Q. When the time comes for me to get the H1N1 vaccine, should I get the nasal spray or the shot?

A. Some people shouldn't get the nasal vaccine, which contains a live, weakened virus. This group includes all those 50 and older, pregnant women, children under two and those with a medical condition that puts them at higher risk for flu-related complications.

Q. How can I avoid getting the flu, especially if I haven’t been vaccinated?

A. The experts agree: Washing your hands well and often is the single most important thing you can do to protect yourself against flu viruses and any number of other bugs. And yes, a soap-and-water scrub is the best option because it actually washes the organisms down the drain. If soap and water are not available and your hands aren’t visibly dirty, the second-best choice is an alcohol-based hand rub like Purell, which kills the virus. The Association for Professionals in Infection Control and Epidemiology recommends a product of at least 60 percent alcohol.

Q. Can I get seasonal and H1N1 flu vaccines at the same time?

A. Yes, with one exception. If you receive both vaccines in nasal-spray form—which contains live, weakened virus—then they need to be administered at least four weeks apart. However people 50 and older are advised to get both vaccines as shots, which can be given on the same day, one in each arm.

The pneumococcal vaccine shot also can be given the same day as any flu vaccine. The Centers for Disease Control and Prevention recommends this shot as well to prevent pneumonia, which can be triggered by the H1N1 flu virus.

Q. Has the flu season begun?

A. Yes, most states were reporting significant influenza activity as of September, and that’s unusual for so early in the fall. Presently, most of the viruses circulating are the so-called swine flu, more properly known as the 2009 H1N1 virus.

Q. Can getting vaccinated against pneumonia protect me from H1N1 flu?

A. No, it won’t prevent infection, but it could help ward off a serious and sometimes fatal complication of flu, bacterial pneumonia. A study by the U.S. Centers for Disease Control and Prevention recently found that in 77 deaths from H1N1 flu, 22 involved this bacterial lung infection. And while people age 65 and older are low on the priority list to receive the H1N1 vaccine, everyone in this age group is urged to get the pneumococcal vaccine, along with the seasonal flu shot. This also goes for younger people with conditions like chronic lung or heart disease, which predisposes them to flu-related complications.

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