Scott Webb: Welcome to Stoughton Health Talk. I'm Scott Webb. And as we head into cold and flu season, many of us are wondering whether we should get the flu shot and whether or not we can get the flu shot and the COVID booster at the same time. And joining me today to answer these questions and more is registered nurse Bill Wilson. He's an infection preventionist with Stoughton.

So Bill, thanks so much for your time today. I know it's that cold and flu season and we're all still mindful of COVID, so everyone's got these things on their minds: which shot to get, can we get all the shots, can we get them in the same arm, and so on. So, great to have an expert on. As we get rolling here, do you recommend the flu shot for folks?

Bill Wilson: I absolutely recommend that everyone who's eligible to receive the flu vaccine gets a flu shot every year.

Scott Webb: Yeah. And one of the things I always wanted to ask an infectious disease specialists is when it comes to the flu shot, right? So we know or at least we think it's not the same flu shot, so it's not last year's flu shot, it's this year's flu shot. So how does that work exactly? How do they figure out, you know, how to create the proper shot for that year to deal with like the new strains or variants? Maybe you can explain that to us.

Bill Wilson: When it comes to the influenza viruses, they're constantly are viruses circulating throughout the globe. And what they do, there are so many different variants of that, that there's constant disease surveillance. The WHO and the CDC are compiling the data from around the world. And they make recommendations based on the circulating viruses and the viruses from the previous influenza season as to what would be the recommendations for the vaccine for the upcoming flu season. And then, it's up to the individual countries, like our CDC to make recommendations as to what is going to be in our vaccine for the United States.

Scott Webb: Yeah, Bill. So when we think about who should or shouldn't get the flu shot and, you know, you recommend it pretty much for everybody. But is there any sort of range in terms of ages or is there different versions of the flu shot for kids versus adults? Essentially, is there anyone who shouldn't get the flu shot? And if so, what would those reasons be?

Bill Wilson: Yes, actually, there are individuals who should not receive the influenza vaccine. But first, let's talk about those who do qualify to get the influenza vaccine. Everyone six months of age and older should get an influenza vaccine every season again with rare exceptions. So they have different influenza vaccines that are approved for different age groups. Say for example, pregnant individuals and people with some chronic health conditions should not get some certain types of influenza vaccines and some people should not receive vaccines at all.

With the '22, '23 flu season, there are three flu vaccines that are preferentially recommended for people age 65 and older. Those are the Fluzone, that's a high-dose quadrivalent vaccine, and a Flublok quadrivalent recombinant flu vaccine or the Fluad quadrivalent, it's an adjuvanted flu vaccine. Anyone six months and older, I recommended them to get the flu vaccines for their age range as well.

There's also one additional flu vaccine that is available, and that is the flu nasal spray vaccine. And that is for individuals two years of age through 49 years of age. So, most people in that age group can receive that nasal spray vaccine, including those that have the egg allergies. Those that should not receive a flu shot are, again, children younger than six months of age, because they are too young to get the flu shot, but their pregnant mothers are able to, and they can pass on protection to their infants. Individuals that have severe or life-threatening allergies to any ingredient in a flu vaccine, other than just an egg allergy or egg protein allergy, should not get that vaccine. There are people that have had a severe allergic reaction to a previous dose of an influenza vaccine and they should not get that particular flu vaccine again and may not be able to receive other influenza of vaccines, but should talk to their providers about the possibility of getting a different type of vaccine.

Other individuals that should consider talking with their healthcare provider before getting the flu shot would be those that have had an allergy to eggs or any of the other ingredients of the vaccines, so they can talk to their doctor about that allergy and the type of reactions that they have had. If individuals have had a paralyzing illness called Guillain-Barré syndrome, also known as GBS, those individuals that have had that in the past would want to talk to their medical provider about that history before getting their flu vaccine. And then, of course, if you're not feeling well, if you're feverish or have other symptoms of illness, it's not recommended that you receive the vaccine at that time.

Scott Webb: Yeah. Certainly, I'm a parent so I have kids and I've been getting shots my whole life as well, so good to know that it's safe, certainly effective for children six months and older. And you did just give us a sense of maybe who shouldn't get the shot. For the most part, it's most people, but there are some exceptions, of course. And I think the big question a lot of us have in our minds, especially over the last couple of years, is can we get the flu shot and the COVID shot at the same time? Should we get it in the same arm? Maybe you can put some fears aside.

Bill Wilson: Absolutely. If it is the correct time for you to receive your vaccine, meaning it's been the correct timing for receiving the booster, then you can absolutely get the COVID vaccine and the flu vaccine at the same visit.

Scott Webb: I was thinking about this. I was talking with my wife. I was like, "Well, is it better to get one shot in one arm and one in the other and maybe have both arms be sore?" Is it recommended, Bill, to get them both in the same arm or is it just a personal preference?

Bill Wilson: In general, it's better to receive one in each arm if that is at all possible. If there is a reaction, a localized reaction, then it's a little easier to trace it as to which vaccine it could be attributed to.

Scott Webb: Right. Then, you don't have to say, "Well, was it the flu vaccine or the COVID vaccine?" So, all right, got it. So one in each arm, I'm with you. Is there anything else that we can do to try to stay healthy during the cold and flu season? Obviously, you recommend the flu shot, but whether it's eating right, exercise, quitting smoking, all those things on the hit list, what else would you recommend?

Bill Wilson: There's lots of things you can do to keep yourself healthy. Number one, get your vaccine. Get the flu shot. Number two, stay away from those that are sick. No one wants to stay home or to cancel family gatherings. But if someone is ill, the easiest way to pick up an illness, like the flu, is to be exposed to somebody who's actively shedding the viral particles. So if they are coughing, sneezing, the typical signs and symptoms, sore throat, runny stuffy nose, muscle, body aches, headaches, fatigue or tiredness, and some individuals even vomiting and diarrhea, although that's more common with children than adults; and cough and fever, of course, stay away from those.

The very things that keep us from getting COVID, we've learned so much during this pandemic. And if there's one takeaway people can have from the pandemic is we've learned what to do to mitigate viral spread. That's wash your hands, distancing from those that are sick, staying home when you're ill, getting plenty of sleep, plenty of hydration, drinking plenty of water. Eating foods that are high in nutrients, such as vegetables, fruits, nuts, things that give you energy, to help your body fight the infection and keep your immune system healthy. Staying physically active and managing stress. Those are all wonderful things to keep us from getting sick.

Things you can do to keep from picking up an infection such as influenza, it also is good for preventing COVID, is to make sure that you wash and sanitize your hands using an alcohol-based hand sanitizer. Washing your hands with warm soap and water for at least 20 seconds. Avoid touching your eyes, your nose, or your mouth. And then, remember to clean and disinfect those surfaces that are touched most frequently at home and around others who are sick.

Scott Webb: Well, a lot of great advice today from an expert, Bill. I really appreciate it. You know, some of this stuff seems like common sense, but then when you hear it from an infection preventionist, you know, an expert in it, you go, "Well, if Bill said it, it must be true," right? It's not just something I read on Facebook or something. So, thanks so much and you stay well.

Bill Wilson: Thank you.

Scott Webb: And for more information, go to stoughtonhealth.com.

And that concludes this episode of Stoughton Health Talk. Please remember to subscribe, rate and review this podcast and all the other Stoughton Hospital podcasts. I'm Scott Webb. Stay safe and be well.