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This is the final post of a three part series on the flu shot. In Part 1, I describe where you can get vaccinated. In Part 2, I review the flu shot options for the 2015-2016 flu season.

How many times have you visited a doctor, nurse, or pharmacist, and wished someone could have prepared you for the experience? In this post, I’m going to walk you through what to expect when your health care professional administers the flu shot.

Clothing

This can be the most awkward part of getting your flu shot. Make sure you’re wearing a shirt that allows access to your shoulder (deltoid) muscle. I find a t-shirt usually works best. If you are unable to roll up your sleeves, the health provider will have to get you to unbutton your shirt and remove your arm from the sleeve. This takes time and can be revealing than is necessary, especially if you are getting the shot in a public flu clinic.

Your Health

You’ll be asked how you are feeling today. If you have a severe illness and have a fever, you may want to delay your flu shot. If you’re taking antibiotics or have a mild fever, you do not need to delay the flu shot.

Medical conditions and current medications: The immunizer will ask you about your current health conditions. In particular, they will want to know about conditions that can impact your immune system, or specific conditions that are potential side effects of the flu vaccine. Let the immunizer know which medications you are currently taking. This information can impact which vaccine you receive and which medications you can take post-vaccine to treat your symptoms.

Allergies: Do you have allergies to food or medications that are contained in the flu shot? Ingredients in the flu shot can include preservatives; such as thimerosal, which you’ll typically find in multi-use vials of vaccine; trace amounts of antibiotics, gentamicin, kanamycin, or neomycin; formaldehyde; sugar; ethanol; MSG, surfactants; and trace amounts of egg protein (the influenza virus used in the production of the vaccine is grown in hen’s eggs). All these ingredients are safe, commonly used in pharmaceutical production, and found in tiny amounts in the flu shots.

Preferred site of injection: Anecdotally, I’ve been told the shot hurts less when you get it in your dominant arm. For women with a single mastectomy, you will get the shot in the arm opposite the mastectomy. If you have a double mastectomy, you can receive the flu shot into your thigh muscle.

Pregnant or breastfeeding: Please tell the immunizer if you are pregnant or breastfeeding.

Previous Flu Shots: Have you had any problems or allergies to previous flu shots? If yes, what was the specific product, what type of reaction did you experience, and how quickly did the reaction happen?

Learn more about receiving your 2015 flu shot

Photo courtesy of Steve Ellmore, from the Fort George G. Meade Public Affairs Office.

Injection Pain

Pain caused by vaccines is a common concern. Recently, the Canadian Medical Association Journal published practical guidelines on the management of pain during vaccination injections. Recommendations that apply to health providers include:

  • Do not aspirate (pull-back on the syringe once injected)
  • When receiving multiple vaccines, inject the most painful vaccine last
  • Educate parents and patients about pain management

Recommendations applicable to parents include:

  • Use comfortable positioning, including breastfeeding (for children under 2 years of age), skin-to-skin contact, and holding, and sitting upright (in children three years and older)
  • Have the parents present during the vaccine injection
  • Use a topical (applied on the skin) anesthetic. This medication is usually applied 20-60 minutes in advance of the injection.

Health Insurance

In Canada, you’ll need to bring your provincial health care number in order to get the publicly-funded vaccine. If you do not have public insurance, make sure you have your private medication insurance information readily available.

Informed Consent and Education

The immunizer will review some basic concepts about the vaccine, including what disease it prevents, common and rare side effects and how to manage them, and the overall risks and benefits of the vaccine. They will ask for your consent to receive the flu shot.

Waiting

An extremely rare side effect of vaccines is anaphylaxis, which usually occurs quickly after being exposed to the flu shot. For this reason, you will be asked to wait for 15 minutes after receiving the flu shot. If you feel any throat swelling, itching, hives, wheezing, and lightheadedness, tell your health care professional. If you’re allergic to eggs or have experienced anaphylaxis to another medication or food, you’ll have to wait 30 minutes after receiving the flu shot. Some people may faint after their injection. If this happens you’ll be asked to sit or lie down until you recover. The important thing is to let the health care professional know you’re not feeling well and they can take the best action to manage a side effect.

Conclusion

By being prepared for your 2015 flu shot, you’ll set yourself up for a positive vaccination experience. You’ll be comfortable and relaxed with a good understanding of what to expect when you get your injection or nasal spray.