Cold & Flu Archive

Ask the doctor

Q. I heard there is a high-dose flu vaccine that could work better in older people. Is it safe even if a man has a medical problem like cancer or heart disease?

A. The high-dose flu vaccine is very similar to the standard flu vaccine but appears to provide slightly better protection against influenza. Both vaccines target three different strains of the flu virus, selected from the most common strains predicted to be circulating that year. The viruses are inactivated, or killed, so they cannot cause the flu, even in people with weakened immune systems. Finally, both vaccines can cause mild symptoms of arm pain, redness, muscle aches, or low-grade fever. Although most people have minimal to no symptoms, the high-dose vaccine may slightly increase the side effects.

If you got the flu shot last year and it didn't work, don't reject vaccination.

During last year's battle of The People vs. Influenza, the virus gained the upper hand. Early in the 2014–15 flu season, a new strain of the virus emerged against which the existing vaccine offered virtually no protection. Hospitalizations for flu in older adults spiked to the highest level in a decade.

Vaccines are the best protection people have when it comes to certain illnesses. Older adults should get a flu shot every year.

Some years the flu vaccine works quite well. Other years it doesn’t. It has done a particularly poor job this year against the main flu virus. The CDC reported yesterday that this year’s flu vaccine has been just 18% effective. The estimate for children is even lower. And it looks like the nasal spray vaccine may not have worked at all among children. One reason for this year’s mismatch between virus and vaccine is that experts must decide months in advance which of the hundreds of flu viruses to include in the vaccine. What became the dominant flu virus this year, a new strain of H3N2 influenza A, wasn’t around last year when experts were determining this year’s vaccine.

Your immune system, skin, balance, and heart may be at risk.

As temperatures drop in the winter, weather-related health problems start to rise. "The cold weather brings a number of risks, especially for older adults," says geriatrician Dr. Suzanne Salamon, an instructor at Harvard Medical School. Here are some of the ways you may be vulnerable this winter, and how to fight back.

A high-dose version of the flu vaccine protected older people from influenza infection better than the normal-dose version, according to a study in The New England Journal of Medicine. The manufacturer of the high-dose flu shot, called Fluzone, conducted the study.

The study involved 32,000 people 65 and older who were immunized during the 2011–12 and 2012–13 flu seasons. The high-dose version contained four times the amount of vaccine as in a standard shot.

A study published in the Aug. 14, 2014, New England Journal of Medicine indicates that a high-dose version of the flu vaccine is more effective than the standard dose in preventing the flu for people over 65. The vaccine manufacturer, Sanofi Pasteur, had been required by the FDA to demonstrate that the high-dose version, which contains four times the dose of immune-stimulating antigens, actually works better than the standard dose.

About 32,000 people over 65 were randomly assigned to get either the standard flu vaccine or the high-dose version. All were asked to report any flulike illness they got over the next few months.

Over-the-counter painkillers, decongestants, antihistamines, and combination remedies can sometimes cause other health problems.

Enterovirus D68 is a respiratory infection that has been spreading across the country and making some children quite ill. It is especially problematic for kids with asthma or other respiratory issues. Enterovirus D68 can start out looking like a garden variety cold but lead to serious trouble breathing. What’s a parent to do? The same things he or she would normally do during cold and flu season: hand washing, staying away from people who are sick, regularly cleaning common surfaces like doorknobs, not sharing cups and utensils, and coughing or sneezing into the elbow, not the hands. Those who have children with asthma need to be extra vigilant about their child’s asthma care routine. Most upper respiratory infections are the simple cold. Still, it’s important to stay alert for signs of breathing difficulties.