3 Flu Vaccine Conundrums: Who Needs a Shot and When?
Who needs a flu shot and when is not always straightforward. This year it's more important than ever to know what the CDC recommends. Start with 3 short scenarios.
The overlap of influenza season with the COVID-19 pandemic this year has both medical experts and the lay public concerned.
Many are predicting a larger than usual demand for flu vaccines and the vaccine companies have increased their production in anticipation. Fortunately, no reports of production problems have been reported.
Increased demand would be welcomed--but who needs a flu shot and when is not always straightforward. Test your knowledge of ACIP recommendations with the following 3 flu vaccine conundrums.
Case #1. A medical student rotating through your office mentions that he saw somewhere that statin use interferes with influenza vaccine response. You tell him, yes, there are some studies that suggest this is true…
Which of the above is your answer to the medical student who asks about the risk of statin use interfering with flu vaccine response?
Answer: B. Statins should not be stopped. A 2016 study in the Journal of Infectious Diseases showed decreased efficacy against the H3N2 strains but not the H1N1 or the B strains. The CDC, however, does not recommend that stains be withheld before or after flu vaccine administration.
Case #2. It is October and a 12-month-old is in your office for a well-child visit and to receive: MMR, Prevnar, Hib, Varivax, and influenza. Your medical student asks:“Is it true that giving a flu shot today will increase the risk of a febrile seizure? Should we have mom bring him back in a week for the separate flu shot?” You tell him (after ducking into your office to do a little research first):
Which of the above would you choose to answer your medical student who asks: “Is it true that giving a flu shot today will increase the risk of a febrile seizure? Should we have mom bring him back in a week for the separate flu shot?”
“Is it true that giving a flu shot today will increase the risk of a febrile seizure? Should we have mom bring him back in a week for the separate flu shot?"
Answer: B. Studies have shown a small incremental risk of a febrile seizure when a flu vaccine is given with a Prevnar or DTaP vaccine on the same day vs giving them on a separate day. The CDC does not recommend deferring any of the vaccines listed in the above scenario.
Case #3. You have a child in your office on November 1st who turned 9 the week before. He did have a rapid-flu-test-positive case of the flu last year, prompting mom's decision to get him vaccinated this year. He did receive a dose of Flumist (the live attenuated nasal vaccine) 5 weeks earlier.
Which of the above do you tell the mother of a 9-year-old who tested positive for influenza last year and who has already received one dose of Flumist, 5 weeks ago?
