“I believe I heard on the news that it is suggested that older adults receive a second flu vaccine,” wrote Marina from California. “Is that wise?”
Studies have shown that most people, including older individuals and those with specific medical conditions, would not benefit from two flu vaccines in a season. But the Centers for Disease Control and Prevention does recommend that people 65 and older should receive the higher-dose flu vaccine because they are at higher risk. High-dose vaccines have a significantly higher concentration of the virus antigen than standard doses, so they should enhance the immune system’s response.
Karen from New York works for a major medical center that requires all employees to receive the flu vaccine before the end of October. “However, it seems that flu season is peaking now in February, and I am concerned that any immunity from the vaccine is already waning,” she wrote. “My partner and I are over 60, and we both have underlying conditions, though we are active day to day. Would you please comment on employer mandates and the ability of employees to maximize protection based on age and condition?”
This is a tricky issue. Flu season often starts as early as October and can last until April and even into May. The peak is generally between December and February.
In mandating flu shots before the end of October, employers are aiming for some protection throughout flu season. Vaccine effectiveness is highest in the two to four weeks after vaccination and steadily drops in the months after. If hospitals were to change the deadline to, say, the end of November, health-care workers might enter flu season unprotected. On the other hand, if workers received the flu shot in October, they should still have partial protection in February and probably into April.
I think the best advice, especially for more vulnerable people, is to wait until mid- to late October to get the flu shot. I would not advise waiting beyond then.
Lisette from Missouri wrote to say that she and her family have not yet received the flu vaccine. “We are not anti-vax, we just lost track,” she said. “Is there any benefit to getting the vaccine now?”
Yes, there is. Flu season is not over yet. It will take a couple of weeks to develop optimal immunity, but getting the shot now can still reduce the chance of infection and complications. About 54 percent of children and 55 percent of adults are in Lisette’s family’s boat. I would highly encourage them to obtain the shot now and not delay any further.
Annie from Massachusetts wants to know if she could have had the H5N1 avian flu and not seasonal flu. “I’m 74 years old. I’ve gotten the flu at least seven times in my life, but I’ve never been as sick as I was last month,” she explained. “Could I have caught the bird flu?”
I have two questions for Annie: First, was she ill enough to be hospitalized for the flu? If so, she probably had testing there that would have distinguished between H5N1 and seasonal flu. Second, has she had direct contact with farm animals or backyard poultry? If not, it’s far more likely she had run-of-the-mill flu, given its prevalence (there have been more than 24 million infections this season) and the sporadic nature of human bird flu cases (there have been only about 70 known human cases during this outbreak).
That said, I’m still worried that the extent of bird flu spread might be far greater than reported. The CDC released a report last week that found evidence of asymptomatic infection among veterinarians who treat cows. Three out of 150 tested had antibodies to H5N1, suggesting recent infection, though none reported working with infected dairy cattle or had viral symptoms. This follows a previous CDC report documenting asymptomatic infection among farmworkers. (I’ll be reporting more on the bird flu situation soon.)
“With everyone getting the flu, my son tells me I should stop going to the pool,” wrote Anneke from Maryland. “I used to swim every day. Now, I swim twice a week and attend aqua-aerobics class twice a week. Please tell me I don’t need to stop. Water keeps me sane. I turn 87 this month.”
You can keep doing water activities while reducing your risk. For instance, you could avoid the locker room by dressing in your swimwear and wearing a swim poncho over it. You could also go during times when you don’t have to share a lane. As for your class, consider staying around the edge and as far from others as you can. And look for other ways to cut risk: Mask while in crowded public places and consider pausing some higher-risk social activities until influenza activity in your area decreases.
