5 questions about the flu shot, answered by a Mass. General doctor

"The biggest change for this year is that we're expecting the flu season to start earlier."

FILE - In this Feb. 7, 2018 file photo, a nurse prepares a flu shot at the Salvation Army in Atlanta. The nation’s nasty flu season has been fading for two weeks now, and health officials now feel confident the worst is over. The Centers for Disease Control and Prevention said the season apparently peaked in early February, when 1 of every 13 visits to the doctor were for fever, cough and other symptoms of the flu. That intensity level was among the highest seen in a decade. But CDC officials on Friday, March 2, said it's been falling since then, and last week dropped to 1 in 20. (AP Photo/David Goldman, File)
In this February 2018 file photo, a nurse prepares a flu shot for a patient. – AP Photo / David Goldman, file

If you didn’t get a flu shot yet this year, it’s time, according to Dr. Ali Raja, executive vice chairman for the department of emergency medicine at Massachusetts General Hospital.

“The biggest change for this year is that we’re expecting the flu season to start earlier,” Raja said. “We’ve already seen cases around the country of patients with the flu. Normally, you can wait until November — even as late as Thanksgiving — to get the flu shot. But I’m telling patients that if you haven’t gotten yours already, you’re already behind the ball.”

Here, Raja answers five of our questions about the flu shot.

1. Can you get the flu from a flu shot?

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“This is a common misconception,” Raja said. “The flu shot can’t give you the flu. It doesn’t have a live virus that gives you the flu.”

If you feel a little ill after getting the shot, that’s normal, he said.

“As your body has its expected reaction to the vaccine, it’s going to make you feel ill the next day or two,” Raja said. “But that will go away, and you’ll have the immunity build-up afterwards.”

2. Who should — and shouldn’t — get a flu shot?

“The flu shot is safe unless you’ve had an allergic reaction to the flu shot before,” Raja said.

If you’ve had an allergic reaction to the flu shot, you should not get it, he said.

“I recommend everybody above the age of six months get the seasonal flu vaccine,” Raja said. “But I especially hammer that point home in children under the age of eight and patients over the age of 65.”

Those two groups don’t have strong immune systems, he said. Also, children come into contact with a lot of germs and viruses at school.

flu shot
In this February 2018 file photo, a nurse prepares a flu shot from a vaccine vial. —David Goldman / The Associated Press

3. I can’t handle needles, or the shot makes my arm too sore. What should I do?

“If you find that you usually have a sore arm after the flu shot, it’s not at all inappropriate to take acetaminophen or ibuprofen to help with that,” Raja said.

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Raja said some of his patients have reported feeling better after placing a hot pack on the vaccine site. The heat can relax the muscle and help with pain, he said.

Those wary of needles can ask for the nasal spray, he said.

“It is a live vaccine, unlike the shot,” he said. “But it’s altered, so it can’t actually cause the flu.”

Pregnant women should not get the nasal spray, he said, but they should absolutely get a flu shot.

4. What happens if you get a flu shot, but get the flu anyway?

You could still get the flu after receiving the shot, Raja said, but the vaccine will make it less severe.

“The flu shot varies in how effective it is year after year,” he said. “Some years it can be low as 30 percent effective in preventing the flu. Some years it can be as high as 70 percent. But, regardless of whether or not it prevents you from getting the flu, the evidence shows that if you do get the flu, you are both going to have less severity and a shorter duration of symptoms.”

In order to make enough of the vaccine in time for flu season, experts build it based on predictions about that year’s flu season, Raja said. It’s too early in the season to know how effective this year’s shot will be, Raja said.

5. Where can you get a flu shot?

You can call your doctor’s office and find out if it is offering a flu clinic, Raja said. In many cases, you don’t even need an appointment, he said.

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“Almost all pharmacies are offering the flu shot, and the pharmacist can give you the flu shot very safely,” Raja said.

Before heading to the local pharmacy, though, it’s a good idea to call ahead to make sure they have enough of the vaccine that day.

“We’ve been seeing situations where patients have not been able to get their flu shots despite carving out time or taking time off of work to go to the pharmacy, just because everybody is doing it right now,” Raja said.

Your place of work may also offer flu vaccines, so it’s worth asking your employer, he said.