Health and Science News for Parents

It’s flu shot season! And there are more options than ever before

written by Tara Haelle

It’s that time of the year again! I will be working on updating my massive post on myths about the flu vaccine over the next week, but in the meantime, I’ve gone and gotten my own flu vaccine. This year, I got the FluMist, the nasal vaccine, at Walgreens, which is running a pretty awesome promotion through October 13 called “Get a Shot. Give a Shot.” Partnering with the United Nations Foundation’s [email protected] program, Walgreens will donate one vaccine to children in developing countries for every vaccine administered at one of their U.S. pharmacies. You can watch a video about the program below.

I got the nasal flu vaccine this year. Photo taken by an unnamed helpful pharmacy staff member.

I got the nasal flu vaccine this year. Photo taken by an unnamed helpful pharmacy staff member.

I expected the process to quite smooth, and it mostly was, except the delay when I realized my insurance plan frustratingly doesn’t consider Walgreens in-network. I can get a 50% reimbursement for the vaccine that I submit info for, but the only way for me to get a flu shot fully covered by my insurance was to go to my doctor’s office or find an in-network pharmacy (of which there is one, which I’ve never heard of, in Peoria). I could have headed to my doctor’s office, but I went ahead and paid out of pocket at Walgreen’s for a couple reasons. First, my boys were with me, and I wanted my older son to see me getting the vaccine that he’ll be getting on Thursday. The FluMist is quadrivalent, which means it contains all four strains recommended by the World Health Organization, and it’s more effective for children aged 2 to 8 than the injection is. (Note that children under 2, adults over 49, pregnant women and individuals with certain conditions should not get the FluMist because it’s a live vaccine.)

I also went with Walgreens because I really support their Get a Shot Give a Shot program. As I head off to Mozambique in a few weeks, I’ll be reminded of how many children in the developing world still desperately need vaccines and all the different agencies working together to make that happen. I am willing to pay a little out of pocket to support a business who is working with those agencies. Finally, the pharmacy staff at my local Walgreens is simply outstanding. They have always been very friendly and helpful, and they go out of their way to be accommodating whenever they can. It may not be a “local” business as part of large national corporation, but I am still happy to patronize any place where I am treated well.

As I mentioned, I got the FluMist because I wanted the protection of four strains. There is never a guarantee of which strains will be circulating, so every extra bit of protection is helpful, especially when the flu vaccine’s effectiveness varies considerably from year to year. The only injection the pharmacy had available was trivalent Fluvirin (covering three strains), and since I’m not pregnant this year, I’m able to get the live vaccine, thereby stimulating my immune system to develop antibodies against the following four influenza strains:

  • an A/California/7/2009 (H1N1)pdm09-like virus
  • an A/Texas/50/2012 (H3N2)-like virus
  • a B/Massachusetts/2/2012-like virus
  • B/Brisbane/60/2008-like virus

Unusually, these are the same strains as in last year’s flu shot, but I got the shot again because flu vaccines are not designed to provide immunity beyond a single season. Typically, this is because it’s expected that different recommended strains each year will require new formulations. In fact, the WHO has already announced new strains – different from this year’s – to be included in next year’s vaccine, including those to be used for the Southern Hemisphere (currently heading into summer) during the next flu season. However, even when the strains are identical from last year’s shot to this year’s, there is some evidence that immunity from the seasonal flu shot wanes over the year. While it’s certainly possible I still have antibodies for the three strains from last year’s shot, I would rather ensure that my immunity is as strong as it can be each season.

The FluMist is a quadrivalent live vaccine which is contraindicated for some conditions. Photo by Tara Haelle

The FluMist is a quadrivalent live vaccine which is contraindicated for some conditions. Photo by Tara Haelle

So, what flu vaccine should you get this year? The flu vaccine is still unfortunately not among our most effective vaccines, due largely to how many strains of flu exist and how the strains change over the year. However, it still reduces the risk of the flu anywhere from approximately 40% to 70% (ish) each year. Whether you are immunocompromised, allergic to eggs, afraid of needles or have some other limitation, there is likely a flu vaccine option for you. I recommend checking out this *excellent* Washington Post piece that runs through all the options: the basic (trivalent) flu shot, the quadrivalent shot, the nasal spray (quadrivalent), the high-dose vaccine (for older adults), the recombinant vaccine (egg-free!), the PharmaJet-delivered vaccine (trivalent, no needle!), and the intradermal shot.

As always, neither this blog nor the Washington Post article nor any other news article is doling out medical advice. Always consult your doctor regarding which flu vaccine is right for you and your family members.

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5 Responses to “It’s flu shot season! And there are more options than ever before”

  1. Thank you! This was a great, straightforward explanation of why we should get the shot again this year, even though it contains the same strains. I knew about the recommendation for flu mist for children, but wondered whether you have stumbled upon any studies/information on which is more effective in adults. I got the mist because I hate shots, but wondered about the effectiveness in adults. Thanks for a great post.

    • Tara Haelle

      The mist appears to be about as effective in adults as the shot is. It’s not clear why the effectiveness of the mist is better for younger kids or why that superior effectiveness drops off as age increases. For adults, either shot or mist is fine though.

  2. Great post! I’m choosing Flu Mist for my little ones this year, too, primarily because the CDC now recommends this vaccine for kids ages 2-8. But regardless of which variation you decide on, the most important thing is to get vaccinated!

  3. b

    Is the quad shot the same strains this year as well? I hadn’t heard that, and am not eligible for the nasal spray.

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