Everything you need to know about this year’s flu shot

Jessica Rothman

Updated 2015

It’s that time of year again — time to get your flu shot! Be sure to check if your office, school, or local government is giving free flu vaccines first, because this is becoming more and more common.  If not, do not worry! Most (if not all) pharmacies and doctors’ offices — even those in supermarkets — have the vaccine available in either the nasal spray or the injection. This should be free (no co-pay at all) under nearly every insurance plan, thanks to the Affordable Care Act (Obamacare), which requires health insurance companies to provide free preventive services such as flu shots. Just call first to make sure they have the vaccine you want when you are planning to be there.

Which should I get: the injectable vaccine or the nasal spray?

This year, there are two different ways to get your flu vaccine: an injection (shot) or nasal spray. There are also two different kinds of the flu vaccine injections: the trivalent and quadrivalent versions. The trivalent contains 3 different flu strains, and the quadrivalent contains 4 different flu strains.1 The nasal spray is quadrivalent.2 Experts have no opinion whether the trivalent or quadrivalent version is better, so do not worry about which you receive (and feel free to ask if one will cost you more than the other).

The nasal spray flu vaccine should not be taken by anyone with long-term medical conditions (such as heart, kidney or breathing problems), or if you are pregnant, have a compromised immune system, have an egg allergy, or are younger than 2 or older than 49.3  Those individuals should get a flu shot instead.  Otherwise, the choice is up to you.

What’s new this year?

This year, the Centers for Disease Control and Prevention (CDC) recommended that children ages 2-8 should receive the nasal spray vaccine.  This recommendation is based on evidence that those children will be better protected against contracting the flu.  However, there are exceptions: the nasal spray vaccine is not recommended for children with asthma, have compromised immune systems, have a history of an egg allergy, or take aspirin regularly.  Those children should get the flu shot instead.4

Other things to remember for young children

Children ages 6 months to 8 years old, who have never received a flu vaccine, either the nasal spray or injection, are recommended to receive two doses. There should be at least 4 weeks in between the two doses.  Since the components of the 2014-2015 vaccine are the same as the 2013-2014 vaccine, it is not necessary for children in this age group who were vaccinated last year to receive two doses – one dose will be enough.5 

If I’m over 65, is there anything different for me?

As we age, the flu can be more dangerous, but at the same time vaccines are less effective because our immune systems are not as strong.  That’s why individuals over the age of 65 might want to receive a high-dose version of the flu vaccine.  This is a new type of flu vaccine that is 4 times as strong as the regular flu vaccine.  A 2014 study in the New England Journal of Medicine found that those who received the high-dose version had a stronger immune response and were better protected against getting the flu. The study was conducted during the 2011-2012 and 2012-2013 flu seasons, with nearly 32,000 adults over 65 randomly assigned the high-dose vaccine or the regular vaccine.6

What should you do if you have an egg allergy?

Although people with egg allergies should not use the flu vaccine nasal spray, there are several different options available using flu shots. If you have an egg allergy but can eat lightly cooked eggs, you can receive any of the vaccinations.7 If your only reaction to eating eggs is hives, and you are between the ages of 18-49, you should receive the recombinant influenza vaccine (RIV3) called FluBok.8  For those who are younger than 18 or older than 49, you can receive any of the inactivated flu shots.  You should be observed by medical professionals for at least 30 minutes after your injection to make sure you don’t get an allergic reaction.

The RIV3 (FluBok) vaccine is also an option for anyone between 18 and 49 with a serious egg allergy.  If you have a serious egg allergy and are under 18 or over 49, or if RIV3 is not available, you are still able to receive any of the other inactivated influenza shots but you should take precautions, by being vaccinated by a doctor who has experience handling severe allergic reactions.  It is unlikely that even those with a severe egg allergy will have an allergic reaction from the flu vaccine, but it is better to be more careful, just in case.9

Why isn’t the flu vaccine very effective in 2015?

Since the flu viruses change every year, each year scientists do their best to predict what flu viruses will be the most common during the upcoming flu season. The seasonal vaccine needs approximately 6 months to manufacture – long before it is obvious exactly what flu viruses are most common  that year.  In a good year, the vaccine can reduce your risk of getting the flu by 60%. Unfortunately, for the 2014-15 flu season, the vaccine is only working for about 23% of patients. It is possible, however, that those who get the flu won’t be as sick if they got the vaccine disease so it is important to get vaccinated.

What now?

Now that you have all the information you need, it’s time to go get your flu shot! You’ll be happy that you did once flu season starts.

All articles on our website have been approved by Dr. Diana Zuckerman and other senior staff. 

  1. Vaccine Information Statement, 2014. Centers for Disease Control and Prevention. Retrieved from href=”http://www.cdc.gov/vaccines/hcp/vis/vis-statements/flu.pdf”>http://www.cdc.gov/vaccines/hcp/vis/vis-statements/flu.pdf  
  2. Vaccine Information Statement, 2014. Centers for Disease Control and Prevention. Retrieved from href=”http://www.cdc.gov/vaccines/hcp/vis/vis-statements/flulive.pdf”>http://www.cdc.gov/vaccines/hcp/vis/vis-statements/flulive.pdf  
  3. Vaccine Information Statement, 2014. Centers for Disease Control and Prevention. Retrieved from href=”http://www.cdc.gov/vaccines/hcp/vis/vis-statements/flulive.pdf”>http://www.cdc.gov/vaccines/hcp/vis/vis-statements/flulive.pdf  
  4. Eduardo Azziz-Baumgartner. The 2014-2015 Flu Season: Vaccine Recommendations, 2014. Medscape: WebMD. Retrieved from href=”http://www.medscape.com/viewarticle/832236?src=wnl_edit_specol”>http://www.medscape.com/viewarticle/832236?src=wnl_edit_specol#vp_1  
  5. Grohskopf L, Olsen S, Sokolow L, Bresee J, Cox N, Broder K, Karron R, Walter E. Prevention and Control of Seasonal Influenza with Vaccines, 2014. Morbidity and Mortality Weekly Report. Centers for Disease Control and Prevention. Retrieved from href=”http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6332a3.htm”>http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6332a3.htm#fig1  
  6. Sandra Adamson Fryerhofer. High-Dose Flu Vaccine in Older Adults: Worth It?, 2014. Medscape: WebMD. Retrieved from href=”http://www.medscape.com/viewarticle/832588?src=wnl_edit_specol”>http://www.medscape.com/viewarticle/832588?src=wnl_edit_specol  
  7. Recommendations Regarding Influenza Vaccination of Persons Who Report Allergy to Eggs, 2014. Morbidity and Mortality Weekly Report. Centers for Disease Control and Prevention. Retrieved from: href=”http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6332a3.htm”>http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6332a3.htm#Fig2  
  8. Influenza Vaccines United States, 2014. Centers for Disease Control and Prevention. Retrieved from href=”http://www.cdc.gov/flu/protect/vaccine/vaccines.htm”>http://www.cdc.gov/flu/protect/vaccine/vaccines.htm  
  9. Recommendations Regarding Influenza Vaccination of Persons Who Report Allergy to Eggs, 2014. Morbidity and Mortality Weekly Report. Centers for Disease Control and Prevention. Retrieved from: href=”http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6332a3.htm”>http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6332a3.htm#Fig2