3/14/10: This has not been a normal year! Every year we recommend Flu Immunization for the usual kind of flu, which we call “seasonal flu.” But this year we also have had the Swine Flu, also called Novel H1N1. So this year we've needed to give two separate flu vaccines. On 2/22/10 the FDA announced that next year's Seasonal Flu vaccine will include H1N1, so it looks like we'll just have one flu vaccine next year.

Seasonal Flu – For Seasonal Flu, we give both FluMist* and Flu shots. FluMist is given by a spray in the nose – no shot! This is for patients 2-49 years old only. For younger children 6-24 months old, and others who shouldn’t get FluMist (see below*), we give flu shots. We have some stock of these in our offices, although as of 3/14/10 our supply of Seasonal Flu shots and mist is limited; we have shots available for under age 3 in most offices, but little if any of the Seasonal Flu vaccine for older children -- so please call for an appointment or to be put on a call-back list.

H1N1 (Swine) Flu – The H1N1 vaccine is available in both nasal and injectable form, just like the seasonal flu vaccine. For children under 10, two vaccines a month apart are recommended. Second doses are available now, so please call for an appointment if your child is under age 10 and only received one so far. We have been sporadically receiving deliveries of both H1N1 Nasal Mist and H1N1 Shots in our offices, so our supplies change from week to week.

As of 3/14/10, we do have a supply of H1N1 Injections and Nasal Mist in most of our offices. (*See bottom of this page for who should not get Mist). As vaccines have become available, we are contacting people on our call-back lists, based on medical risk priority criteria, vaccine version available, and also the order on our list. We will continue to update this site as our supplies of H1N1 vaccine change, so please check back here on our website, and call for an appointment or to be put on a call-back list.

Please see our news article on H1N1 Vaccine Recall - Not to Worry for more information about the 12/15/09 and 12/23/09 recalls of some doses due to slighlty lower strength. No action is necessary.

Here is a list of the highest-priority groups for receiving the H1N1 vaccine:

• Pregnant women
• People who live with or care for children younger than 6 months of age
• Health care and emergency medical services personnel with direct patient contact
• Children 6 months through 4 years of age
• Children 5 through 18 years of age who have certain chronic medical conditions, such as:
  • Asthma or other chronic lung disease
  • Immune system problems or taking immunosuppressive medicines
  • Heart disease (except hypertension)
  • Kidney disease
  • Liver disease
  • Neurologic or neuromuscular disorders
  • Hematologic (blood) disorders
  • Metabolic diseases (including diabetes)
  • Taking aspirin or aspirin-containing medicine

Timing of Flu Vaccines: Seasonal and H1N1 – The timing is important only for "live" vaccines, which include Flu Nasal Mist as well as a few other childhood vaccines (MMR, Chickenpox, and Rotateq). Live vaccines must be separated by 4 weeks (minimum 28 days). Therefore, if your child has recently had one of these vaccines, including the FluMist Seasonal flu vaccine, and if you also want the Nasal Mist version of the H1N1 vaccine, there must be at least 4 weeks (28 days) between them.

More Information – Please visit our Health Library section on Influenza for more information about seasonal flu and H1N1 flu. Here are some good resources from the CDC and Children's Hospital of Philadelphia:

• What To Do if You Get Sick
• Taking Care of a Sick Person in Your Home
• Novel H1N1: What You Should Know
Here are the Vaccine Information Statements (VIS) from the CDC:
• “Seasonal Flu Shot” VIS
• “Seasonal Flu Nasal Spray” VIS
• “H1N1 (Swine) Flu Shot” VIS
• “H1N1 (Swine) Flu Nasal Spray” VIS

* Nasal Flu Vaccine (Seasonal FluMist, or H1N1 Nasal Mist) should NOT be given to the following people:

• Children under age 2, or adults over age 49;
• Pregnant women;
• People allergic to eggs, egg proteins, gentamicin, gelatin or arginine, or who have had life-threatening reactions to previous influenza vaccination;
• Children and adolescents on aspirin or aspirin-containing therapy;
• Patients with asthma, or to children under 5 years who have had any wheezing during the preceding year;
• Patients with a history of Guillain-Barre syndrome; or with immune system problems or taking immunosuppressive medicines; or with certain underlying medical conditions, including heart disease (except hypertension), kidney disease, liver, neurologic or neuromuscular, hematologic (blood) or metabolic diseases (including diabetes); or
• People who are close contacts of immunosuppressed people who require protected environments.