It’s fall, so it must be time for my annual mantra – Get Your Flu Vaccine!!


Everyone, 6 months of age and older, needs to be vaccinated 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 most common flu vaccine being given this year is the “trivalent vaccine,” affording protection to 3 different flu viruses: two types of influenza A (H1N1 and H3N2) and 1 type of influenza B.  The nasal spray vaccine is “quadrivalent,” protecting against an additional type of influenza B.


There are multiple types of vaccines and delivery systems being offered this season:


“Nasal Spray Flu Vaccine” or “Flu Mist”

  • Nasal spray, or flu mist, is a live attenuated vaccine, containing living, but weakened, influenza virus
  • Approved for people ages 2 – 49 yo
  • Generally NOT RECOMMENDED for people with neuromuscular diseases, such as Duchenne, on or off corticosteroids.
  • It is safe for caretakers, siblings and classmates who are around your child to receive the nasal spray, or 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%). 


Traditional Influenza Vaccine, or “Flu Shot”

  • Traditional flu shot is an injection into the muscle, usually given in the upper arm or thigh 
  • People ages 18-64 may be offered flu vaccine given via a “jet injector”  (The jet injector uses a very narrow stream of fluid to penetrate the skin, rather than a needle.  Side effects using this method included tenderness, swelling, pain, redness, itching and bruising at the site for up to 7 days post-vaccination)
  • The traditional flu shot contains inactivated (dead) virus and IS RECOMMENDED for all patients with neuromuscular diseases, including patients taking chronic daily steroids. Because the virus is dead, there is no risk of getting the flu from the flu shot.


New “Intradermal Flu Vaccine”

  • “Fluzone Intradermal” is a new flu vaccine delivery system, approved for adults ages 18-64 yo
  • This delivery method uses a needle that is 90% smaller than the regular flu shot needle, delivering the influenza vaccine to the skin, rather than into the muscle
  • The intradermal vaccine uses 40% less antigen than the flu shot, however protection from the flu using the intradermal delivery method provided an immune response similar to the flu shot
  • Common side effects to the intradermal vaccine are the same as the traditional flu vaccine, but this delivery method is reportedly less painful.
    • The intradermal flu vaccine 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.


High-Dose influenza vaccine

  • The Fluzone High-Dose is recommended for people ages 65 and older
  • This high-dose vaccine contains 4 times the amount of antigen as traditional flu vaccines
  • Intended to create a stronger immune response, and better protection, against the flu
  • This vaccine is given via injection into the muscle



  • 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 
  • Intradermal flu vaccine may also cause redness, swelling, toughness and itching at the injection site


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 vaccines as soon as they are available
  • Nasal spray flu vaccine is not generally recommended for people with Duchenne
  • Common side effects to flu vaccines are mild and go away within 7 days
  • Best time to get vaccinated is as soon as possible!


Learn more

Vaccination Recommendations 

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