Influenza vaccination - yes or no?

What is a flu shot?

The flu vaccination is a vaccination against the influenza virus. It is recommended annually for people at risk, such as the elderly or chronically ill, as well as for groups of people who come into contact with people at risk. The vaccination should be given at the beginning of the flu season, in October or November. As a rule, the immune system should have built up adequate protection within ten to fourteen days after the vaccination.

What are the benefits of a flu shot?

The flu vaccines are developed annually against the likely three or four variants of the flu virus that will be most widespread in Germany in the coming flu season. The standing vaccination commission of the Robert Koch Institute (STIKO) recommends the use of the quadruple vaccine, which has been available since 2013/2014. That is why it is important to get vaccinated annually, preferably at the beginning of the flu season in October / November. The flu vaccine is usually very well tolerated, so only minor side effects such as reddening or swelling are to be expected.

People at risk, such as the chronically ill or the elderly, should get vaccinated, as an infection with the flu virus due to the weakened immune system with a higher risk of serious consequences, such as pneumonia, is to be expected in them, as in people with an intact immune system.

The flu vaccination does not offer one hundred percent protection against getting the flu.On the one hand, this is due to the fact that there are numerous types of the influenza virus, and on the other hand, that chronically ill people or people with a weakened immune system cannot provide complete vaccination protection. Vaccinated people still have the advantage that the flu may be milder than without a previous vaccination. Ultimately, the flu vaccination significantly reduces the risk of getting seriously ill.

Groups of people who have increased contact with high-risk patients, such as medical staff, should also be vaccinated in order to minimize the risk of infection.

What are the disadvantages of a flu shot?

The flu vaccination is usually very well tolerated. Nevertheless, side effects may occur. There may be redness or swelling of the puncture site, which may also be painful. In addition, general symptoms such as tiredness, nausea, muscle pain or shivering can occur. The symptoms usually go away completely within a day or two.
Read more on the subject at: Side effects of the flu shot

Very rarely, allergic reactions, inflammation of the small blood vessels or a decrease in the number of platelets (which are responsible for blood clotting) may occur. Patients who knowingly are allergic to ingredients of the vaccine or to egg white should seek advice from their doctor as to whether and under what circumstances vaccination can be carried out.

It can also be a disadvantage that the flu vaccination is necessary every year in order to receive sufficient vaccination protection for the new flu season. In doing so, forecasts are made as to which three or four virus types will occur most frequently in the coming flu season. That is why the flu vaccination is only about 60 percent effective, as the forecasts are not one hundred percent accurate every year and the virus can also change during the current flu season.

The statement that the flu vaccination prevents around 60 percent of all infections is based on healthy adults. People at risk with a weakened immune system may have a lower level of vaccination protection. In spite of this, the vaccination is to be considered sensible and recommended, as an infection is likely to be milder than without vaccination.

Who should be vaccinated?

The permanent vaccination commission of the Robert Koch Institute (STIKO) makes recommendations as to who should be vaccinated against the flu virus. The STIKO currently recommends vaccination for risk groups, i.e. groups of people who have an increased risk of the disease being more severe than for groups of people with an intact immune system.

The STIKO currently recommends having the following groups of people vaccinated:

People over 60 years of age
Pregnant women from the 4th month of pregnancy
Children, adolescents and adults with a chronic illness
Children, adolescents and adults with a congenital or acquired immune deficiency or an infection with HIV
Medical staff and staff in care facilities
Residents of retirement or care facilities
People in contact with poultry or wild birds

People over the age of 60 are at increased risk of complications such as pneumonia because the immune system's performance decreases with age. A vaccination against pneumococci, the most common pathogen for bacterial pneumonia, is also advisable.

Pregnant women from the 4th month of pregnancy or in the presence of a chronic illness from the 1st month of pregnancy should also be vaccinated.

Children, adolescents and adults with a chronic illness and the associated increased health risk should also be vaccinated.

In the case of a congenital or acquired immune deficiency, as well as an infection with HIV, the STIKO also recommends a vaccination.

Medical staff and staff in care facilities should also be vaccinated, as they are exposed to an increased risk of infection. The residents of old people's and nursing homes should also get vaccinated annually.

Who shouldn't get the flu vaccine?

The STIKO recommends not to be vaccinated if you have a current illness (temperature above 38.5 ° C) or an acute infection. The vaccination should be made up soon after recovery.

If there is an allergy to the ingredients of the vaccine, such as egg white, a vaccination should definitely be carried out in consultation with the doctor or the vaccination should be omitted in the event of a severe allergy. Under certain circumstances, the vaccination can also be carried out under special supervision, such as in a hospital.

Unlike adults, children and adolescents usually receive a live vaccine. This should not be used in case of immune deficiency, severe asthma or therapy with salicylate.

Should pregnant women get the flu vaccine?

The STIKO recommends that healthy pregnant women be vaccinated from the 4th month of pregnancy and, in the case of a chronic illness, as early as the 1st trimester of pregnancy at the beginning of the vaccination season in autumn. The reason for this is that pregnant women can get infected more easily and have an increased risk of more severe disease courses. Since 2010, a flu vaccination has therefore been recommended for all women who are pregnant in autumn and winter.

Antibodies can also be transferred to the child via the placenta, so that one hopes for protection for the newborn in the first months after birth, in which the newborn cannot yet develop sufficient antibodies of its own.

A dead vaccine is used in adults for flu vaccination. This can theoretically be vaccinated every month of pregnancy. Numerous studies have shown a high level of safety for pregnant women as well as the unborn child, so that one does not have to worry about the vaccination if there are no indications against a flu vaccination.

Read more on the subject at: Flu vaccination during pregnancy

Should children be vaccinated against the flu?

The STIKO does not make a general recommendation for children and young people. This means that children and adolescents who do not have an increased risk of serious disease progression, for example due to a chronic disease or an immune deficiency, usually do not need to be vaccinated.

The STIKO only recommends a vaccination for children and adolescents with a chronic illness or an immunodeficiency, as this creates the risk of more severe disease courses. Vaccination may also be recommended if children have increased contact with persons at risk, for example if they live in the same household and are in close contact.

Children and adolescents are usually vaccinated with a live vaccine that can be applied as a nasal spray.