Hello, Reddit. We are Dr. Michael Smith, WebMD’s chief medical director and Dr. Hansa Bhargava, WebMD’s senior medical director. Have a question about the flu? Ask Us Anything!

I feel WebMD is often looked down upon by some members of the public and some MDs, are all of your "contributers" actual verified MDs and if so what does that verification process look like?

Great question! Actually, WebMD is one of the few health content sites that has almost EVERY piece of information verified by real doctors. Verification of these doctors include making sure they are Board Certified, licensed and up to date. We also have a team of doctors ‘in house’ that work side by side with the writers/editors. So you can be assured that WebMD provides trustable up to date information. Hope this helps! - Dr Hansa Bhargava

I’ll add to what Dr. Bhargava said … I’ve been with WebMD for nearly 20 years and as the Chief Medical Director, I head up the team of doctors that ensure the accuracy of WebMD’s information. That includes our full-time staff of doctors as well as over 100 health professionals that we work with all over the country. So thank you for bringing up this question because the process we use the ensure the credibility of our content is obviously something that’s very near and dear to my heart. - Dr. Michael Smith

...”ALMOST every...” FTFY

There are very few pieces of content that aren’t reviewed by a physician or health professional (e.g. dietitian). This includes blogs, which are already written by a health professional, and message boards, which are posts and opinions from the WebMD audience. A board-certified physician does review all other content, including news, feature articles, videos, tools, assessments, quizzes, WebMD Magazine content, etc. - Dr. Michael Smith

If this season's flu shot is "wrong" but predicts the flu strain in 10 years, will the flu shot today still protect me to this future strain when exposed in 10 years?

You raise an excellent point! One of the benefits of getting the flu vaccine every year is the potential that this year’s flu vaccine will help protect you against future years. This does happen, but we don’t have good evidence about how long the protection lasts (and likely wouldn’t last as long as 10 years). The protection does weaken over time, so that’s one reason why you should get the flu vaccine every year. In addition, the strains differ from year to year, so getting the flu vaccine every year is your best bet to protecting yourself against the most likely flu viruses for that year. - Dr. Michael Smith

Honest question, so does this mean that the long term consequences, good or bad, are unknown due to not having good evidence?

You are on it! Love how much you’re thinking through this issue. The flu vaccine was first introduced in the 1940s. So it’s been around for quite some time. We have a lot of evidence now on the effectiveness and also the safety. Not to say that we won’t learn more over time but at this point, we do have a lot of information to base our decision on. - Dr. Michael Smith

How do you tell the difference between the flu and other upper respiratory infections?

Really happy you asked this question because it’s an important one. I often tell people that when you get the flu, you feel like you’ve been hit by a mack truck. What I mean by this is one minute you feel OK, and then a couple of hours later, your body aches, you start getting a fever, often with chills, and you just want to go to bed and stay there. There are other viruses that can cause similar symptoms, and that’s why we sometimes use the term flu-like illness. There is a test specifically for the flu that we sometimes use. A cold, and other common respiratory viruses, come on more slowly, often starting with a runny nose or sore throat. It usually takes a day or two for your symptoms to peak but typically are not as severe as the flu. - Dr. Michael Smith

Do we really need to get flu shots? I tend to get sick after I get the shot.

I think it's really important to get the flu shot. Experts ‘redesign’ the flu shot every year to try to make it most effective. The flu shot not only helps protect against the flu, but helps protect against hospitalization too. Last year 80% of kids who died from the flu did NOT get the flu shot. So yes, definitely get it. -Dr Hansa Bhargava

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Sometimes, facts are scary unfortunately. And the point is really, how do you best protect yourself against diseases that can be serious. Of the kids who died from the flu, 80% had not been vaccinated. Honestly, I think the flu shot is your best protection against the flu: I recommend it to my patients and my kids get it too. Hope this helps. - Dr Hansa Bhargava

I just had a baby about 3 weeks ago and she's obviously too young to get the vaccine. However, I made sure I got the flu shot during my 37th week of pregnancy. How protected is she?

That’s great that you got your flu shot in pregnancy. This means that your body has had the chance to create the antibodies against the flu (the predicted flu) and these can be passed thru to your baby via breastfeeding. I would still be careful about exposing your baby under that age of 2 months to anyone who is sick though, because in the winter there are many viruses (as well as the flu) that circulate, that can cause your baby to get sick. - Dr Hansa Bhargava

I hear that this flu season is expected to be a tough one. I'm curious: What kinds of things go into making such a prediction?

At this point there is no official word that this year will be a bad flu season. But let’s take last year as an example. Just like every other year, it’s tough to know how bad the flu season will be. But last year turned out to be a very severe year, with around 80,000 deaths attributed to the flu. So I wouldn’t rely on these predictions because they’re not based on hard science. The severity of the year will depend on many factors, including weather. That’s why I get the flu vaccine every year because I want to do everything I can to prevent the flu, even if the season tends to be milder. Fingers crossed that will be the case this year but we won’t know for quite some time. Flu season typically peaks in February. - Dr. Michael Smith

I just looked up my symptoms on the computer and it said I could have “network connectivity problems”. Is that a bad thing? Should I be worried?

If you get the flu, don't do what Leslie Knope did and try to power through. We all want to be a hero but it’s not good for you (this is a case where you actually do need to rest when you have the flu) and it’s not good for those around you (the flu is highly contagious). When you have the flu, stay home and let your body fight the flu. Once you no longer have fever without the need for fever-reducing you’re good to go to work. Till then, take care of yourself and others. - Dr. Michael Smith

What sorts of new developments are out there in terms of flu vaccine? Is anyone marketing an effective non-adjuvanted vaccine that is updated yearly?

I ask because I haven't been able to get one in almost 20 years due to it triggering a rather severe brachial neuritis the last time, and I'd really prefer to, if possible (intranasal is contraindicated for me, too).

Quoting Dr Smith here: ‘The flu vaccine (the shot or the nasal spray) is different than other vaccines. With the flu vaccine, we have to predict the flu viruses that are most likely to cause the flu that year. While experts do their best to predict the most common viruses, it’s obviously tough to be 100% correct because there are many possible strains of the virus circulating. We vaccinate against three or four strains that are predicted to be the most common. The effectiveness of the flu vaccine varies from year to year. Even in a year when it’s only 40% effective, like last year, it’s still absolutely worth it.‘

But there are certain cases in which the vaccine is not given. I’m not sure about your brachial neuritis. I would definitely talk to your doctor about whether the vaccine is safe for you. - Dr Hansa Bhargava

If it is a myth why do so many ppl including me get sick after taking that shot? Is it just bad timing for many ppl to the point of creating myths?

Yes, it is a myth that people get sick after the flu shot. Sometimes people may feel tired, or have aches after the flu shot or have some soreness where the needle went in, but they don’t get the flu from the shot. Also, if you happen to be exposed to the flu within 2 weeks of getting the shot, the flu shot will not help you as it takes 2-3 weeks for your immune system to react to it and build up antibodies. So it may ‘look’ like you got the flu from it but you didn’t. This is how these myths can be perpetuated. But please know that the flu shot is safe, and is the best protection against the flu. - Dr. Hansa Bhargava

I haven't had the flu (or a cold) for at least 3 decades. I work retail, so I have contact with hundreds of people daily. Is this normal?

Well I would certainly say you’re lucky! Sounds like you have a good immune system that’s helped you fight off the flu and cold. Of course, it only takes once to get the flu to realize the power in getting the vaccine. And the fact that you come into contact with so many people would put you at greater risk. So the recommendation would still be to get the flu vaccine to help protect yourself and even others, especially babies younger than 6 months who are too young to get the flu vaccine. - Dr. Michael Smith

I am pregnant and just starting my second trimester. I will be getting my flu shot at the end of the month. I couldn’t seem to get a clear answer on the safety of the flu shot during my first trimester (even from my OB office), so i opted to delay for a few weeks. What is your advice to expecting mothers on getting the flu shot during their first trimester?

The CDC does recommend that it is safe to get a flu shot at any stage during pregnancy. The thought process is that if you get the flu while you are pregnant, it puts you and the baby at risk for serious complications and problems. There was a small study that had an association (not causation) of flu shots with miscarriage but getting the flu itself or getting very sick can result in miscarriage. Additionally, by getting the flu shot, you can pass on the antibodies that your body makes to your baby. I do think that getting the flu shot is a wise decision, but certainly speak to your doctor about it. - Dr Hansa Bhargava

Why do some people have a really effective immune system and some don't. In other words there's people who seem to get the flu really bad every year and some who never do. Or if they do it's fought off quickly with only minor symptoms. Any ideas ??

You are right: people definitely respond differently to infections, just as they respond differently to food, activity, stress and other things. I think genetics and environment both have an impact on your body’s ability to defend itself. But certainly eating well, exercising and getting enough sleep can certainly help, as can the flu vaccine. Take care of yourself by doing all these things and hopefully you won’t get the flu or get sick as much! -Dr Hansa Bhargava

Will donating plasma regularly after I receive a vaccine adversely affect my immunity?

You should be just fine. There are no issues with donating blood or plasma after getting the flu vaccine. - Dr. Michael Smith

Tamiflu question: I’ve got a 6 year old who is epileptic and on keppra, and a 3 year old. How effective is tamiflu? Is it recommended for kids with epilepsy? Is it recommended at all? We always get the flu shot.

Good question. Tamiflu is effective for most people against the flu if given within the first 48 hours. However, if your child is on other medications and/or has an underlying illness such as epilepsy, you should really discuss with your doctor (who knows your child best) to decide whether Tamiflu is the right choice. - Dr Hansa Bhargava

Does a flu shot have the potential to make antigen detecting rapid flu test show positive? I’ve contacted the CDC about this and can find no answer with them or uptodate. Thanks.

The rapid flu test is typically a nasal swab. The flu shot will not make this test positive. The nasal flu vaccine can make the test positive if given within the last 7 days before the test. - Dr. Michael Smith

What should I say to people who say that getting the flu vaccine gives people the flu?

This is one of the most common myths about the flu. In fact, a recent survey showed that over half of parents think that the flu vaccine can give you the flu. Simply, it can’t. It’s just not possible. Here’s why. The flu shot is a dead virus. It just contains the parts of the virus so your immune system responds. The nasal flu vaccine is a weakened virus (medical term is attenuated), and it’s weakened to the point that it also absolutely cannot cause the flu. Keep in mind that after you get the flu vaccine, some people may feel a little tired, sometimes even a very low fever, for a day or so. That’s a normal reaction. Another issue is that it takes a couple of weeks for the vaccine to protect you. So if you get the flu within 2 weeks of getting the vaccine, the vaccine hadn’t been around long enough to protect you. The flu vaccine is by far the best way to prevent the flu (even if it’s not 100%). - Dr. Michael Smith

I’ll add to Dr Smith’s answer here- as a pediatrician, I know that this is truly a myth. The flu shot does not give you the flu. But what it does is protect you not only from the flu, but the bad consequences from the flu such as hospitalization and death. In fact 80% of the deaths due to flu in kids last year, happened in kids that were not vaccinated against the flu. Also, a child died recently from the flu in Florida- and had not had the flu vaccine. So definitely get the flu shot. It is very protective. - Dr Hansa Bhargava

Thank you for the response. If I may I would like to ask a follow up question. What is going on in the body that is causing the malaise and low grade fever after receiving the vaccine? Thank you once again for taking the time for this AMA.

Good question! Sometimes you can get these symptoms from the flu shot as the immune system is ‘primed’ and learning how to fight against the flu. If you are worried or the symptoms are not getting better, definitely talk to your doctor. - Dr. Hansa Bhargava

How many strands of flu are there, and how many strands does the shot protect against? I have heard the shot protects agains 3-4 strands per time you get it... How do doctors decide what type to vaccinate against?

It’s unclear how many strains of the flu virus circulate in a given year. You’re right that experts identify the most common 3 or 4 strains that are most likely to cause the flu in a given year. Experts will even look at the flu season in the southern hemisphere, which would happen about 6 months before that in the northern hemisphere, to help predict the most likely strains. Depending on the type of flu vaccine you get, it will protect you from 3 or 4 strains. Get your flu vaccine early in the year (like now) so you will hopefully be able to get the one that protects you against 4 strains (most flu vaccine is against 4 strains). - Dr. Michael Smith

How effective is this year’s flu shot against this years strain? And some follow ups, how can we check this year’s prevention’s accuracy and effectiveness?

We don’t yet know how effective this year’s flu vaccine is. We won’t know that until the flu season is over, unfortunately. CDC experts will go back and look at rates of the flu in people who did and did not receive the flu vaccine. Last year’s flu vaccine was estimated to be 40% effective. I realize that may sound low, but when you’re talking about a condition that last year killed 80,000 Americans, the benefit from even 40% effectiveness is enormous. - Dr. Michael Smith

Thanks for doing this AMA.

I haven't had a flu vaccine in about 10 years and I've never had the flu before. Will getting the vaccine now compromise my immune system's ability to handle the flu the way it has been my whole life? Are there any risks or side effects of getting flu vaccinated after so many years of not getting it?

Glad you are considering getting the flu vaccine. Getting the vaccine now will not compromise your immune system; in fact it will help it be able to fight off the flu, if you are exposed to it. Side effects from the vaccine, just like anything else (food or medication) is having an allergic reaction. Also, some people may have local irritation at the site of the shot or tiredness, and achiness afterwards. But it is a safe and effective vaccine and the best protection against the flu. So, I’m glad you are thinking about it. -Dr Hansa Bhargava

Is the nasal spray as effective as the injection for prevention?

Yes, the nasal spray is just as effective, but because its a live attenuated vaccine, only people who are aged 2-49 can get it. Also, if you have a chronic disease or a compromised immune system, it may not be the best choice. Talk to your doctor to see what is right for you. - Dr Hansa Bhargava

I have never received the flu shot before and have never gotten sick from the flu.

Is there anything wrong with continuing to rely on my high immune system, or any studies suggesting occurrence rates of flu sickness are higher or lower after taking the flu shot in people who have never previously had the flu?

It's great that you've never had the flu. Similarly, I'm not sure I have either. That said, I still get the flu vaccine every year because it's the best way to protect myself and to protect others around me. There's no data to speak to flu occurrence rates in those who have never had the flu. Would be a great study though! I just know that I don't want the flu if I can help it because it'll lay you up for day, a week or more, so I choose to take whatever steps I can even though I don't seem to get it either. I'm sure some of my protection comes from the vaccine. - Dr. Michael Smith

how do you respond to the argument that the flu shot is inadvertently leading to the development of a "superflu" that will be resistant to vaccines? similar to the argument that overuse of antibiotics is creating superbugs. (full disclosure: i just got my flu shot anyway.)

Wise choice to get your vaccine. To date, we see no evidence of the emergence of a super flu. Yes, last year was a bad year but the lowest number of deaths in a flu season was just 7 years ago. The severity goes up and down from year to year. I would argue that the vaccine will help prevent the emergence of a “superflu” because we are targeting each year’s flu vaccine against the most common strains. Take the swine flu (H1N1) pandemic of 2009. After that, we began to target the vaccine against this strain. Now we see much less of this strain. So I’ll continue to get my flu vaccine year after year to protect myself and my local community. - Dr. Michael Smith

I think I got the flu yesterday and have a ton of chest congestion/coughing/wheezing which kept me up most of the night. Should I be looking more towards something with a cough suppressant or an expectorant for tonight?

If you are having difficulty, either should help. But if the cough gets worse, you have a fever or trouble breathing, or you are not getting better- make sure you see your doctor. - Dr. Hansa Bhargava

Since the protection of the flu shot weakens over time, when should I get the flu shot to be best protected for the inevitable middle-of-winter peak flu spread?

You should get the flu vaccine by the end of September (meaning if you haven’t already gotten the vaccine, make plans to do so as soon as possible). The vaccine will protect you throughout the entire flu season, which typically goes through March or as late as April. It won’t wear off that quickly. But then you’ll want to get the flu vaccine again next year for the very issue you raise -- the effect does wear off over time but it’ll at least last several months during this year’s flu season. - Dr. Michael Smith

If you've had the flu before getting the flu shot is getting the shot still beneficial or a moot point?

You should absolutely still get the flu vaccine. The flu vaccine protects against 3 or 4 strains of the flu. So you would be protected against additional strains of the flu that you didn't have. After having it once, I’m guessing you’d really like to do what you can to not get it again. And the flu vaccine is your best approach. - Dr. Michael Smith

Thanks! I'm pregnant and have been sick with this bug for over five weeks. Not something I want to repeat if I can help it haha!

And because you’re pregnant, that’s another reason to get the flu shot (you can’t get the nasal flu vaccine if you’re pregnant). The flu shot will not only protect you but it will help protect your newborn from the flu since the antibodies will pass to your baby. Of course this flu season will be over by the time you give birth but it can only help you and the baby. And congratulations on your pregnancy! - Dr. Michael Smith

If I do not get the flu shot, what risk do I pose to others who are likewise unvaccinated?

If you do not get the flu shot, and you get the flu, you can absolutely infect others. The groups who are most vulnerable are babies under 6 months, people who may have chronic disease (heart disease, seizures), and people who have compromised immune systems (such as those with cancer or HIV or even the elderly) can get very sick with the flu. So, getting the flu shot is not only protecting you, but also your loved ones. - Dr Hansa Bhargava

This morning I started to feel a slight sore throat and runny nose coming on, and think I might be getting a cold. Can I still get a flu shot? At what point would I be too sick to get it?

At this point it sounds like you can get the flu vaccine. If you have a fever, chills, or are sick to the point where you feel like you just want to stay in bed, then you’d want to wait to get the flu vaccine till you’re better. But if you have a cold, which it sounds like what you have, getting the flu vaccine is fine. When you go to get the flu vaccine, they’ll ask you a few questions to make sure you feel OK and as long as your symptoms don’t worsen, all should be good. - Dr. Michael Smith

Why are there so many people who normally don’t get sick, except for after they get the flu shot?

It is a myth that people get sick after the flu shot. Sometimes people may feel tired, or have aches after the flu shot or have some soreness where the needle went in, but they don’t get the flu from the shot. Also, if you happen to be exposed to the flu within 2 weeks of getting the shot, the flu shot will not help you, as it takes 2-3 weeks for your immune system to react to it and build up antibodies. So it may ‘look’ like you got the flu from it, but you didn’t. This is how these myths can be perpetuated. But please know that the flu shot is safe and is the best protection against the flu. - Dr Hansa Bhargava

One more question for you, do you have any links to unbiased resources or information for vaccine skeptics / antivaxxers that you reccomend? One argument I've heard is that the studies are "biased" and funded by the pharma corporations that make the vaccines and therefore can't be trusted.

My personal go-to source for up-to-date flu information is the CDC. It’s also a main source that we use in reporting the latest flu information on WebMD. There have been many studies looking at the effectiveness of the flu vaccine, funded by either the government or other organizations -- and yes, sometimes including pharma. Based on all the available evidence, I am confident that my best bet against getting the flu is the flu vaccine. - Dr. Michael Smith

I have the flu right now, will you come to my house and smother me with a pillow?

But in all seriousness, are there any medicines you recommend over others that are commonly used for flu symptoms?

Yeah the flu is pretty grueling, isn’t it?! If you’ve had flu symptoms for less than 48 hours, call your doctor to see if antiviral medicines may help you. They can help decrease the length of symptoms by a day or so. But after 48 hours of symptoms, their effectiveness is much less. You can also use over the counter cold and flu medicines based on the symptoms that you have. Try to match your symptoms to one of the medicines on the shelf. Your pharmacist can help you with this too, as I know there are many choices. - Dr. Michael Smith

I’m pregnant, due in November and my husband’s family is refusing to get the flu shot. My husband, myself, and our daughter did get it recently. How important is it for them to get it if they’re going to be around the baby? How long would they need to stay away?

Unfortunately, they believe the shot is a live virus, the shot makes you get the flu, that there is mercury in the shot, and that it causes autism and we are having trouble convincing them otherwise. I’d really hate to tell them they can’t see the baby right away but I also want my baby to be safe.

That is a tough situation. Your baby is most at risk the first 6 months of their life since the baby can't get the flu vaccine until 6 months of age. That means the baby needs to rely on others around to protect themselves so they don't transmit it. It's great that you got the flu vaccine because the antibodies your body produces against the flu will transfer to the baby and help protect. I would say it's obviously important for them to get the flu vaccine to help protect the baby. And you can't really rely on symptoms because someone can have the flu virus and be contagious for a day or more before they actually develop symptoms. - Dr. Michael Smith

What would happen if I got 2+ flu shots for this season?

Can you "overdose" from flu shots?

There would be no reason to get more than one flu shot, but if you did -- it wouldn't be a problem. You can't overdose from flu shots. Some people actually get a high-dose flu vaccine. The high-dose flu vaccine contains 4 times the amount of antigen (the viral particle that produces the immune system response to protect you) as the regular flu shot. It's recommended for people 65 and older because they tend to not have as strong of an immune response to the regular flu vaccine. We give them a higher dose of the flu vaccine to produce an adequate immune system response to protect them. So if you've had the flu vaccine this year, there is no reason to get another. But if you somehow did, it wouldn't be an issue. - Dr. Michael Smith

We always get vaccinated, but I’ve heard elderberry syrup can help the immune system. Is there medical science to back that up?

Elderberry can help if you get the flu. Studies shows that if you start taking elderberry as soon as you notice flu symptoms, it can help decrease the duration of symptoms. However, research doesn't support using it regularly to prevent the flu. Unfortunately nothing has shown to be effective other than the flu vaccine. But be sure to keep your hands nice and clean, wash frequently, and try not to touch you face, mouth, or eyes, which is the way the virus often makes its way into our bodies. - Dr. Michael Smith

What are the best ways to prevent from getting the flu if you are unable to get the flu shot due to medical reasons?

If you can't get the flu vaccine, then do everything you can to prevent the flu virus from making its way to your nose, mouth or eyes. So that means washing your hands frequently. And do what you can to not touch your face because that's a common way the virus makes it from our hands to our mouth or nose and into our bodies to cause the flu. Other strategies you can use are disinfecting items around that other people may have touched. Also if you don't have access to soap and water, then alcohol-based gels are another option (not the best so always wash when you can). Obviously try to avoid being around anyone that's sick and if you are, immediately wash your hands and disinfect any items they may have come in contact with. - Dr. Michael Smith

What is your opinion on GSB survivors getting the shot?

If you develop Guillain-Barre syndrome within 6 weeks of getting the flu vaccine, you should talk to your doctor about whether the flu vaccine is right for you. It needs to be a personal discussion between you and your doctor to determine what is right for you. - Dr. Michael Smith

Is there any good argument against vaccination?

Personally, I dislike anti vaxxers and disagree with them, but are they correct about any of their arguments?

Good question! The answer is simply no. None of their arguments are correct. Many ‘anti-vaxxers’ may believe that the flu vaccine causes the flu- that’s wrong. Some still may believe the myth that it is linked to autism. This has been disproven over and over and over again. Essentially there is no argument against vaccination. We are incredibly lucky to have vaccines- so lucky that we, as a society have forgotten what horrible diseases Polio, Diphtheria, Measles and other such illnesses are. And how all of these can cause severe health problems. Not getting the flu vaccine puts you and your kids at risk for serious health problems and at higher risk for death from flu. So definitely get that flu shot- speak to your doctor! - Dr Hansa

Why are flu shots only like 50% effective? At what percent does it stop being worth it to get?

The flu vaccine (the shot or the nasal spray) is different than other vaccines. With the flu vaccine, we have to predict the flu viruses that are most likely to cause the flu that year. While experts do their best to predict the most common viruses, it’s obviously tough to be 100% correct because there are many possible strains of the virus circulating. We vaccinate against three or four strains that are predicted to be the most common. The effectiveness of the flu vaccine varies from year to year. Even in a year when it’s only 40% effective, like last year, it’s still absolutely worth it. It’s by far the best way to prevent the flu and given the number of hospitalizations and even deaths that occur from the flu (80,000 Americans died last year from the flu) it’s still your best bet and highly recommended. We see that people who don’t get the vaccine are more likely to not only get the flu but to have life-threatening complications. We’re already seeing that trend this year. - Dr. Michael Smith

Who makes money by me getting the flu vaccine? Everyone says it's "free" but nothing is free... how much does it cost and who does that money go to?

Your cost of the vaccine will depend on your insurance and the place that provides the flu vaccine. One reason it’s often free to us is that healthcare providers and insurance companies understand that to help keep medical costs down, it’s best for people to get the flu shot. High costs are associated with people getting the flu, flooding the medical system, and potentially landing in the hospital. Personally, I’m fine with someone making money off of a valuable service to me, and that’s what I consider the flu vaccine. - Dr. Michael Smith

Thank you, but what does it cost the insurance companies? and who gets paid? I don't believe that it's to keep costs down, if that were the case, they wouldn't be selling $10 cough drops to patients.

As a physician, my concern is my patients, so my concern is how much it costs them to get the flu vaccine and whether costs are preventing them from getting a treatment that I feel is effective for, in this case, preventing disease. So the fact that people have access to the flu vaccine for “free” or low cost is of value to me and my patients. - Dr. Michael Smith

How are the predictions made in regards to which strains are expected to be prevalent? Where does the data come from?

It's a complex process. Over 100 influenza centers in over 100 countries perform year-round surveillance for the flu. This involves testing thousands of influenza virus samples. They evaluate these data and determine which strains are the most common ones circulating. The vaccine is then developed based on this analysis. It's up to the individual countries to determine which viruses are included in the vaccines licensed in that country. In the US, the FDA makes this final decision. - Dr. Michael Smith

I live on the upper east coast of the US and was told by an epidemiology professor that the flu virus travels up the coast over the course of the Winter and often mutates by the time it gets to this area. He suggested getting the flu vaccine either twice (at the season start and middle) or one a little later (early Dec, Late Nov.) in the season. Is there any truth to this? How often is the virus likely to mutate over the course of the season?

I have never seen any evidence to suggest this. We typically see the flu season increase in the more northern areas of the US before the southern regions. That's at least partly due to cold temperatures and more and more people spending more time indoors, thus spreading the flu from person to person more quickly. There's no evidence to suggest that getting two doses of the flu vaccine is beneficial. Plus, the strains in the flu vaccine are the same so you would end up getting an identical vaccine whether you get the vaccine early or late in the flu season. There's no need to do this. Get the vaccine early in the season so that you benefit from the protection throughout the flu season. - Dr. Michael Smith

My girlfriend has never been vaccinated for the flu. Not even when she was young. She’s not against it, just has never had the shot.

As she has never caught the flu, would it be significantly worse if she catches it now, at 25?

Even though the strains of the flu virus vary from year to year, we do know that having the flu in any given year, or getting the flu shot, does offer some protection in later years. That said, we can't say that she would have significantly worse symptoms if she catches the flu now. My recommendation would be to get the shot because it only takes once to have the flu to convince you that you want to do everything you can to not get it again. - Dr. Michael Smith