Facts About Influenza (Flu) and Flu Vaccine - Special Considerations for the HIV Positive Person

When encouraging patients to receive the flu vaccinevirus isnot capable of causing illness), which causes
everyfall, I always find it amazing that so manythe body torespond by developing antibodies to
people havemisconceptions about the flu and the fluprotect against the flu.
shot. If I were toask a group of patients what theIt is this response that causes common side effects
flu is, I would get manydifferent answers, includingof thevaccine, such as a slight fever, chills, headache,
descriptions of symptoms of aviral gastrointestinalandfatigue, for the first 24 hours after the vaccine is
syndrome (nausea, vomiting,diarrhea), a sinusgiven.
infection, the common cold, or of trueinfluenza (flu)Remember, this is not the flu.
infection.Some people should not be vaccinated; they include:
Influenza (referred to as flu in this article) is apeoplewith a severe allergy to eggs, people who
seriousand extremely contagious viral respiratoryhave had a severereaction to the flu shot in the
illness.past, children less than 6months of age, and people
Complications of the flu can lead to hospitalizationwith a history of Guillain-Barresyndrome (a paralyzing
anddeath. According to the Centers for Diseaseneuromuscular disorder). If you havea moderate or
Control (CDC):severe illness with a fever, you should waituntil those
Every year in the United States, 5% - 20% of thesymptoms resolve before getting vaccinated.
populationgets the flu, approximately 200,000 peopleIf you are HIV positive, most healthcare providers
are hospitalizedfrom flu complications, andwillrecommend that you receive the flu vaccine each
approximately 36,000 people diefrom the flu.year.
The symptoms of the flu include fever (usuallyAlthough there has been some debate and
>102F),headache, extreme fatigue, sore throat,controversy overthis issue, it is generally thought that
dry cough, runny orstuffy nose, and muscle aches.vaccination offerssignificant benefits to the HIV
Nausea, vomiting, anddiarrhea are uncommon withpositive person, includingthe prevention of serious
the flu. Although some flusymptoms resemble thosecomplications of the flu such asbacterial pneumonia
of the common cold, flu symptomshave a muchand activation of HIV replication
more abrupt onset and are more severe than(leading to an increase in HIV viral load and a
thoseof a cold. Possible complications of the fludecrease inthe CD4 cell count). In addition, the flu
includebacterial or viral pneumonia, sinus infections,may resemblesymptoms of an HIV or AIDS related
earinfections, dehydration, and worsening of otheropportunistic infection;thus, avoiding the flu will avoid
medicalconditions such as diabetes, asthma, or chronican unnecessary workup. Thevaccine itself is well
lungdisease. These complications can prolong thetolerated by most people, includingthose who are HIV
illness and maylead to hospitalization.infected. There may be a very slight andtemporary
The flu virus spreads from person to person throughrise in the HIV viral load, but this will quicklyresolve
coughingor sneezing. You may get infected byafter vaccination. Studies have shown that thebody's
touching somethingability to respond to any vaccine and to build
(such as a doorknob or telephone) that has flu virusupprotective antibodies may be decreased when the
on itand then touching your mouth or nose. The bestCD4 cellcount is below 2oo, but it is still
way toprevent the flu is to get a flu vaccination eachrecommended to vaccinatethese people, as there
yearbetween October and December. The flu shotmay still be some protectivebenefit.
can be offered toall healthy people who want toYou may hear about the Nasal-Spray Flu Vaccine, and
decrease their risk ofgetting the flu. Certain peoplethinkthat this would be a great alternative to getting
are at high risk for flucomplications and should beanotherinjection. Sorry, but if you are HIV positive
strongly encouraged to receivethe vaccine. Theseyou cannotreceive this vaccine. The nasal spray
groups are: children (6 months-5 yearsold), pregnantvaccine is a livevaccine, which contains weakened live
women, people over age 50, people withchronicvirus (instead ofkilled virus in the injection), and is
medical conditions such as diabetes,capable of producingsevere illness in anyone with a
asthma,emphysema, HIV infection, aids, heartweakened immune system. Ifyou are HIV positive,
disease), and peopleliving in long term care facilitiesyou should never receive any livevaccines for this
such as nursing homesand prisons. In addition, allreason.
healthcare workers andhousehold contacts of peopleIn conclusion, the flu vaccine is the best
in the high risk groups, aswell as household contactsprotectionagainst getting the flu. However, you may
of infants less than 6 months ofage, should bestill get otherviral respiratory illnesses or even a strain
vaccinated to prevent the spread of the virustoof the flu thatwas not included in the flu shot.
those people.Besides vaccination, thenext best defense against
Let's clear up another very common misconception:viral illness is frequent andthorough hand-washing and
The flushot does not give you the flu, and does notthe use of antibacterial hand gelswhich can be carried
make you sick!in your pocket, purse, or car. Thiswill help to prevent
I can't even count the number of times that patientsyou from transferring virus you comeinto contact
havetold me that they received the shot and got thewith to your mouth and nose.
flu. Thevaccine consists of killed influenza virus (killed