Note: Several of you have also asked about the enterovirus, a mild to severe respiratory illness going around now. The CDC has provided helpful information so that you can be aware of the symptoms caused by this virus.

Unfortunately, influenza viruses love the fall weather as much as we do. Everyone needs to be protected against influenza, and protecting children with neuromuscular disease is especially important. A 2005 study done by the CDC found that children with neuromuscular disease are at a 6-fold greater risk of flu-related respiratory failure.  

The flu vaccine this year is the same as the 2013-2014 vaccine:

“Nasal Spray Flu Vaccine”

  • A live attenuated vaccine, which contains living, but weakened virus.
  • Generally NOT RECOMMENDED for people with neuromuscular diseases, such as Duchenne, on or off corticosteroids.
  • Nasal spray flu vaccine is safe for caretakers, siblings and classmates who are around your child to receive flu mist, as the risk of your child “catching” the flu from a close contact vaccinated with flu mist is quite low (0.6-2.4%). 

Influenza Vaccine, or “Flu Shot”

  • Injection into the muscle, usually given in the upper arm or thigh. 
  • The flu shot contains inactivated (dead) virus and IS RECOMMENDED for patients with neuromuscular diseases and patients taking chronic steroids. Because the virus is dead, there is no risk of getting the flu from the flu shot.
  • Recommended for patients with neuromuscular diseases over age 6 months for 2012-2013 is the IIV4 vaccine. 
  • The IIV4 is a quadrivalent vaccine that will protect against 4 kinds of flu viruses: influenza B/Massachusetts (2012-like antigen), influenza A/California (H1N1 – like antigen), influenza A/Victoria (H3N2-like antigen) and a B/Brisbane/2008-like virus. If the quadrivalent vaccine is not available (as availability is severely limited), please do not wait to immunize – the trivalent vaccine protects against three flu viruses and will provide coverage against the same viruses as the quadrivalent with the exception of the B/Brisbane virus. Please discuss this with your healthcare provider. 


  • Children ages 6 months – 8 years may need 2 doses of flu vaccine if they have not had 2 or more doses of flu vaccine since July 2010. The first dose should be given as soon as vaccine is available; the second dose should be given at least 28 days later. Please ask your health care provider if your child will need one or two doses.

Common Side Effects

  • Pain at the injection site
  • Low-grade fever
  • Slight tiredness
  • Mild generalized muscle soreness 

These side effects are most common in children getting their first flu shot, and will go away on their own within 1-2 days.


  • Get vaccinated is as soon as it is available in your community, (preferably by October); vaccines can be given throughout the flu season. 
  • It takes about 14 days for the body to build up antibodies for the 3 viruses in the vaccine.  Those antibodies will protect against those 3 or 4 flu viruses. 

If your current health coverage doesn't include seasonal flu vaccines as a preventive health benefit, MDA's Flu Shot Program can help. Through MDA, individuals affected by neuromuscular disease can receive a free flu shot through their local MDA-sponsored clinic, or they can receive reimbursement (up to $35) for the cost of flu vaccines received from licensed health professionals, including those located at retail pharmacies. Learn more about the MDA’s Flu Shot Program.

What Else Can We Do to Stay as Healthy as Possible?

  • Wash hands often with soap and water for 15-20 seconds, especially after using the restroom and changing diapers
  • If soap and water is not available, use an alcohol based hand sanitizer.
  • Wash your hands before preparing food or eating.
  • Avoid sharing utensils with or drinking after someone who is sick
  • Avoid touching eyes, nose, and mouth with unwashed hands


Pearls of Care

  • Get flu shots as soon as they are available
  • Nasal spray flu vaccine is not generally recommended
  • Common side effects are mild and go away
  • Best time to get vaccinated is as soon as possible!

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