10/06/2014 12:53 EDT | Updated 12/06/2014 05:59 EST

What You Need to Know About Fighting the Flu

pale sick woman with a flu ...
pale sick woman with a flu ...

Flu Shot or Nasal Spray -- Which to Choose?

We can't deny that viral season is upon us. My office and emergency room is filled with children and parents with runny noses, coughs, fevers and fatigue. Many worry it's the dreaded enterovirus-68, with fear over respiratory illness requiring hospitalization. Though I am sure that many of my patients do in fact have this infection, thankfully very few are becoming ill enough to require hospital-based care.

My office and emergency room is filled with children and parents with runny noses, coughs, fevers and fatigue.

This high viral season reminds us that we should consider getting flu vaccines. Influenza has maintained a low profile so far this Fall, though no doubt it will rear it's head in the coming month or two, as it does each year. Have you forgotten H1N1 from last year?

Have you forgotten H1N1 from last year?

In North America we now have two excellent flu vaccine options, the classic flu shot, and the lesser-known flu nasal spray. Both offer similar levels of protection, but some people are better suited for one or the other option.

Who should be vaccinated against the flu?

The Centre for Disease Control (CDC) and National Advisory Committee on Immunization (NACI) recommends that everyone six months and older get immunized against the flu, unless there is a medical reason not to. Why risk getting sick if you don't have to?

Those most encouraged to get the vaccine include:

• Children age six months and up

• Adults 50 years and older

• Children on Aspirin therapy, who are at higher risk of Reye's syndrome (that can lead to liver and brain swelling) if they catch the flu

• People with lung, heart, liver and blood diseases, and those with diabetes

• Kids and adults with weakened immune systems

• People who work with those at risk (health care workers, caretakers of patients with the above conditions, teachers)

• Caregivers to young children

Here are some details to help you decide which you want to use:

The flu shot

The vaccine is given by injection into the upper arm. It is made from dead influenza virus and cannot infect you with the flu.

Side effects

Most side effects are mild and short lasting. Soreness of the arm is most typical. Mild fever and achiness is also possible.

Who can get the flu shot?

• Children and adults six months and older

Who shouldn't get the flu shot?

• Babies less than six months of age

• People who have had the illness Guillain-Barre Syndrome in the previous 6 months

• People who have had life threatening anaphylaxis to the flu shot in the past

• Egg allergy is no longer a contraindication to flu vaccine. The Canadian National Advisory Committee on Immunization (NACI) and American College of Allergy, Asthma, and Immunology say the vaccine has such a low amount of egg protein that it's unlikely to cause an allergic reaction. If you have a severe egg allergy, please discuss with your doctor.


• Most patients can get the flu shot

• It is considered safe and effective at preventing the flu


• Let's face it, it's a shot, which many kids and adults are not a fan of.

The Nasal Flu Vaccine

This vaccine is sprayed into the nose. The vaccine is 'live' though weakened and cannot cause the flu. Flu like symptoms may occur however.

Side effects

• Side effects from the nasal flu vaccine can be more severe that those from the shot.

• Runny nose, wheezing, fever, vomiting, headache, sore throat and cough are common side effects.

Who can get the nasal flu vaccine?

• Most people between 2-49 who are healthy and not pregnant

Who cannot get the nasal vaccine?

• Children less than two years of age

• Adults older than 50 years

• Pregnant women

• Anyone taking ongoing ASA therapy

• Children with heart disease, severe asthma, diabetes, and kidney disease, Guillain-Barre Syndrome or with weakened immune systems.

• Anaphylaxis to eggs or previous flu vaccine


• The nasal spray may be more palatable to some people compared to the shot

• It may be more effective at preventing the flu in kids 2-8 years of age


• There are more limitations on who can safely get this vaccine

Talk to your doctor or health care practioner about which option is best for you! For more on colds and viruses going around, check this out.


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