The suggested date for flu vaccine administration is around October 15. A couple of years ago, it was suggested that patients older than 65 receive a second shot around February 15. Now, a third shot is being proposed for this population around June 15. Your comments on a three-flu-shot protocol, please.
—Gerard K. Nash, DO, Amarillo, Tex.

The challenging aspect of influenza is its constant change from year to year. As we all know, the vaccine is an educated guess to protect against the most likely strains for the upcoming year. According to the CDC, there is no benefit in providing additional vaccines of the same formulation to older patients or other persons with suboptimal immune response to the vaccine. One shot per year for all individuals is the best course of action. Remember that for patients who travel across the equator, the seasonality of influenza is reversed in the Southern Hemisphere, and flu is endemic throughout the year in tropical areas.
—Cedric W. Spak, MD, MPH (117-24)