I worked in a flu lab for a year and was part of the team trying to understand the genetic nature of the flu virus. How did it change it’s genetic makeup so quickly each year so that we needed to update our flu vaccination annually? Little did I expect to have to deal with questions on what to do about egg allergy. You see, until recently, all flu vaccines were prepared in eggs. Now, there are some brands available that are not made in eggs. Should a child or adult with egg allergy try to brave the flu season naturally or should they protect themselves by taking a vaccine, until recently only made in eggs?

A flu virus

The Flu photo (from CDC archives http://www.cdc.gov/h1n1flu/images.htm) which shows the external H and N proteins that change to require new vaccine every year and the internal, coiled RNA genetic material.

If you have never had the flu, chances are you may never get the flu. You may want to get expert advice on whether you need any protection at all. If you or your child has gotten the flu in the past, chances are that you and/or your child will get the flu again, and it may be best to get advice from an allergist on the safest vaccination options if egg allergy is an issue. There is an excellent article in the British Medical Journal in 2009 by Lajeunesse and colleagues on egg allergy and flu vaccines. You may also want to see my article on “Should I get the flu vaccine this year?” for the 2011-2012 flu season.

Egg free vaccines have recently been researched and produced using a new technique in a mammalian cell line instead of eggs. Surface antigen, split virion, subunit, split flu, and inactivated flu vaccines are grown in hens’ eggs and do contain residual egg proteins. During the 2008 flu season, some but not all flu vaccines reported maximum egg protein content above 1.2 ug/ml with levels up to 2ug/ml. The proposed safety egg content is less than 1.2ug/ml (0.6ug per dose). Some vaccines often have much less residual egg protein, although still grown in egg cultures, such as virosomal vaccines, which are highly purified.

The youngest and the oldest are most at risk from succumbing to the flu. Certain elderly are recommended a much higher dose of flu vaccine to be effectively protected. It is important to note that egg-free mammalian culture based flu vaccines are now available or under clinical trials and should be given preferentially under expert advise to individuals allergic to egg. If an egg-free vaccine is unavailable, then check the maximum egg content of the vaccine and ensure that it is below 1.2ug/ml. The vaccination should be done in a center experienced in management of anaphylaxis if the doctor advises so. A single dose protocol is effective for individuals with less severe allergy. A 2 dose split protocol is recommended for asthma prone or anaphylaxis prone individuals.

In USA, flu vaccines developed in egg-free manufacture protocols are unavailable. So, if you are allergic to eggs, do visit an allergist. They have a protocol with which they could administer the vaccine. The steps include pricking your arm with egg extracts to elicit an allergy response from which they determine the pros and cons of giving you the vaccine. In Europe, Flugen is under clinical trial and showing promise. Celvapran (Baxter) a pandemic vaccine for A/H1N1 and Optiflu (Novartis) a seasonal flu vaccine have good safety records for egg allergy. You may also read “Next generation of flu vaccines coming of age: Cell – based technology may replace egg – based flu vaccines“, by Teddi Dineley Johnson

It is predicted that the H1N1 will return in 2010 fall around the same time as it did in 2009. The spring flu may have been displaced by the fall flu. If so, then it may be a race against time to vaccinate our kids safely and effectively before the fall H1N1 flu season descends upon us. Take advise, be cautious, and make a wise decision. If you had the H1N1 flu last year, then you may have a level of natural immunity to this year’s H1N1 flu virus. You may not need a vaccine for this flu variety, however, a vaccine would give you a quicker defense response on exposure (booster). This flu season the vaccine includes protection against additional A and B flu varieties called a trivalent protection. This vaccine gives you protection hopefully until next September, unless new flu strains develop before that. There is a race to produce a ‘life time’ flu vaccine targeting proteins of the flu virus that do not usually change every year. Then, one vaccine would give us life time protection. Until then, we have to consider the flu vaccine annually to protect us against the crafty new flu virus strain. I have full confidence in our global flu scientists and believe they can outwit the wily flu virus.

As for eating naturally to prevent the flu, there are oranges, providing vitamin C, there is garlic reputed to keep a family save through many recipes and always ginger, against inflammation. Gargling with salt daily in flu season is very helpful.

This article has been cited by ALLVoices, which covers health news and other news in San Francisco.