MORE ABOUT COLDS AND FLU

You may have questions about the influenza (flu) vaccine, about when to get it, who can get it, its safety and effectiveness, and more. Here are answers to some common questions about flu vaccination.

Who should have the flu shot?

The Australian Government recommends that everyone over the age of 6 months has a flu vaccination every year.

It’s difficult to predict who will catch influenza (‘the flu’), or who will become seriously ill from it. The flu can require hospitalisation and can even be fatal.

Getting vaccinated against the flu helps protect both you and the people around you. It’s particularly important to protect vulnerable people in the community who can’t be vaccinated, such as babies who are younger than 6 months and adults with low immunity.

When should I have the flu shot?

Your immunity is strongest and most effective for 3 to 4 months after you are vaccinated. Flu season in Australia usually runs from June to September, peaking in August, so it is important to get your flu shot in April or May.

Does the flu vaccine protect against COVID-19?

The flu vaccine won’t protect you against COVID-19 (coronavirus), but it will reduce your risk of influenza — which leads to thousands of hospitalisations each year. By getting the flu vaccine, you can reduce the strain on the health service.

Can I get the influenza (flu) vaccine and COVID-19 vaccine at the same time?

You can get the Pfizer or AstraZeneca COVID-19 vaccine and the flu vaccine — but not on the same day. You should wait at least 7 days between receiving a dose of COVID-19 vaccine and the flu vaccine.

You aren’t required to have the vaccines in any particular order. The order will likely depend on vaccine availability, so you may receive whichever vaccine you have access to first.

If you’re having the Pfizer vaccine, this means you may be able to get a flu vaccination in between the 2 doses, if appropriate.

In special cases, your healthcare provider may consider shortening the time period between the different vaccines — or they may suggest you receive the vaccines on the same day. This will only be considered if:

• there’s a high risk that you’ll be exposed to one of the diseases
• it’s highly likely that the opportunity of receiving either vaccine will be missed
• by the time COVID-19 vaccine doses become available to a certain population group, the flu season is imminent

If this is suggested, you’ll be counselled about any possible adverse events from each vaccine. You’ll be advised to report any adverse events.

Ask your doctor or pharmacist for more advice on how to schedule vaccinations.

Can the flu shot give me the flu?

No. All flu vaccines used in Australia are ‘inactivated’, which means they do not contain the live flu virus — so you can't catch the flu from the vaccine.

Less than 1 in 6 people experience side effects from the flu shot that are similar to the early signs of the flu. These may include fever, tiredness and muscle aches. These side effects can start within a few hours of vaccination and sometimes last for 1 to 2 days. They usually go away on their own, once your body has developed an immune response to the vaccine, which will protect you from the flu virus.

It’s important to remember that the side effects show the vaccine is triggering an immune response, which is what it’s designed to do.

Sometimes I get the flu despite having had the flu shot — why should I bother?

Flu vaccination prevents illness in up to 6 in 10 healthy adults under the age of 65. Because the vaccine is not effective in absolutely every case, some people may still catch the virus after having the flu shot. But the risk of illness is still reduced.

Although most people who get the flu recover without lasting effects, the flu can be very serious in some people and may require hospitalisation. In some cases, it can even be fatal. It’s not possible to predict who will be severely affected.

Vaccination against the flu both reduces your chances of getting it and the severity of the symptoms if you do. So it’s still important to have the shot.

Do children, adults, pregnant women and the elderly need a different vaccine?

Generally, children, adults and pregnant women get the same vaccine to protect them against the flu. However, if your child is under 9 years old and has not been vaccinated before, they will need to get 2 doses of the vaccine, at least 4 weeks apart, in their first year.

In 2018, 2 new flu vaccines (Fluzone High-Dose and Fluad Quad) became available for people aged 65 years and over. These vaccines are not available for people younger than 65. (Fluzone High-Dose is not available in 2021.)

Is it true that the flu vaccine can cause febrile seizures in young children?

A febrile seizure is a convulsion in a child with a fever (high temperature). They can occur in up to 1 in 20 children aged between 6 months and 6 years old. Febrile seizures usually last around 1 to 2 minutes with loss of consciousness, but nearly all children will recover quickly, regardless of the cause.

Influenza itself can cause fever and results in more febrile seizures than vaccination. In one study, more than 1 in 20 children hospitalised with the flu in Australia had a febrile seizure. In comparison, only 1 in 20,000 children will have a febrile seizure related to fever following a flu shot.

Is it OK to get the flu vaccine more than once in the same flu season?

Studies have not shown there is any benefit for most adults getting more than one dose of vaccine in the same flu season. However, it’s recommended that some people get 2 doses of the flu vaccine in one season:

• children under 9 years old who have not ever been vaccinated against the flu
• people who are having flu vaccination for the first time after a stem cell transplant or organ transplant
• pregnant women, who may be vaccinated with the next season’s influenza vaccine if it becomes available in the latter part of their pregnancy, even if they had the previous season’s vaccine
• overseas travellers who are going to the northern hemisphere winter

Can I get the flu vaccine if I have an egg allergy?

The influenza vaccine is typically grown in eggs. But the traces of egg protein that remain after the vaccine is made are so tiny that the Australasian Society of Clinical Immunology and Allergy (ASCIA) says both adults and children with egg allergy can be safely vaccinated against the flu. The risk of anaphylaxis after vaccination is very low, estimated at 1.35 cases per 1 million doses.

It is rare for people with egg allergy to experience other side effects, such as hives, wheezing, vomiting or abdominal pain, after getting the flu shot. If you are concerned, ask your doctor if you, or your child, can be observed by staff for 30 minutes after receiving the vaccine (instead of the recommended 15 minutes).

Can I get the flu vaccine if I have a latex allergy?

Influenza vaccines used in Australia don’t contain latex and are safe for people with a latex allergy or sensitivity. While the product information for Fluarix Tetra and Fluad Quad state that some presentations of the vaccine cannot be considered latex-free, these presentations are actually not supplied in Australia.

What is the cell-based influenza vaccine and is it better than egg-based vaccines?

The production of influenza vaccines traditionally involves hen’s eggs. However, there is a different method for cell-based influenza vaccines — such as Flucelvax Quad, the only cell-based flu vaccine approved for use in Australia. It’s approved for use in people aged 9 years and older but has not been added to the National Immunisation Program (NIP) schedule.

Studies show that cell-based vaccines have a similar efficacy and safety profile to standard (egg-based) flu vaccines. Normally, neither type is recommended over the other.

However, standard flu vaccines are preferred for use in pregnancy because a large body of evidence supports their safety for pregnant women. The safety of cell-based flu vaccines during pregnancy hasn’t been assessed.

What is an ‘enhanced’ influenza vaccine?

An enhanced flu vaccine is one that contains an ‘adjuvant’, an ingredient designed to increase the immune-system response to the vaccine. People aged 65 and older are often given an enhanced influenza vaccine because — since the immune system weakens with age — they don’t respond as well to the flu vaccine as healthy, younger adults.

Fluad Quad is an enhanced flu vaccine recommended for people aged 65 and over in Australia.

Can I have the flu vaccine if I take immune checkpoint inhibitors?

Immune checkpoint inhibitors are a type of medicine used to treat some cancers, including metastatic melanoma, renal clear cell carcinoma, non-Hodgkin lymphoma, non-small cell lung cancer and other solid organ tumours. Checkpoint inhibitors include ipilimumab, nivolumab and pembrolizumab.

People taking checkpoint inhibitors may have a higher risk of immune-related side effects following influenza vaccination. Talk to your oncologist about the risks and benefits of the flu shot.

For more information on the flu vaccine, go to the Department of Health website or call the National Immunisation Hotline on 1800 671 811.