What's new with the flu?
As a doctor, I’ve certainly had my share of flu shots.
Generally it’s the same every year, you roll up your sleeve, feel a poke and it’s over.
Sometimes there’s a little muscle soreness for a day.
This year I thought I would try a new option for healthy people age 18 to 64 who are needle phobic.
It’s called the intradermal influenza vaccine and there are two things that make it different from the traditional shot.
First, and most notably, the needle is tiny. Frankly I’ve had splinters much larger than that needle. The manufacturer actually says its 90% smaller than the usual needle, I would not disagree.
Another notable element is the intradermal injection requires much less vaccine to be injected. That’s because your body reacts to the influenza vaccine more efficiently when it’s given in the skin compared to giving it in a muscle.
The benefit of the smaller amount of vaccine is significantly important in years where there might be a vaccine shortage.
If less vaccine is needed, the national supply can go farther.
The real question, what does it feel like?
I had my shot in my left upper arm and honestly I hardly noticed it going in. It felt like a bite from a biting fly. I say that because, like a biting fly, the initial discomfort is not bad but some people have delayed reactions. I am one of those people. The next morning I noticed the area was red, itchy and slightly swollen, about the size of an irregular nickel. This is not uncommon, and in studies comparing the intradermal injection to the traditional intramuscular flu shot skin reactions like mine were more frequent. Personally I’m not afraid of needles so all things being equal I’d probably just get the regular shot in the future. If you are bothered by needles though I’d say this is a great option. Just be aware it is slightly more expensive.
Another option more commonly available this year is the high dose flu vaccine approved for adults 65 and older.
It contains 4 times the amount of influenza antigen, that’s the protein that stimulates your immune system to protect you, than the traditional vaccine. Dr. Allison Weinmann, an infectious disease specialist at Henry Ford Hospital in Detroit has experience with this vaccine.
“The theory is if you give more protein the more you get a better antibody response which has been shown in studies,” says Weinmann.
But she adds, “It's sort of controversial because we don’t know whether the clinical outcomes match the antibody response. So according to her, right now the Centers for Disease Control and Prevention doesn't prefer one vaccine over the other. If you are over 65 it’s best to discuss that option with your physician."
Every year the influenza vaccine is made to specifically cover the strains experts think are most likely to affect the United States.
This year the flu vaccine contains 3 components as usual. According to Weinmann, the H1N1 component is the same one that’s been in for the last few years but there's a different influenza a and b strain this year.
I often hear from people concerned about the preservative, thimerisol. It's used in flu vaccine vials meant to be used for more than one dose. Dr Weinmann has reviewed the topic carefully and says, “There's been a lot of studies that have shown no association between thimerosol which is the preservative in multidose vials and any diseases.”
Still, she adds if you have concerns there are many thimerosol free influenza vaccine formulations available, just talk to your doctor.
The most important thing is just to get out there and get vaccinated.
This is my left arm where I had the new tiny needle flu shot (intradermal). 48 hours after it is still red with a slightly itchy raised bump. It's definitely not a bother but if you are thinking of this option you should be aware that it could happen. I'll let you know when it's gone.