Flu Vaccine Update for the 2008/2009 Season
Wednesday, October 15, 2008
It’s flu season again, and people are already lining up for their flu shot. Each year, however, the flu shots change to cover what experts predict will be the “going” strains for the coming year. Last year they guessed wrong, and the flu shot wasn’t very effective. Let’s hope they get it right this year (as they did for the few years prior to last year). The available brands are virtually identical to what they were last year as far as manufacturing and ingredients go (including mercury).
The most important thing for infants, children, and pregnant women is to MAKE SURE YOU ARE GETTING A MERCURY-FREE FLU VACCINE. Here are all the flu vaccines for the 2008/2009 flu season:
FLUZONE Shot
This is the only brand approved for all age ranges, from young infants to adults. It comes in four different formulations:
Pre-filled syringe for infants 6 through 35 months – NO mercury.
Pre-filled syringe for children 3 years and older and adults – NO mercury.
Single-dose vial for children 3 years and older and adults – NO mercury.
Multi-dose vial for infants 6 months and older, children and adults – contains the full dose of mercury.
FLUZONE is the only brand of flu shot approved for young infants and toddlers. BEWARE – the multi-dose vial has the full dose of mercury. You have to make sure you are getting a single-dose pre-filled syringe or vial, NOT the multi-dose vial.
FLUMIST Nasal Spray
An alternative to the flu SHOT for young children is the FLUMIST nasal spray. There is no mercury in this formulation. It is approved for children 2 years and older and adults through age 49.
FLUVIRIN Shot
This shot is approved for children 4 years and older and adults. It comes in two formulations:
Pre-filled syringe – has a trace of mercury (see below)
Multi-dose vial – has the full dose of mercury
FLUARIX Shot
This is only for adults 18 years and older. It only comes as a pre-filled syringe with a trace amount of mercury.
FLULAVAL Shot
This is only for adults 18 years and older. It only comes as a multi-dose vial with the full dose of mercury.
AFLURIA Shot
This is only for adults 18 years and older. It has two formulations:
Pre-filled syringe with no mercury
Multi-dose vial with the full dose of mercury
Nasal Spray Versus the Shot?
Overall I have no preference between the two. The nasal spray is a great alternative for anyone who wanted the shot, but can’t find a mercury-free version. It seems that the nasal spray works a little better, but causes flu-like side effects more often. It also shouldn’t be used in anyone with asthma or a history of wheezing. The shot seems to not quite work as well, but may cause fewer side effects.
What is the Difference Between Trace and Full-Dose Mercury?
In trace mercury vaccines, mercury is added to the manufacturing process as a preservative, but is then filtered out at the end before being put into single-dose syringes or vials. A full preservative isn’t needed because this vial or syringe is only opened and used once, and then discarded. The amount of mercury in vaccines that are labeled “trace” is less than 1 microgram. I believe that this amount is completely harmless (as opposed to the full dose).
In full-dose mercury vaccines, the mercury is not filtered out. The preservative is needed for these large 10-dose vials because many doses are drawn out, and the solution needs to stay sterile during that process. The amount of mercury in these large vials is 25 micrograms per dose (any infants through age 3 getting a Fluzone shot from the multi-dose vial with mercury would only be getting a half dose, so each shot would be 12.g micrograms).
Why Not Just Make All Flu Shots Without Mercury?
The challenge is space and money. The five different companies that make the flu shot have to scramble every year to make enough. It costs more money and takes up more manufacturing time and space to put single doses of the flu shot into syringes or single-dose vials, compared to putting 10 doses into larger vials. In order to accommodate the demand, manufacturers have to make most of their product “in bulk” this way. In the future I hope that more companies will change over to mercury-free formulations, or the almost-as-good trace mercury formulations.
Infants and Pregnant Women – Just Say No To Mercury
The debate over whether or not mercury in the flu shot is enough to cause harm continues to rage on, with no clear resolution yet. I believe it is prudent in the mean time to avoid giving any full-dose mercury shots to children under 3 and to pregnant women. What should you do if all you can find is a full-dose version? Just say no, and tell your doctor why. Maybe if enough patients do this, doctors will order and demand more of the mercury-free version for next year. For kids 2 years and older, get the nasal spray instead (this can’t be given to pregnant women).
New Flu Shot Recommendations for This Year?
The ACIP, AAP and CDC have decided that it would be beneficial for all children to get a flu shot every year until age 18. Previously the recommendation was for all children until age 5. They don’t know whether or not to push this new policy for THIS year, or wait until next year, because they don’t know if there will be enough flu vaccine to go around to cover all children and teenagers. They don’t want to make a new policy unless they have enough vaccine to cover it. But whether it goes into effect this year or next, it is now believed by medical experts that it’s best to get a flu vaccine for all children and teens every year.
ALL OF THE INFORMATION IN THE VACCINE BOOK REGARDING FLU SHOTS FOR LAST YEAR IS STILL THE SAME FOR THIS YEAR (with the one exception that in the book I state that Fluvirin brand only has trace mercury, and this they also make a full-dose mercury version). FOR MORE INFORMATION ON DECIDING WHETHER OR NOT TO GET A FLU VACCINE, VISIT www.TheVaccineBook.com
YOU CAN VIEW THE PRODUCT INSERTS FOR THIS YEAR’S FLU VACCINES YOURSELF AT www.fda.gov/cber/flu/flu2008.htm
The most important thing for infants, children, and pregnant women is to MAKE SURE YOU ARE GETTING A MERCURY-FREE FLU VACCINE. Here are all the flu vaccines for the 2008/2009 flu season:
FLUZONE Shot
This is the only brand approved for all age ranges, from young infants to adults. It comes in four different formulations:
Pre-filled syringe for infants 6 through 35 months – NO mercury.
Pre-filled syringe for children 3 years and older and adults – NO mercury.
Single-dose vial for children 3 years and older and adults – NO mercury.
Multi-dose vial for infants 6 months and older, children and adults – contains the full dose of mercury.
FLUZONE is the only brand of flu shot approved for young infants and toddlers. BEWARE – the multi-dose vial has the full dose of mercury. You have to make sure you are getting a single-dose pre-filled syringe or vial, NOT the multi-dose vial.
FLUMIST Nasal Spray
An alternative to the flu SHOT for young children is the FLUMIST nasal spray. There is no mercury in this formulation. It is approved for children 2 years and older and adults through age 49.
FLUVIRIN Shot
This shot is approved for children 4 years and older and adults. It comes in two formulations:
Pre-filled syringe – has a trace of mercury (see below)
Multi-dose vial – has the full dose of mercury
FLUARIX Shot
This is only for adults 18 years and older. It only comes as a pre-filled syringe with a trace amount of mercury.
FLULAVAL Shot
This is only for adults 18 years and older. It only comes as a multi-dose vial with the full dose of mercury.
AFLURIA Shot
This is only for adults 18 years and older. It has two formulations:
Pre-filled syringe with no mercury
Multi-dose vial with the full dose of mercury
Nasal Spray Versus the Shot?
Overall I have no preference between the two. The nasal spray is a great alternative for anyone who wanted the shot, but can’t find a mercury-free version. It seems that the nasal spray works a little better, but causes flu-like side effects more often. It also shouldn’t be used in anyone with asthma or a history of wheezing. The shot seems to not quite work as well, but may cause fewer side effects.
What is the Difference Between Trace and Full-Dose Mercury?
In trace mercury vaccines, mercury is added to the manufacturing process as a preservative, but is then filtered out at the end before being put into single-dose syringes or vials. A full preservative isn’t needed because this vial or syringe is only opened and used once, and then discarded. The amount of mercury in vaccines that are labeled “trace” is less than 1 microgram. I believe that this amount is completely harmless (as opposed to the full dose).
In full-dose mercury vaccines, the mercury is not filtered out. The preservative is needed for these large 10-dose vials because many doses are drawn out, and the solution needs to stay sterile during that process. The amount of mercury in these large vials is 25 micrograms per dose (any infants through age 3 getting a Fluzone shot from the multi-dose vial with mercury would only be getting a half dose, so each shot would be 12.g micrograms).
Why Not Just Make All Flu Shots Without Mercury?
The challenge is space and money. The five different companies that make the flu shot have to scramble every year to make enough. It costs more money and takes up more manufacturing time and space to put single doses of the flu shot into syringes or single-dose vials, compared to putting 10 doses into larger vials. In order to accommodate the demand, manufacturers have to make most of their product “in bulk” this way. In the future I hope that more companies will change over to mercury-free formulations, or the almost-as-good trace mercury formulations.
Infants and Pregnant Women – Just Say No To Mercury
The debate over whether or not mercury in the flu shot is enough to cause harm continues to rage on, with no clear resolution yet. I believe it is prudent in the mean time to avoid giving any full-dose mercury shots to children under 3 and to pregnant women. What should you do if all you can find is a full-dose version? Just say no, and tell your doctor why. Maybe if enough patients do this, doctors will order and demand more of the mercury-free version for next year. For kids 2 years and older, get the nasal spray instead (this can’t be given to pregnant women).
New Flu Shot Recommendations for This Year?
The ACIP, AAP and CDC have decided that it would be beneficial for all children to get a flu shot every year until age 18. Previously the recommendation was for all children until age 5. They don’t know whether or not to push this new policy for THIS year, or wait until next year, because they don’t know if there will be enough flu vaccine to go around to cover all children and teenagers. They don’t want to make a new policy unless they have enough vaccine to cover it. But whether it goes into effect this year or next, it is now believed by medical experts that it’s best to get a flu vaccine for all children and teens every year.
ALL OF THE INFORMATION IN THE VACCINE BOOK REGARDING FLU SHOTS FOR LAST YEAR IS STILL THE SAME FOR THIS YEAR (with the one exception that in the book I state that Fluvirin brand only has trace mercury, and this they also make a full-dose mercury version). FOR MORE INFORMATION ON DECIDING WHETHER OR NOT TO GET A FLU VACCINE, VISIT www.TheVaccineBook.com
YOU CAN VIEW THE PRODUCT INSERTS FOR THIS YEAR’S FLU VACCINES YOURSELF AT www.fda.gov/cber/flu/flu2008.htm
Labels: Vaccine News
posted by Dr. Bob Sears @ 11:18 AM
18 Comments:
At October 15, 2008 2:39 PM ,
Catherina said...
Thanks for the run down of the brands - I still have not had time to look at strains etc - what do you think regarding emerging strains and composition of this year's vaccine?
At October 15, 2008 3:56 PM ,
Dr. Bob said...
I don't know because I don't know all the details regarding strain history and what may emerge this year. We just don't know that until the flu season is half way over.
At October 20, 2008 12:25 PM ,
Anonymous said...
Thanks very much for the information -- particularly on the brand without mercury for infants. I'm still debating whether or not to get my 22 month old the shot. We passed last year and lucked out, but I plan to take her out to more children's classes, etc. this year. I clicked on the link you provided for more information on making a decision, but was re-routed to your original post. I ordered your book online, but it hasn't arrived yet. My question? Are you a strong advocate for the shot with toddlers? Are we taking a huge risk if we don't get it? I've been reading your posts as of lately and elected to get the MMR separately (we recently did measles) but need to wait for the book in order to review your entire alternative schedule.
Thank you. I approach all these vaccines with great caution...
At October 23, 2008 5:52 AM ,
Anjmarie said...
Dr. Bob,
I have read so much conflicting information on the validity of the flu shot and am trying to weed out alarmist hype vs. sound advice. I've read that the flu shot is essentially a big business venture and that most doctors don't even get one themselves. In your opinion, are there any dangers in the mercury-free version if we're able to obtain one? Even those versions still contain aluminum, correct? My kids are 21 mos and 5 years.
Thanks so much for your continued dedication to help parents make an informed decision.
At October 23, 2008 9:05 AM ,
jenn said...
Thanks so much for the rundown on all of the flu shots available this year. I do have one question though. In looking at the product insert for the FLUZONE vaccine it says this about thimerosal/mercury:
"There is no thimerosal used in the manufacturing process of the No Preservative single-dose presentations of Fluzone vaccine. The multi-dose presentation
of Fluzone vaccine contains thimerosal, a mercury derivative, added as a preservative. Each 0.5 mL dose contains 25 μg mercury."
Does this mean there is mercury in all .5mL doses or just those taken from the multi-dose presentation?
At October 28, 2008 7:55 PM ,
Shannon said...
What flu vaccine is recommended for breastfeeding mothers?
At October 29, 2008 8:14 PM ,
Tiffany said...
What about the study that showed the flu shot being no more effective than a placebo in children under 2?
At October 30, 2008 3:55 AM ,
Anonymous said...
Is the pre-filled syringe Fluzone shot for infants 6 through 35 months the same thing as influenza split virus by Sanofi Pasteur Manufacturer? The reason being is my 15-month old received the flu split virus shot, yesterday, before I read your article.
At October 31, 2008 10:08 AM ,
Anonymous said...
I am breastfeeding and do not want to give my 1 yr old the flu shot. Does it make sense to think that if I get the flumist, she will get a little extra boost of antibodies through my breastmilk than with the injection- or am I just increasing her risk of getting the flu with the live virus vaccine?
At November 3, 2008 2:19 PM ,
NoToVax said...
When are you guys going to learn that all vaccines are poisonous, toxic and thus dangerous to the health of your loved ones. They don't have any beneficial effect whatsover. Your vaccination schedule is like an investment portfolio, that's right, a wide array of chronic, recurrent and systemic diseases waiting to happen. The more you invest on it, the more they will suffer. Thrive on a healthy body and not on vaccines. Just my humble opinion.
At November 5, 2008 11:46 AM ,
Allisan said...
I am so paranoid and upset now. I just got the flu shot and I am 16 weeks pregnant. I called the OBGYN where I got the shot and asked which one they gave me and it was the Fluzone one that has mercury...Will this harm my baby? I am so upset and nervoud now. I am wreck :( Is there anything I can do? Please Help me Dr. Sears. What is the % that this will have any effects on my baby..if so what can it do? Thank You so much....I bought your Vaccine Book today. I am looking forward to reading it.
At November 13, 2008 11:34 AM ,
DR. Bob said...
Great comments and questions.
I am not a huge fan of the flu shot, since research on it's effectiveness is questionablein young children. Overall, it doesn't seem to be as protective as most other vaccines are. So, you have to wonder if it's even worth getting. MORE research will have to be done to determine it's effectiveness in young children. So, I don't consider it as important as most vaccines. But I don't have a problem giving it. I do give it to patients who ask for it.
There is no aluminum in it, so don't have to worry about that.
For Fluzone, see my blog again - it specifies which one has mercury.
For pregnant or breastfeeding women, just get any mercury free (or AT least just trace mercury) brand.
At November 17, 2008 1:02 PM ,
Anonymous said...
I had already received a normal dose (contains mercury)
>of the Influenza vaccine. I wasn't aware at the time of
>the mercury content issue.Therefore I didn't tell the
>nurse at the time that I was trying to get pregnant and
>to give me the mercury free vaccine. Now after
>researching it on the internet, I am terrified to get
>pregnant because I think I will have a child with autism.
>All these websites say to ask for a mercury free vaccine.
>But it is too late for me since I have already recieved
>it. My question is how long does the thimerosal last in
>the body and will it affect my baby if I was to get
>pregnant soon?
>
> Thank you,
>
> Corinne
At December 11, 2008 2:42 AM ,
Vaccine said...
Thanks for the good read, I will definitely return for an update!
http://www.vaccinerx.com
At December 16, 2008 12:03 AM ,
alexr said...
As I have an egg allergy, I've never had any of the many widely-marketed flu shots.
I've also not been knocked down with some horrible death flu. I often see my coworkers/peers who have gotten the annual shot come down with [probably flu] seasonal illnesses anyway.
Just offering a data point.
At January 10, 2009 7:05 AM ,
Tsu Dho Nimh said...
Sears says:"If a doctor can look a patient in the eye and say, “I’ve spent weeks investigating all these issues personally and reviewing all the research myself, and, along with the expert backing of the AAP, CDC, and ACIP, I believe that the vaccines are safe and should be given according to the CDC schedule,”
My take on this is that Sears should also spend weeks researching every drug, every condition, every treatment, reading all the research ... and then when would he have time to pay attention to patients?
At January 12, 2009 7:00 AM ,
Sue said...
Thank you for clarifying Dr. Offit's misleading information.
Several years ago I read Dr. Offit's vaccine book, the one my Pediatrician gave me. After perusing the book, I went through the chapters page by page (just as I was trained to do in law school). There were many INACCURACIES in the book, along with statements indicating a perspective as being the only one when in fact there are valid counter arguments to those opinions and supposed "facts" and "statistics".
By the time I was half way through, I felt Dr. Offit's book was more like advertisement for Big Pharma than honest & accurate information for parents. Therefore, I no longer find Dr. Offit's work credible.
Knowing Dr. Offit attacks the work of Dr. Sears furthers my mistrust in his work.
Congratulations, Dr. Sears, for pointing out the misleading character of Dr. Offit's review of your book. If only more medical professionals and researchers would do the same...
At January 12, 2009 7:04 AM ,
Sue said...
Dr. Sears:
I'd be curious to know your opinion of the book "A Shot in the Dark" by medical historian Harris Coulter, and/or the most recent vaccine book by Neil Miller "Are Vaccines Really Safe and Effective?".
Thanks.
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