freeCE: What This Year’s Flu Season Has To Offer

Flu Season

With September 23rd marking the start of fall this year, many people have started to look forward to what this colder season has to offer. Changing leaves, holidays, and school breaks are some of the things that first come to people’s minds. However, for many healthcare professionals and cautious parents, they know another season is approaching. A “fifth season” of the year is known as flu season.

When Is Flu Season?

Flu season is the most typical time that the flu will occur during the year. The normal season in the United States occurs between October & May. The peak, or months with the most reported cases, is December-February.

What is the Flu

The flu, or influenza, is caused by influenza virus A and B. It primarily targets the throat, nose and lungs. It is spread from person to person mainly by respiratory droplets. These droplets can reach people up to 6 feet away.

The flu typically presents with a quick onset of symptoms that include:

Fever
Chills
Body aches/headaches
Runny nose
Fatigue
Cough

Symptoms can include any of the above in combination together and range from mild to severe.

The flu can be detected in a person 1 day before symptoms begin and 5-7 days after. If a person is experiencing symptoms, it is best to go to the doctor and distance others so they may not get the flu as well.

What to do to Stay Protected

Vaccination

To prevent yourself or others from getting the flu, the best practice is to get a flu vaccine every year. The best time to be vaccinated is September and October, before the flu season has really begun. However, receiving your vaccine too early may decrease the effectiveness of the vaccine to last the entire flu season. It is recommended to not get your vaccines early, like in June or July, unless instructed by your healthcare provider. Vaccination for prevention has been shown to reduce doctor visits for flu-associated issues by 40-60%. It also shows a decrease in flu severity and hospitalization if you were still to get the flu after being vaccinated.

There are two types of flu vaccines, activated and inactivated.

The activated vaccine can come in two forms, a nasal mist or an intramuscular shot. The intranasal spray can be used for ages 2-50 years old. The live vaccine shot can be given to someone 18 years or older.
The inactivated vaccine comes only in an intramuscular shot and can be given to those 6 months and older.

If you are 65 years or older and/or have certain medical conditions, your doctor may recommend a specific brand or type of vaccine. Pregnant patients and young children may also have specific criteria as well. If any changes to your health occur or you fit one of these other criteria, it is best to talk to your healthcare provider to determine the best time and type of flu vaccine to receive before being immunized.

Egg allergies in patients have been a controversy for the flu vaccine in the past. However, it is recommended that patients with an egg allergy still receive their yearly flu vaccine. If a patient has a severe allergy, it is recommended to be vaccinated in an inpatient or outpatient facility to be monitored right after administration. A patient who is 18 years or older who wants to avoid any egg products may receive Flublok Quadrivalent^Ⓡ.

Common side effects of the vaccine are injection site pain and redness. You may also feel tired or have a fever the next couple of days.

Medication

If you do get the flu, your doctor may prescribe an antiviral medication. Antiviral prescriptions are specifically for the flu and should not be confused with antibiotics because they treat different disease states. It is best to begin the medication within two days of symptom onset. Your doctor may choose your specific prescription based on your age, medical conditions, dosage form, and severity of illness.

The most commonly used antiviral is oseltamivir. Other common ones to be prescribed are baloxavir, peramivir, and zanamivir. These medications come in a variety of dosage forms, making it easier for patients to adhere to its use.

Oseltamivir is typically given twice a day for 5 days. It comes in a pill and liquid suspension form. It is one of the best options for pediatrics because it can be used in patients 14 days old and older.
Baloxavir is a single dose pill that can be given to patients 12 years and older. Patients who are 5-12 years old may use this pill as well, but must not have any chronic medical conditions. This medication should be avoided in patients who are pregnant or may be pregnant because that population has not been studied.
Peramivir is an intravenous (IV) drug to treat patients 6 months and older. It may only be administered to a patient with a provider present. It is typically used in patients with more severe symptoms or if patients are not able to tolerate PO medications. It can be given in a single dose for uncomplicated patients and once daily for 5-10 days in hospitalized patients.
Zanamivir comes in a powder form and is breathed in through an inhaler device. It is given to a patient twice a day for 5 days. It can be used in patients 7 years and older that do not have respiratory issues, like asthma or COPD.

While all these medications have a usual set length of use, your doctor may change it based on a patient’s symptoms, flu severity, and/or patient’s medical conditions.

Pharmacy Role in Vaccines

Pharmacies play a huge role in the administration of vaccines. Of the 18,009,374 vaccines given for the 2022-2023 flu season by October 1, 2022, 10,526,543 were administered at pharmacies. Therefore, it is essential for pharmacy staff to be helpful in vaccinations. As a technician, you can research and study flu vaccine general information to help aid customers in their understanding. A technician can also receive a certificate to administer vaccines and relieve pharmacists from that role at times. It will also help to increase vaccination availability at pharmacies.

Resources:

Kumari R, Sharma SD, Kumar A, et al. Antiviral Approaches against Influenza Virus. Clin Microbiol Rev. 2023;36(1):e0004022. doi:10.1128/cmr.00040-22
Rand CM, Olson-Chen C. Maternal Vaccination and Vaccine Hesitancy. Pediatr Clin North Am. 2023;70(2):259-269. doi:10.1016/j.pcl.2022.11.004
Influenza (flu). Centers for Disease Control and Prevention. September 29, 2023. Accessed October 16, 2023. https://www.cdc.gov/flu/index.htm.
Lexicomp. Accessed October 17, 2023. https://online.lexi.com/lco/action/home?refid=1.