Can I get the tetanus and flu shots together? And should I even get a flu shot?
December 11, 2011 2:11 PM   Subscribe

Is it okay to get a tetanus and a flu shot on the same day? Also, is the flu shot really necessary?

I'm getting laid off, so I'm getting in all my booster shots and doctor visits before I lose my job. I'm getting a tetanus booster because I think it's been 10-ish years since my last one. I'm wondering if I should also get a flu shot. I'm a healthy early 30s female - I've never had the flu, but I do live in a big city so I guess I'm exposed to a lot of other peoples' germs. No kids and no regular exposure to children.

So two questions - if I do decide to get the flu shot, can I get it on the same day of the tetanus shot? Might as well just get them done together, right?

And my other question is - is the flu shot worth getting, or not really? I hear all these horror stories about people getting sick for days or even weeks after getting the shot, and I really don't want to be laid up in bed for the holidays. Those of you who had the flu shot this year - did you have any reaction other than the normal soreness on the arm?

posted by emily37 to Health & Fitness (44 answers total)
I've had no side effects from the flu shot other than not getting the flu. Also, for whatever reason, in the few years I have been getting the flu shot, I have also not had any colds. I don't know if that's coincidence or not, but perhaps my immune system is freed up to fight other infections once I get the flu shot.
posted by dfriedman at 2:20 PM on December 11, 2011 [1 favorite]

Yeah, I'll probably end up getting the flu shot. Better safe than sorry, I guess. I've read in a few places that it's worth asking for the SHOT, which is dead virus, rather than the nasal vaccine, which contains a weak live vaccine.
posted by emily37 at 2:22 PM on December 11, 2011

I am not a doctor, so check with a doctor on interactions. But I am not aware with a problem of getting both on the same day. We schedule my kids' flu vaccinations on the same day they have a scheduled checkup vax, and we've never been told to separate them.

I hear all these horror stories about people getting sick for days or even weeks after getting the shot, and I really don't want to be laid up in bed for the holidays. Those of you who had the flu shot this year - did you have any reaction other than the normal soreness on the arm?

The flu shot doesn't make you sick unless you have an allergic reaction. So either you know a lot of people who have allergic reactions to vaccines, or you've frankly heard a lot of uninformed horse hockey. I know I have.

But understand that the vaccination isn't a guarantee against infection -- if you're exposed to enough virus, you'll still get sick. But your body's immune system will respond better, and you won't get as sick as you would have.
posted by middleclasstool at 2:23 PM on December 11, 2011 [1 favorite]

The flu shot is worth getting not only to help you avoid getting sick; it's true that you might get the flu and not have too bad a time of it. The wider social implication is that by getting vaccinated, you help avoid spreading it to other people who can't who have a higher risk of serious illness or even death associated with the flu (e.g., infants, the elderly, people with compromised immune systems, etc.). When I was going through chemotherapy this time last year, my doctors said I had to explicitly make sure that anyone who came to visit me had been vaccinated, because my immune system was so weak. But there were still times I had to go out in public, and of course I had no way of knowing who had been vaccinated or not (plus there was a pertussis outbreak going on at the same time, which made me doubly alarmed), so that always made me a little nervous.

tl;dr: don't just get the shot for yourself. Get it for the people around you.
posted by scody at 2:29 PM on December 11, 2011 [17 favorites]

What? Here's information from the CDC on how the flu vaccine works. If you're exposed to a strain outside this season's three, you are as likely to get these flues and just as severely as if you were not vaxed at all. Likewise, if you are exposed to any flu in the two weeks before you acquire immunity, you will also get sick. Ergo, all those "and I have never been so sick!" people, who happened to get flu right after being vaxed. It's a very specific breed of horse hockey.
posted by DarlingBri at 2:31 PM on December 11, 2011

(yow, that second sentence came out really garbled. Should be " help avoid spreading it to other people who can't take the risk of getting sick because they have a higher risk of serious illness...")
posted by scody at 2:31 PM on December 11, 2011

Thanks guys. Anyone get tetanus and flu shots at the same time? Any issues?
posted by emily37 at 2:45 PM on December 11, 2011

I got the flu shot a few days ago, and had a somewhat sore arm (common and acknowledged to be caused by the shot, no biggie). The night I got the shot, I also had a low fever with chills, and the following morning felt fairly crummy, possibly just from dehydration, possibly something more. I've also known people who have had side effects along these lines.

The CDC website links to studies which show that the rate of these flu-like side effects is the same as with just a saline injection. In other words, feeling mildly sick after getting the shot does happen, but it happens as often with a placebo. (So you might end up having a night of feeling sort of crummy, but it's due to the placebo effect. Knowing about the stats and placebo effect ahead of time did not prevent me having these effects including a low fever.)

Of course, you might also get sick for real, if you have been incubating a bug already. But that would just be coincidence.

The flu shot literature says it takes 2 weeks for you to develop enough antibodies in reaction to the vaccine to be protective against the flu, so there is a lag there.

Another thing they advise is that if you're doing to have a Bad (allergic) Reaction to the shot, it will happen very shortly after getting it, so plan to hang around the place where you get the shot for 10 or 15 minutes so you are in a supervised setting. (I got mine at the drug store pharmacy and they suggested this.)

My answer like everyone else's is: get the shot unless you have some strong reason not to.
posted by LobsterMitten at 2:52 PM on December 11, 2011

I wouldn't get both in the same day because of potential muscle pain from the tetanus shot. That shot is a bastard and I wouldn't want another shot on top of it contributing to any more muscle pain. If getting the tetanus shot, I'd either get the flu nasal spray the same day or wait on the flu shot (you can always get it at a free or low-cost flu clinic after you lose your job).
posted by dayintoday at 2:54 PM on December 11, 2011

What if you get them in opposite arms?
posted by emily37 at 3:00 PM on December 11, 2011

Take a couple of Tylenol before you go in. I've had success at eliminating pain after tetanus shots by icing the affected area and making sure I move the arm around and keep it stretched out.
posted by kamikazegopher at 3:05 PM on December 11, 2011

I got mine the same day, one in each arm. I felt kind of shitty the next day but I was also traveling and starting a new medication so it's hard to say the vaccines had anything to do with that.
posted by padraigin at 3:07 PM on December 11, 2011

Check when your insurance ends too; I had a grace period (end of the month that I was laid off I believe) when I left so you may have a few more days too than you think.
posted by ejaned8 at 3:08 PM on December 11, 2011

I got the both the tetanus (DTap) and flu shot the same day, as I have a two year old. The nurse insisted on giving them in opposite arms. The DTap arm was sore enough that I could not lie on it while sleeping for several days. The soreness in the flu arm cleared up after a day or so.

You should be fine.
posted by theBigRedKittyPurrs at 3:12 PM on December 11, 2011

I have asthma (and no insurance) so I get the flu shot every year. I really don't want to get the flu, which is bad enough on its own but can also make my asthma flair up, and not be able to go to the doctor. I've never had a problem, only a very slightly sore arm. I also have a 2-year-old nephew and I don't want to get him sick.
posted by shoesietart at 3:29 PM on December 11, 2011

Also, is the flu shot really necessary?
Hello Can O'Worms! ;)

A few datapoints for your consideration:

1. A flushot offers you zero protection from any of the thousands of rhinoviruses (common cold) that you will encounter on doorknobs and such throughout the season.

2. The flushot offers only protection from three flu viruses that doctors at the epidemiology center took a best guess at as to their prevalence this season in the U.S. That best guess was made last flu season. The reason there has to be a year's interval is to allow ramp-up time for vaccine production. The flushot offers zero protection for any of the thousands of other flu viruses which you could conceivably encounter this year.

3. The flu shot is only 59% effective (at best) in a general population at preventing flu. So close to a 50-50 chance of it actually working for you.

4. Annual Fly shots bring in billions of dollars a year to Big Pharma. Big Pharma pays many millions to lobby politicians as we all know. Donald Rumsfeld made millions from bird flu shots (Tamiflu) that his Dept of Defense alerted the country about because he owned a large stake in the company that made the bird flu shots.

You are going to have to decide on their worth - but I am putting the above infor out there as well. Certainly if you are older (60+) or infirm it's probably worth your while up the odds a little bit in your favor
posted by Poet_Lariat at 3:34 PM on December 11, 2011 [2 favorites]

Have you had flu shots before, did you get sick from them? I get very little muscle soreness, if any, from the flu shot (including this year). I wouldn't worry about it unless you have some reason to believe that you personally react badly to flu shots. (DTap gave me a couple days' sore arm though.)

I think you should just ask the doctor when you go in whether they think it's reasonable to get both shots. If you end up not getting the flu shot, that's not a big deal, IMHO— you're not especially vulnerable or spending time with vulnerable people— but I think getting the shot is worth it, because having the flu is fucking miserable. Weigh the chances of being laid up in bed from the shot (tiny: 1 in 100000 or less) vs. being laid up in bed from the flu (relatively huge, even if you hardly ever get the flu, that's maybe 1 in 10 per year?).
posted by hattifattener at 3:38 PM on December 11, 2011

"Anyone get tetanus and flu shots at the same time? Any issues?"

My 6-month-old (who is now two) got his flu and DPT (diptheria-pertussis-tetanus) on the same day, along with HiB, PCV, Hep B, and Polio. My current five-month-old will receive this happy treatment next month. You will be FINE. They'll probably do opposite arms if you ask. I'd probably do the same arm, myself, so all the ouching was on one side, but I am very wimpy about shots.

If you want to be like my children, you have my permission to scream bloody murder for five solid minutes afterwards and then drink a lot of milk until you feel better.
posted by Eyebrows McGee at 3:46 PM on December 11, 2011 [3 favorites]

Those of you who had the flu shot this year - did you have any reaction other than the normal soreness on the arm?

No adverse effects here, or last year, or the year before that. The other effect is that I have not contracted the flu in any of those years.

Donald Rumsfeld made millions from bird flu shots (Tamiflu) that his Dept of Defense alerted the country about because he owned a large stake in the company that made the bird flu shots.

Tamiflu is not a flu vaccine. This is poorly-informed conspiracy nonsense.
posted by grouse at 3:51 PM on December 11, 2011 [19 favorites]

I've gotten them both, along with one or two others. I can't remember which went into what arms, but both my arms were sore. They hurt, yes, but it wasn't bad.
posted by Neekee at 4:16 PM on December 11, 2011

(Guys, can we all just agree to stop with the anti vs. pro flu shot derail? I know I'm tired of it - I can't be the only one!)

Emily: there is no contraindication to getting these two vaccines in one day (I'm assuming you're not immunocompromised, not currently ill, etc.). I would recommend getting one in each arm.

That said, there are 2 varieties, so to speak, of tetanus shots that are given to adults. One is solely a tetanus booster; it provides protection against tetanus. The other is a TDaP booster. It provides protection against tetanus, diptheria, and pertussis (whooping cough). Some individuals lose their immunity to pertussis as they age (their body simply isn't producing enough antibodies). It can be lethal in children, and it's nasty and absolutely no fun to get as an adult. I would recommend considering the TDaP booster, provided you haven't already gotten one in the last 10 years and (obviously) with your healthcare provider's OK based on your immunization record.
posted by pecanpies at 4:19 PM on December 11, 2011

I'm diabetic and get a flu jab every year. I have also had a tetanus jab within living memory, although I did not have both at the same time. The only issues I've ever had with either jab was a sore arm (much more sore in the case of the tetanus, although not excruciatingly so - just stiff and achy as if someone had whacked me on that muscle) so given a choice I would certainly get them done in different arms and have the potentially more painful one done in my non-dominant arm. The flu jab I had the other week was absolutely painless, although I think it can depend on who's administering it - I've had people who've obviously mistaken my arm for a dartboard in the past and thrown the needle in from 20 yards away.

Re: flu - my experience in the 12 or so years I've been getting it is that the one year I missed the jab was the one year I got the flu, which could be entirely coincidental but was a singularly miserable experience. I'll take the risk of a slightly achy arm, thangyewverrmuch.
posted by Martha My Dear Prudence at 4:19 PM on December 11, 2011

Recent thoughts is NOT to take a Tylenol after a vaccine as it may cause the vaccine to be not as effective
posted by bottlebrushtree at 4:21 PM on December 11, 2011 [1 favorite]

[Please stick to the question, folks. Thanks. ]
posted by restless_nomad (staff) at 4:30 PM on December 11, 2011

I've always gotten a flu shot--for many years my grandfather, who had COPD, lived with us and it was more to protect him from exposure than me, although the one year I didn't get it, I ended up with a case of the flu so bad that I missed about 6 weeks of college. I also got swine flu before the vaccine was available in my area, and it was pretty dreadful, too.

Anyway, the upshot of those two experiences is that I (a) never want to go through it again, and (b) never want to inflict it on anyone else.

The reason you sometimes get feel actually sick after a flu shot is if one of the strains included in this year's shot is similar to last year's. You will still have some active antibodies from last year's strain, and the shot will trigger an immune response. So you might feel sick for a day. Take some tylenol, take it easy, and you'll be fine by morning (I usually schedule my shot for later in the day for this very reason). FYI: This is one of those years.
posted by elizeh at 4:40 PM on December 11, 2011

FWIW, this year, I got a flu shot and a tetanus shot (the one including whooping cough and diptheria) on the same day, and experienced absolutely no problems.

I felt a bit flushed and hot for about half an hour later that day, but that's how I usually respond to a flu shot, so I considered this response normal. At any rate the hot feeling didn't last long and wasn't terribly uncomfortable for me.

The nurse used one shot per arm - flu shot in one arm, tetanus in the other. I had some soreness in one arm, I'm sorry I don't recall which one, but it was minor and I didn't consider it a huge inconvenience, given the benefits to myself (and others) of getting the vaccinations.

Hope this info. helps you.
posted by joseph conrad is fully awesome at 4:58 PM on December 11, 2011

The year I got the flu shot was the only year I didn't get the flu, YMMV.
posted by devymetal at 5:02 PM on December 11, 2011

I got both at the same time, and like others, the tetanus shot (+ the other stuff mentioned above) arm hurt for a couple days, but that was the worst of it, and I've gotten the flu shot many times and never gotten even the slightest side effect from it. And unless you are seriously allergic to it, I'd doubt you'd get sick for more than a couple days and should be fine by Christmas time (if that's the holiday you were worrying about).
posted by katers890 at 5:19 PM on December 11, 2011

If you want to get the most mileage out of your vaccines, make sure you get Tdap (the tetanus vaccine with pertussis) rather than just Td. Pertussis (whooping cough) incidence has been on the rise in adults and so all adults are recommended currently to get Tdap as a one time booster.

In answer to is the flu shot worth getting, I always get the flu shot so I had never had the flu until I got the swine flu before the vaccine came out for that. Wow, that was miserable, the shot is definitely easier! I've had flu and Td before and just arm soreness, but Td does hurt more. As a doctor I would have to disagree that flu shots are promoted as some sort of favor to Big Pharma. I've never seen any rep detailing for the flu shot. Sure, a lot of medications are made by the big pharma companies, that doesn't mean buying them is selling out to The Man or something, if they actually have utility. Tamiflu is the treatment for the flu, so if Pharma wanted to sell more it would be discouraging people from getting the vaccine...
posted by treehorn+bunny at 5:45 PM on December 11, 2011 [2 favorites]

Guys, can we all just agree to stop with the anti vs. pro flu shot derail?

Er, it's part of the actual question, not a derail.

posted by hattifattener at 6:53 PM on December 11, 2011 [3 favorites]

I got them both at the same time and had the same experience as theBigRedKittyPurrs - the tetanus arm was sore if I moved it for a day, then just sore if I put pressure on it for another three or four days. You'll be fine.
posted by kyla at 7:53 PM on December 11, 2011

I recently got both on the same day. With the exception of some minor arm pain that day and the next, no other issues.
posted by FlyByDay at 8:00 PM on December 11, 2011

[Seriously, take side discussions to MeMail or elsewhere. Not here. Thanks.]
posted by jessamyn (staff) at 8:23 PM on December 11, 2011

I've gotten flu, tetanus, and pneumonia on the same day and same arm. Only issue was the tetanus gave me a sore arm for a few days. If you sleep on your side, get it in the arm you don't sleep on.
posted by obol at 9:09 PM on December 11, 2011

I have gotten my flu shot for this year, and I had minor arm soreness, as I usually do. No other reaction.

I got the Tdap a couple of years ago and had much worse swelling and soreness at the injection site from that. It was significantly worse that what I usually get from the flu vaccine. If I were to get them both at the same time, I would probably ask for the flu shot in my right (dominant) arm and the Tdap on my left (non-dominant) side.
posted by gingerbeer at 9:20 PM on December 11, 2011

I am an epidemiologist and a nurse, but IANY epidemiologist, IANY nurse, and IANA physician.

The 2011 Recommendations of the US Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) may be found here, or if you prefer a 64-page pdf with a pretty picture on the front, here.

Boiled down extremely, to answer your first question:

- anyone getting more than one vaccination at a visit should have them in different anatomic sites
- there is no evidence of interaction between two or more inactivated antigen vaccines, nor between inactivated and live antigen vaccines.
- the adult tetanus and diphtheria toxoid vaccine (tetanus shot) is inactivated-antigen. You may get a live, attenuated intranasal vaccine or an inactivated injection for your flu shot.

So you can get the two shots together (which will be cheaper in terms of copays, too). Your provider will probably put one in each deltoid unless you ask otherwise. Or you might get the live vaccine, which is a spray up the nose, and avoid the whole issue.

Is it worth getting a seasonal flu vaccination? In the 2011 recommendations specific to seasonal influenza, ACIP says yes, if you're a person in the US 6 months of age or older. This year's formulation is the same as last year's, but even if you got vaccinated last season, it's recommended you get vaccinated again (because your immune response to the virus drops off over the course of the subsequent year.)
It's not too late, either - last week was National Influenza Vaccination Week in the US. Here is the CDC flu site, which is stuffed full of information.
posted by gingerest at 9:26 PM on December 11, 2011 [2 favorites]

Those of you who had the flu shot this year - did you have any reaction other than the normal soreness on the arm?

posted by eddydamascene at 9:45 PM on December 11, 2011

posted by mlis at 9:47 PM on December 11, 2011

Anecdotal evidence: I try to get the shot every year, and nearly every year I DON'T get the shot, I have been stricken with what I think is the flu. The worst reaction to the vaccine I've gotten was a sore arm for a day or two. No worse than the soreness a good workout gives me.

This is my answer to "is it worth getting":

The 59% effective number is somewhat misleading. It comes from a meta-study using data going back 50 years. So it means that the effectiveness year to year averages out to 59%. And I believe it includes the times when the patients got a different strain of flu than the vaccine was designed to cover. So while that doesn't change the end result, it does imply that the vaccine works better than 59% on the strains it was meant to work for.

Also, this test only tests when it doesn't work. We don't know how often it does work- how many times did we get exposed to a flu virus over a flu season, and it was successfully fought off? How many of the 59% were never exposed, or were exposed a dozen times over the course of a season?

Secondly, we can't test for the variability of the effectiveness. Even with the vaccine, if one is exposed to the virus, the immune system still has to work to kill it off. But having antibodies means the immune system has a head start and the infection won't be as bad. Chances are, if someone who was vaccinated does get the flu, they won't be as sick for as long as they otherwise would have been.

Thirdly, part of the effectiveness of a vaccine is in the herd immunity. Even if it only worked in 20% of people, that's 20% fewer people out in the world sneezing out viruses for the rest of us to catch. The flu virus can be quite geometric in its spread, so knocking some percentage off of the number of people catching and spreading it will make a difference. It might not be enough in every circumstance, but it's something. In other words, maybe the flu shot doesn't work *in* you, just in those around you to the same effect.

Finally, the effectiveness doesn't just drop dead in the spring. The effectiveness does taper off, but over the course of successive years, you will have a sort of rolling protection against a variety of strains.
posted by gjc at 5:46 AM on December 12, 2011 [2 favorites]

In the hospital where I work it is the policy that everyone gets the flu vaccine or else gets fired (there are some exception but you have to document them pretty well). Of course, that is as much for the protection of patients and families as it is our own health, but the hospital pays for the vaccine and its administration, and so must figure it is a worthwhile investment. I would get the vaccine for myself and my family whether I had to pay for it or not.

As for arm soreness, I used to take acetaminophen or an NSAID like ibuprofen along with the flu shot, but a nurse once told me to get it in my dominant (right in my case) arm rather than my non-dominant arm as is often done. The idea being that using that arm more would work out any muscle soreness; it seems to work well for me. Of course that is not helpful when getting shots in both arms, but is worth thinking about when that is not the case.
posted by TedW at 7:02 AM on December 12, 2011

I got a tetanus and flu shot on the same day just a few days ago. The only concern that the nurse practitioner had was that I would be sore in two arms rather than one. I've had no reaction other than the aforementioned soreness (they wound up doing both sticks on the same arm, so it was just the one--nondominant--arm that was sore, but it was very mild soreness).
posted by drlith at 7:36 AM on December 12, 2011

When I went to Belize I had to get a bunch of shots, including tetanus, hep, and others. I had them throw in a flu shot for the hell of it. No big deal.

Also, I've only had the flu once, and it was a year I didn't get the shot. My take: It doesn't hurt, and might help. So why not?
posted by coolguymichael at 10:06 AM on December 12, 2011

My anecdote: I had not just tetanus but Tdap and the flu shot at the same time, in opposite arms. Total sum of consequences: the tetanus side was a little achey for a day.
posted by en forme de poire at 11:26 AM on December 12, 2011

Follow up for anyone that's curious - I got both the Tdap and flu shots 48 hours ago at the same time, in the same arm, with the only side effects being a moderately sore arm that seems to be getting better. The shots themselves did not hurt.

The nurse did highly recommend that I get both shots in the same arm so I wouldn't have two sore arms - that's what she said she would do herself.
posted by emily37 at 3:17 PM on December 18, 2011

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