Can

a flu shot give you the flu? Do I really need a flu vaccine every year?
No, a flu shot cannot cause flu illness. Flu vaccines given with a needle are currently Yes. CDC recommends a yearly flu vaccine for just about everyone 6 months and
made in two ways: the vaccine is made either with a) flu vaccine viruses that have older, even when the viruses the vaccine protects against have not changed from
been inactivated and are therefore not infectious, or b) with no flu vaccine viruses the previous season. The reason for this is that a persons immune protection from
at all (which is the case for recombinant influenza vaccine). The most common side vaccination declines over time, so an annual vaccination is needed to get the
effects from the influenza shot are soreness, redness, tenderness or swelling where optimal or best protection against the flu.
the shot was given. Low-grade fever, headache and muscle aches also may occur.
In randomized, blinded studies, where some people get inactivated flu shots and Why do some people not feel well after getting the seasonal flu vaccine?
others get salt-water shots, the only differences in symptoms was increased Some people report having mild reactions to flu vaccination. The most common
soreness in the arm and redness at the injection site among people who got the flu reaction to the flu shot in adults has been soreness, redness or swelling at the spot
shot. There were no differences in terms of body aches, fever, cough, runny nose or where the shot was given. This usually lasts less than two days. This initial soreness
sore throat. is most likely the result of the bodys early immune response reacting to a foreign
substance entering the body. Other reactions following the flu shot are usually mild
Are any of the available flu vaccines recommended over the others? and can include a low grade fever and aches. If these reactions occur, they usually
For the 2017-2018 flu season, the Advisory Committee on Immunization Practices begin soon after the shot and last 1-2 days. The most common reactions people
(ACIP) recommends annual influenza vaccination for everyone 6 months and older have to flu vaccine are considerably less severe than the symptoms caused by actual
with either the inactivated influenza vaccine (IIV) or the recombinant influenza flu illness.
vaccine (RIV). The nasal spray flu vaccine (live attenuated influenza vaccine or
LAIV) should not be used during 2017-2018.There is no preference for one vaccine What about serious reactions to flu vaccine?
over another among the recommended, approved injectable influenza vaccines. Serious allergic reactions to flu vaccines are very rare. If they do occur, it is usually
There are many vaccine options to choose from, but the most important thing is for within a few minutes to a few hours after the vaccination. While these reactions can
all people 6 months and older to get a flu vaccine every year. If you have questions be life-threatening, effective treatments are available.
about which vaccine is best for you, talk to your doctor or other health care
professional. What about people who get a seasonal flu vaccine and still get sick with flu
symptoms?
Is it better to get the flu than the flu vaccine? There are several reasons why someone might get a flu symptoms, even after they
No. Flu can be a serious disease, particularly among young children, older adults, have been vaccinated against flu.
and people with certain chronic health conditions, such as asthma, heart disease or 1 One reason is that some people can become ill from other respiratory viruses
diabetes. Any flu infection can carry a risk of serious complications, hospitalization besides flu such as rhinoviruses, which are associated with the common
or death, even among otherwise healthy children and adults. Therefore, getting cold, cause symptoms similar to flu, and also spread and cause illness
vaccinated is a safer choice than risking illness to obtain immune protection. during the flu season. The flu vaccine only protects against influenza, not
other illnesses.
2 Another explanation is that it is possible to be exposed to influenza viruses,
 which cause the flu, shortly before getting vaccinated or during the two-
week period after vaccination that it takes the body to develop immune Should I wait to get vaccinated so that my immunity lasts through the
protection. This exposure may result in a person becoming ill with flu end of the season?
before protection from the vaccine takes effect. CDC and the Advisory Committee on Immunization Practices (ACIP)
3 A third reason why some people may experience flu like symptoms despite recommend that flu vaccinations begin by the end of October, if possible.
getting vaccinated is that they may have been exposed to a flu virus that is
However, as long as flu viruses are circulating, it is not too late to get
very different from the viruses the vaccine is designed to protect against.
vaccinated, even in January or later. While seasonal flu outbreaks can
The ability of a flu vaccine to protect a person depends largely on the
similarity or match between the viruses selected to make the vaccine and
happen as early as October, most of the time flu activity peaks between
those spreading and causing illness. There are many different flu viruses December and February, although activity can last as late as May. Since it
that spread and cause illness among people. For more information, see takes about two weeks after vaccination for antibodies to develop in the
Influenza (Flu) Viruses. body that protect against flu virus infection, it is best that people get
4 The final explanation for experiencing flu symptoms after vaccination is that the vaccinated in time to be protected before flu viruses begin spreading in their
flu vaccine can vary in how well it works and some people who get community. Although immunity obtained from flu vaccination can vary by
vaccinated may still get sick. person, previously published studies suggest that immunity lasts through a
full flu season for most people.
Can vaccinating someone twice provide added immunity?
In adults, studies have not shown a benefit from getting more than one dose of
How the Flu Virus Can Change: Drift and Shift
vaccine during the same influenza season, even among elderly persons with
Influenza viruses are constantly changing. They can change in two different
weakened immune systems. Except for some children, only one dose of flu vaccine
is recommended each season.
ways.
One way they change is called antigenic drift. These are small changes in
Is it true that getting a flu vaccine can make you more susceptible to other the genes of influenza viruses that happen continually over time as the virus
respiratory viruses? replicates. These small genetic changes usually produce viruses that are
There was one study (published in 2012) that suggested that influenza vaccination pretty closely related to one another, which can be illustrated by their
might make people more susceptible to other respiratory infections. After that location close together on a phylogenetic tree. Viruses that are closely
study was published, many experts looked into this issue further and conducted related to each other usually share the same antigenic properties and an
additional studies to see if the findings could be replicated. No other studies have immune system exposed to an similar virus will usually recognize it and
found this effect. For example, this article [99 KB, 5 pages] in Clinical Infectious respond. (This is sometimes called cross-protection.)
Diseases (published in 2013). Its not clear why this finding was detected in the one
But these small genetic changes can accumulate over time and result in
study, but the preponderance of evidence suggests that this is not a common or
viruses that are antigenically different (further away on the phylogenetic
regular occurrence and that influenza vaccination does not, in fact, make people
more susceptible to other respiratory infections.
tree). When this happens, the bodys immune system may not recognize
those viruses.
 persons aged 18 through 64 years.
This process works as follows: a person infected with a particular flu virus A high-dose trivalent shot, approved for people 65 and older.
develops antibody against that virus. As antigenic changes accumulate, the A recombinant trivalent shot that is egg-free, approved for people 18 years
antibodies created against the older viruses no longer recognize the newer and older, including pregnant women.
virus, and the person can get sick again. Genetic changes that result in a virus A trivalent flu shot made with adjuvant (an ingredient of a vaccine that
with different antigenic properties is the main reason why people can get the helps create a stronger immune response in the patients body),
flu more than one time. This is also why the flu vaccine composition must be approved for people 65 years of age and older (new this season).
reviewed each year, and updated as needed to keep up with evolving viruses.
Quadrivalent flu vaccines include:
The other type of change is called antigenic shift. Antigenic shift is an 5 Quadrivalent flu shots approved for use in different age groups, including
abrupt, major change in the influenza A viruses, resulting in new children as young as 6 months.
hemagglutinin and/or new hemagglutinin and neuraminidase proteins in 6 An intradermal quadrivalent flu shot, which is injected into the skin
influenza viruses that infect humans. Shift results in a new influenza A instead of the muscle and uses a much smaller needle than the
subtype or a virus with a hemagglutinin or a hemagglutinin and regular flu shot. It is approved for people 18 through 64 years of age.
neuraminidase combination that has emerged from an animal population 7 A quadrivalent flu shot containing virus grown in cell culture, which is
that is so different from the same subtype in humans that most people do approved for people 4 years of age and older.
not have immunity to the new (e.g. novel) virus. Such a shift occurred in A recombinant quadrivalent flu shot approved for people 18 years of age and
the spring of 2009, when an H1N1 virus with a new combination of genes older, including pregnant women (new this season).
emerged to infect people and quickly spread, causing a pandemic. When shift
happens, most people have little or no protection against the new virus.
While influenza viruses are changing by antigenic drift all the time, antigenic What is the difference between a cold and the flu?
shift happens only occasionally. Type A viruses undergo both kinds of The flu and the common cold are both respiratory illnesses but they are
changes; influenza type B viruses change only by the more gradual process caused by different viruses. Because these two types of illnesses have similar
of antigenic drift. symptoms, it can be difficult to tell the difference between them based on
symptoms alone. In general, the flu is worse than the common cold, and
Trivalent flu vaccines include: symptoms are more common and intense. Colds are usually milder than the
Standard-dose trivalent shots (IIV3) that are manufactured using virus flu. People with colds are more likely to have a runny or stuffy nose. Colds
grown in eggs. Different flu shots are approved for different age generally do not result in serious health problems, such as pneumonia,
groups. Most flu shots are given in the arm (muscle) with a needle. bacterial infections, or hospitalizations. Flu can have very serious associated
One trivalent vaccine formulation can be given with a jet injector, for complications.
 Can humans be infected with swine influenza viruses?
How can you tell the difference between a cold and the flu? Yes. Swine flu viruses do not normally infect humans, however, sporadic
Because colds and flu share many symptoms, it can be difficult (or even human infections with influenza viruses that normally infect swine have
impossible) to tell the difference between them based on symptoms alone. occurred. When this happens, these viruses are called variant viruses. Most
Special tests that usually must be done within the first few days of illness can commonly, human infections with variant viruses have occurred in people
tell if a person has the flu. exposed to infected pigs (e.g., children near pigs at a fair or workers in the
swine industry). In addition, there have been documented cases of multiple
What are the symptoms of the flu versus the symptoms of a cold? persons becoming sick after exposure to one or more sick pigs. Also, cases of
The symptoms of flu can include fever or feeling feverish/chills, cough, sore limited person-to-person spread of variant viruses have occurred.
throat, runny or stuffy nose, muscle or body aches, headaches and fatigue
(tiredness). Cold symptoms are usually milder than the symptoms of flu.
People with colds are more likely to have a runny or stuffy nose. Colds
generally do not result in serious health problems.

Why are human infections with variant viruses of concern?
Influenza viruses that infect pigs may be different from human influenza
viruses. Thus, influenza vaccines made against human influenza viruses are
generally not expected to protect people from influenza viruses that
normally circulate in pigs. In addition, because pigs are susceptible to avian,
human and swine influenza viruses, they potentially may be infected with
influenza viruses from different species (e.g., ducks and humans) at the same
time. If this happens, it is possible for the genes of these viruses to mix and
create a new virus. This type of major change in the influenza A viruses is
known as antigenic shift. If this new virus causes illness in people and can be
transmitted easily from person-to-person, an influenza pandemic can occur.
This is what happened in 2009 when an influenza A H1N1 virus with swine,
avian and human genes emerged in the spring of 2009 and caused the first
pandemic in more than 40 years.