From Sioux City, Iowa, USA:
Our pediatric endocrinologist has suggested a flu shot for our four-year-old son, diagnosed with diabetes this past Spring. I've heard both ways, that the shot can or cannot give a person the flu. What is the truth, and should I get him one or not? Our family doctor says he'll need two shots a month apart. He doesn't have much contact with people outside of the two children at an in-home daycare or our household. Should we get one? And what about the rest of the family? Thanks for your help!
Flu shots are recommended for people with diabetes, but are not an absolute must. Every year, infectious disease specialists try to predict which strains of the flu will come to the US. There are many strains of the flu, and there can be different strains every year. Sometimes they predict correctly, sometimes they are wrong. Each year there is a new flu shot, which only protects you from the most likely strains to hit. If you get the flu shot, you can still get a "flu-like" illness from other strains of either the influenza virus or other viruses.
Because high blood sugars make you more susceptible to getting pneumonia if you get the flu, it is recommended for people with diabetes to get the flu shot. If your child gets any flu-like syndrome, (whether or not he gets the shot) it is important to check the blood sugars frequently and give extra insulin if the blood sugars are high.
Like many vaccines, the flu shots can give you a mild "flu-like" reaction for up to a few days after the vaccine. (Some of my patients say sometimes their blood sugars go high for a day or so after the shot also and they may need some extra insulin.) Two shots, a month apart, are recommended for children under 9 the first year they receive the vaccine. Older children and adults only require one shot even if it is the first time they are receiving the vaccine. These recommendations can also change from year to year depending on the strain of flu covered by the vaccine.
[Editor's comment: Flu shots are generally recommended for people with certain chronic diseases (such as diabetes, lung conditions, and heart disease) to protect them if there's a bad epidemic; they are also recommended for the elderly (who might not tolerate a severe acute illness as well as younger healthy people), nursing home residents (since there are so many frail individuals living in close proximity), and health-care professionals (I guess they want us docs and nurses to remain healthy to treat the people who get the flu!). I sometimes advise flu shots for people who are in close contact with extremely high-risk individuals, but I don't encourage family members of people with diabetes to automatically get the shots unless they fit one of the other categories I've mentioned. WWQ]
Original posting 9 Nov 97
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