Should you get a flu shot?
As the cold and flu season approaches we receive many calls about vaccination. This season we are also all wondering about H1N1 (swine) flu virus.

Vaccination for the seasonal flu (influenza A) is recommended as soon as the vaccine is available in the fall. There are two forms of the vaccine available; live attenuated virus (nasal spray) and genetically modified (the injection). The nasal spray vaccine should NOT be given to patients taking immunosuppressant medications including but not limited to: prednisone, methotrexate, Enbrel, Humira, Remicade, sulfasalazine, Arava, Plaquenil, Imuran, Cellcept, Cytoxan, Orencia, Cimzea, and Simponi.

Most individuals have no pre-existing antibodies to H1N1 (termed swine flu because it is endemic in pigs).  It is recommended that patients on immunosuppressant medications (see above) be vaccinated for H1N1. These patients, along with patients with other chronic illnesses such as malignancy, asthma, diabetes, and heart disease are felt to be at greater risk for complications from the flu (for example , pneumonia). Again, the injection form of the medication is recommended and NOT the nasal spray. A single injection has been shown to result in adequate immunization 8-10 days after the shot is given. Seasonal influenza vaccine and H1N1 vaccine MAY be administered at the same time. 

So, enjoy the changing of the leaves and first snow fall. Be sure to wash your hands and get your Flu Shots!