The Flu Vaccine Menu

Roni Shye
Roni Shye, PharmD BCGP BCACP, is a licensed pharmacist in the states of Florida, Ohio, and Pennsylvania.
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Each year the flu vaccine covers the strains of the virus that were most prevalent the previous flu season. This information is collected and released by the Centers for Disease Control (CDC), the institute that also sets recommendations for vaccination. Following the recent H1N1 (swine flu) outbreak, each yearly influenza vaccination now covers H1N1 as well.

Which form of the vaccine should I get?

There are several different flu shots available to choose from, based on your personal and medical needs.

Trivalent (three component) flu shot:

This is the “standard” flu shot that provides coverage against three strains (H1N1, H3N2 and an influenza B strain) of the flu. It is provided as an intra-muscular injection and is recommended for all patients above the age of six months. Common brand names for this type of shot include Fluvirin, Fluzone, and Afluria. Some of these formulations are also available as “preservative free” options.

Quadrivalent (four component) flu shot:

This is the first year this type of flu shot will be available! The quadrivalent form covers two strains of influenza A and both strains of influenza B. This vaccine provides expanded coverage against the virus, and will likely replace the standard flu shot in the coming years. Common brand names for the quadrivalent shot include Fluarix Quadrivalent and Flulaval Quadrivalent.

Live nasal mist:
FluMist Quadrivalent is the flu vaccine available as a nasal spray. This version is squirted into the nasal passages, and is indicated for persons aged two to forty-nine. This form covers against the four strains of the virus. Since the vaccine is live (it had components of the active virus in it) it should be avoided if you are considered high risk (immunosuppressed, asthmatic, diabetic or pregnant).

High Dose:

The FluZone High-Dose vaccine is indicated if you are above the age of 65. The higher dose is intended to protect the elderly from complications that can occur from an infection, as they are more likely to have a severe infection and possibly need hospitalization.

Intradermal Vaccine:

The FluZone Intradermal flu shot is an option if large needles make you nervous. The intradermal shot contains several micro needles that provider a shallow injection under the skin, rather than into the muscle. FluZone Intradermal is a trivalent (three component) formulation.

Recombinant Flu Vaccine:

Finally an option for the estimated 1% of adults that are allergic to eggs! For the first time a recombinant vaccine has been developed (cultured in caterpillar cells) that is safe to use if you have an egg allergy. FluBlok is a trivalent vaccine that is indicated for use in patients between the ages of 18 and 49.

The Bottom line

This year there are several options to choose from when you get the flu shot. The quadrivalent vaccine does provide more protection versus the standard flu shot, but the standard shot is still effective. This is because the fourth strain is generally more common in children and does not account for a large number of cases.

Check with your pharmacy or clinic for availability, as not all locations will carry all the available shots. Your insurance may also only prefer particular types of the vaccine. Prices will also vary for each type, with the newer forms tending to cost more.

For more information check out the CDC website:

Now that you know the menu: get your annual flu shot!

Till next week,

The GoodRx Pharmacist

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