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Everything you ever wanted to know about the flu shot

MANATEE -- With the flu season upon us, the Herald submitted questions last week about the flu shot and flu to the Florida Department of Health-Manatee, also known as the DOH-Manatee. Each year, the health department orders the flu vaccine from various pharmaceutical companies throughout the US and administers the shots in Manatee County.

The following answers were received from Dr. Edwin Hernandez, Public Health Services Manager and Sandy Edmoundson, registered nurse, nursing director.

HERALD: How much does a DOH-Manatee flu shot cost this year?

EDMOUNDSON: Children ages 6 months through 18 years old receive the flu vaccine free of charge from the DOH-Manatee. Individuals ages 19 and older are charged $25 for the flu vaccine. There is a high dose flu vaccine for adults ages 65 and older that is $35.

HERALD: How many vaccines are available locally through the health department?

EDMOUNDSON: So far, our health department has ordered: 100 flu vaccine doses for children ages 6 months through 35 months, 2,500 flu vaccine doses for individuals ages 3 years old and up, 150 flu vaccine doses of the high dose vaccine for ages 65 and older and 130 nasal flu mist doses for individuals ages 2 through 49 years old.

HERALD: How long will they be dispensed?

EDMOUNDSON: We will continue to offer the 2014-2015 flu vaccine through June 30, 2015, but we are recommending people get their flu vaccine as soon as possible.

HERALD: What are the hours and locations in Manatee County where the DOH shots will be given?

EDMOUNDSON: During flu season, flu vaccines are provided at our primary location: 410 6th Ave. East, Bradenton, Our clinic's hours of operation are 7:30 a.m. to 4:30 p.m. Flu shots are by appointment or walk-in. To increase community outreach, our health department staff participates in various health fairs throughout Manatee County, offering the flu vaccine to those interested. Our staff also serves businesses in the community who request on-site flu vaccine clinics for their employees. This is a wonderful opportunity for business owners to help their employees stay healthy, which is good for the employee and the employer.

HERALD: What percentage of the Manatee County population do you think will get a flu shot?

HERNANDEZ: People receive their flu vaccine from many sources in Manatee County. The health department supports this strategy; our main goal is to

make sure the public is immunized and healthy. According to the Centers for Disease Control and Prevention 37.5 percent of Floridians age 6 months and older received the flu vaccine during the 2013-14 flu season. Providing flu vaccine data at a county-level is a little more difficult. Many local clinics and pharmacies that provide flu vaccines do not enter the vaccine into Florida's optional vaccine tracking system, FLSHOTS.

HERALD: Do all 67 Florida counties get slightly different flu shots based on prior influenza strains in their regions?

HERNANDEZ: The flu vaccine for any given flu season is the same throughout the United States. Scientists at the Food and Drug Administration, also known as FDA, determine each year which flu viruses will be targeted with the annual flu vaccine.

HERALD: How is a flu shot made?

HERNANDEZ: Believe it or not, for more than 70 years, flu vaccines have been manufactured using eggs. Vaccine viruses are injected into fertilized hen's eggs and incubated for several days to allow the viruses to replicate. After this time period passes, virus-containing fluid is harvested from the eggs. For flu shots, the flu viruses in this fluid are then killed and the virus antigen (which becomes the vaccine that helps us develop immunity to the flu) is purified. After purification is complete, manufacturers put doses of the vaccine fluid into syringes. Each lot of syringes must be tested and approved by the FDA prior to shipment.

HERALD: What is a flu strain?

HERNANDEZ: According to the CDC there are three types of influenza viruses: A, B, and C. Occurrence of Influenza A and B cases increase every winter, causing what we know as the seasonal flu. New and different versions of Influenza A and B virus pop up frequently. These viruses can vary from rare occurrences with moderate symptoms to pandemics with harsh symptoms. Scientists at the FDA adjust the seasonal flu vaccine annually, according to these changes in the flu viruses.

HERALD: Why does the flu have strains?

HERNANDEZ: There are several types of flu viruses and they are constantly changing and mutating. These changes can happen via biological processes slowly, or they can happen quickly. Changes that happen slowly over time are usually the annual changes we see occur in the seasonal flu. Scientists identify these changes, and adjust the vaccine accordingly. This is one of the reasons it is important to receive a new flu vaccine each year. Quicker mutations usually result when two different flu strains combine and infect the same cell. This mutation is what allows flu viruses to move from animals to humans. An example of this type of shift would be the H1N1 (Swine Flu) pandemic in 2009, which was caused by the virus mutating to transfer from pigs to people, and then from people to people.

HERALD: How many strains are there now?

HERNANDEZ: Our 2014-2015 flu vaccine protects against three viruses, including H1N1.

HERALD: What strain do scientists think will be popping up this season?

HERNANDEZ: The H1N1 virus, which caused the 2009 pandemic, is actually active again this year and is affecting young people at a high rate. The Centers for Disease Control report more deaths than usual (nearly 60 percent of this year's flu deaths) have occurred in the 25-65 year old age group. This pattern is similar to what we saw in the 2009 pandemic. This is the first season since the 2009 pandemic that the H1N1 virus has circulated so widely in the United States. This year's flu vaccine is your best protection against active flu viruses, including H1N1.

HERALD: Does the DOH pick a flu shot based on probabilities of the strain?

HERNANDEZ: We rely on scientists at the Food and Drug Administration to make this decision annually for the entire United States. There are currently 141 national influenza centers in 111 countries conducting year-round surveillance for influenza. The World Health Organization recommends specific vaccine viruses for inclusion in flu vaccines, but each individual country makes their own decision for which strains to include in their country's vaccines. In the United States, the FDA decides which viruses our flu vaccines will protect against.

HERALD: What do people say why they are fearful of regarding flu shots?

EDMOUNDSON: Client misconceptions we've heard include: "I get the flu from the shot. I don't like shots. I don't know what's in it. I don't like putting foreign substances in my body. It doesn't work."

HERALD: What do you think started these fears?

EDMOUNDSON: We think these fears are mostly caused by misunderstanding or lack of education on the flu vaccine. Also, family/friends that have coincidentally become ill after receiving the vaccine or religious beliefs or social media. DOH-Manatee is here to answer any questions people have about the flu vaccine. We encourage the public to call or stop by for answers. People can also visit www.floridahealth.gov for more information.

HERALD: In your opinion, why shouldn't people be afraid of the shot?

HERNANDEZ: If you are afraid of needles, the flu vaccine is available in nasal mist form. It's just a little squirt of mist into each nostril. The flu is dangerous. It can be fatal. Each year thousands of people in the United States die from flu and many more are hospitalized. People should be afraid of the flu, not the vaccine. The flu vaccine is the single best protection against the flu and its complications. The flu shot does not have any live viruses, so it will not make you sick with the flu. Vaccine side effects are mild, and can include slight tingling, redness, or soreness at the vaccine site.

HERALD: How does a flu shot work?

HERNANDEZ: Flu vaccines cause antibodies to develop in the body about two weeks after vaccination. These antibodies provide protection against infection with viruses that are in the vaccine. The seasonal flu vaccine protects against the influenza viruses that research indicates will be the most common during the upcoming flu season. Your body's immunity to these flu viruses can diminish over a year. The most common flu viruses can also shift from flu season to season. That is why it important to receive the flu vaccine annually.

HERALD: How many people in Bradenton got flu shots from the DOH-Manatee last year?

HERNANDEZ: During the 2013 - 2014 flu season, DOH-Manatee administered 4,050 flu vaccines throughout Manatee County.

Richard Dymond, Herald reporter, can be reached at 941-745-7072 or via Twitter @RichardDymond.

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