If you have hepatitis C, should you get a flu shot?

The Sick Girl By Felix Vallotton

It feels like fall this afternoon in Michigan folks. I just came home from a doctors appointment, and yes, I got my flu shot. According to the CDC the majority of people who come down with the flu will only have a mild case, however, as we know people with liver disease have a higher chance of flu complications. Infections can have a severe impact on the liver, especially in liver transplant recipients and in people with cirrhosis.

The earlier in the flu season you are vaccinated the better. The flu season begins in October, however the CDC began urging citizens to get their flu shot early, in fact in September they initiated a campaign called “Flu End with U”. The campaign was aimed at eliminating the myths and fears that some people may have about the flu vaccine.

More from Hepatitis C Trust and the CDC

Rena K. Fox, MD

Seasonal flu – get vaccinated if you have hepatitis C

Research by the Health Protection Agency and by Health Protection Scotland has shown that people with chronic liver disease are much, much more likely to develop severe complications if they get flu.

In fact, surprisingly, having a chronic liver disease like hepatitis C is the single biggest risk (more than having heart disease, for example).

Since these complications could potentially be fatal, the Trust is strongly urging everyone with hepatitis C to get vaccinated this winter.

The vaccine should be available from September so we suggest you call your GP now to make an appointment so that you’re protected as soon as possible. The flu virus circulates every winter, usually over a few weeks. The best time to have a flu jab is in the autumn, from September to early November. Do not wait until the winter, when the flu virus will be circulating, before getting your flu jab.

The vaccine will also protect against H1NI flu, which is likely to be one of the strains circulating this year.

There is further information about the flu jab on the NHS Choices website and from the Department of Health including this year’s seasonal flu leaflet.

If you have any concerns please call our helpline on 0845 223 4424 or 020 7089 6221

A Few Questions Answered By The CDC

What sort of flu season is expected this year?

Flu seasons are unpredictable in a number of ways. Although epidemics of flu happen every year, the timing, severity, and length of the epidemic depends on many factors, including what influenza viruses are spreading and whether they match the viruses in the vaccine.

Will new strains of flu circulate this season?

Flu viruses are constantly changing so it's not unusual for new flu virus strains to appear each year. For more information about how flu viruses change, visit How the Flu Virus Can Change.

When will flu activity begin and when will it peak?

The timing of flu is very unpredictable and can vary from season to season. Flu activity most commonly peaks in the U.S. in January or February. However, seasonal flu activity can begin as early as October and continue to occur as late as May.

What should I do to prepare for this flu season?

CDC recommends a yearly flu vaccine for everyone 6 months of age and older as the first and most important step in protecting against this serious disease. While there are many different flu viruses, the flu vaccine is designed to protect against the three main flu strains that research indicates will cause the most illness during the flu season. For information about which viruses this season's vaccine will protect against visit Vaccine Selection for the 2011–2012 Season. Getting the flu vaccine as soon as it becomes available each year is always a good idea, and the protection you get from vaccination will last throughout the flu season.

How effective is the flu vaccine?

Inactivated influenza vaccine effectiveness (VE) can vary from year to year and among different age and risk groups. For more information about vaccine effectiveness, visit How Well Does the Seasonal Flu Vaccine Work?

Will this season's vaccine be a good match for circulating viruses?

It's not possible to predict with certainty which flu viruses will predominate during a given season. Flu viruses are constantly changing (called drift) – they can change from one season to the next or they can even change within the course of one flu season. Experts must pick which viruses to include in the vaccine many months in advance in order for vaccine to be produced and delivered on time. (For more information about the vaccine virus selection process visit Selecting the Viruses in the Influenza (Flu) Vaccine.) Because of these factors, there is always the possibility of a less than optimal match between circulating viruses and the viruses in the vaccine.

How do we know if there is a good match between the vaccine viruses and those causing illness?

Over the course of a flu season CDC studies samples of flu viruses circulating during that season to evaluate how close a match there is between viruses in the vaccine and circulating viruses. In addition, CDC conducts vaccine effectiveness studies to determine how well the vaccine protects against illness. However, it's important to remember that even during seasons when the vaccine is not optimally matched to predominant circulating viruses, CDC and other experts continue to recommend flu vaccine as the best way to protect against the flu.

Can the vaccine provide protection even if the vaccine is not a "good" match?

Yes, antibodies made in response to vaccination with one strain of flu viruses can provide protection against different, but related strains. A less than ideal match may result in reduced vaccine effectiveness against the variant viruses, but it can still provide some protection against influenza illness. In addition, it's important to remember that the flu vaccine contains three virus strains so that even when there is a less than ideal match or lower effectiveness against one strain, the vaccine may protect against the other two viruses. For these reasons, even during seasons when there is a less than ideal match, CDC continues to recommend flu vaccination. This is particularly important for people at high risk for serious flu complications, and their close contacts.

In what years was there a good match between the vaccine and the circulating viruses?

In recent years the match between the vaccine viruses and those identified during the flu season has usually been good. In 17 of the last 21 U.S. influenza seasons the viruses in the influenza vaccine have been well matched to the predominant circulating viruses. Since 1990, there has only been one season (1997–98) when there was very low cross–reaction between the viruses in the vaccine and the predominate circulating virus, and three seasons (1992–93, 2003–04, and 2007–08) when there was low cross–reaction.

What is CDC doing to monitor vaccine effectiveness for the 2011–2012 season?

CDC carries out and collaborates with other partners within and outside CDC to assess how well flu vaccines work. During the 2011–2012 season, CDC is planning multiple studies on the effectiveness of both the flu shot and the nasal–spray flu vaccine. These studies will measure vaccine effectiveness in preventing laboratory confirmed influenza among persons aged 6 months and older, now that the Advisory Committee on Immunization Practices (ACIP) has recommended annual vaccination for everyone in this age group.

What actions can I take to protect myself and my family against the flu this season?

CDC recommends a yearly flu vaccine as the first and most important step in protecting against this serious disease. While there are many different flu viruses, the flu vaccine protects against the three main flu strains that research indicates will cause the most illness during the flu season. In addition, you can take everyday preventive steps like staying away from sick people and washing your hands to reduce the spread of germs. If you are sick with flu, stay home from work or school to prevent spreading influenza to others.

Where can I find information about vaccine supply?

For information about vaccine supply this season, please visit Seasonal Influenza Vaccine Supply for the U.S. 2011–12 Influenza Season.

Is there treatment for the flu?

Yes. If you get sick, there are drugs that can treat flu illness. They are called antiviral drugs and they can make your illness milder and make you feel better faster. They also can prevent serious flu–related complications, like pneumonia. For more information about antiviral drugs, visit Treatment (Antiviral Drugs).

What is antiviral resistance?

Antiviral resistance means that a virus has changed in such a way that the antiviral drug is less effective in treating or preventing illness. Samples of viruses collected from around the United States and worldwide are studied to determine if they are resistant to any of the four FDA–approved influenza antiviral drugs.

What is CDC doing to monitor antiviral resistance in the United States during the 2011–12 season?

CDC routinely collects viruses through a domestic and global surveillance system to monitor for changes in influenza viruses. CDC will continue ongoing surveillance and testing of influenza viruses. Additionally, CDC is working with the state public health departments and the World Health Organization to collect additional information on antiviral resistance in the United States and worldwide. The information collected will assist in making informed public health policy recommendations.

People at High Risk for Developing Flu-Related Complications

• Children younger than 5, but especially children younger than 2 years old
• Adults 65 years of age and older
• Pregnant women
• Also, American Indians and Alaskan Natives seem to be at higher risk of flu complications

• People who have medical conditions including:

• Asthma
• Neurological and neurodevelopmental conditions [including disorders of the brain, spinal cord, peripheral nerve, and muscle such as cerebral palsy, epilepsy (seizure disorders), stroke, intellectual disability (mental retardation), moderate to severe developmental delay, muscular dystrophy, or spinal cord injury].
• Chronic lung disease (such as chronic obstructive pulmonary disease [COPD] and cystic fibrosis)
• Heart disease (such as congenital heart disease, congestive heart failure and coronary artery disease)
• Blood disorders (such as sickle cell disease)
• Endocrine disorders (such as diabetes mellitus)
• Kidney disorders
• Liver disorders
• Metabolic disorders (such as inherited metabolic disorders and mitochondrial disorders)
• Weakened immune system due to disease or medication (such as people with HIV or AIDS, or cancer, or those on chronic steroids)
• People younger than 19 years of age who are receiving long-term aspirin therapy
• People who are morbidly obese (Body Mass Index, or BMI, of 40 or greater)