If you missed last year's early rounds of influenza vaccines -- because supplies ran out or you weren't in a top-priority group or you wanted to see if any unsuspected side effects might occur -- it is not too late to get vaccinated.
Seasonal flu doesn't start to circulate much until the end of December, beginning on the East Coast and then migrating westward. It remains in play until late April, so getting a flu shot, which provides protection in 10 to 14 days, in January is still useful.
The H1N1 virus never disappeared over the summer. By early November it was found in 48 states, and the number of documented cases began to grow while the vaccine remained in short supply.
I am projecting that when this issue hits the street, there will be plenty of vaccine available. The initial shortage of H1N1 vaccine was caused by the failure of H1N1 to grow robustly in chicken eggs, producing only one to two doses out of each egg instead of the usual three doses. Newer techniques are now generating three doses per egg. Therefore, I want to reiterate the broader immunization recommendations, caveats, and reminders.
>People with HIV are a top priority group. They should get only the injectable vaccine.
>Household contacts of people with HIV should also be vaccinated when the demand for the top priority has been met.
>The nasal spray vaccine, which contains live virus and is indicated for ages 2- to 49-year-olds, is safe to give to household contacts of people with HIV. Otherwise, they can get the injectable.
>Both seasonal and H1N1 vaccines can be taken at the same time, provided that one of them is not a nasal spray.
>The flu medications oseltamivir (Tamiflu) and zanamivir (Relenza), which your care provider might give you if you come down with flu-like symptoms, such as fever, aches, and cough, do not interact with anti-HIV medications.
>Hospitalizations from the flu are often the result of a secondary pneumonia. All people with HIV should have already been given a Pneumovax shot, which prevents one of the common causes of severe pneumonia. However, Pneumovax needs to be boosted in five to seven years. Since time flies, check with your health care provider to see when you got your Pneumovax.
>Perhaps most important, wash your hands.
Bowers is an HIV specialist and is board-certified in family medicine. He is in private practice in New York City. Learn more about Bowers at http://www.danbowersmd.com