Which Flu Shot Should You Choose?

4 min read  |  November 04, 2019  | 

Wait, what? There’s more than one?

Yes. In fact, there are multiple variations of the annual vaccination, according to the CDC. And the right flu shot for you will vary depending on your age, immunity level, allergies, and other factors.

At this point, most people understand just how important the flu shot is. Though common, the flu can be a surprisingly dangerous disease, and herd immunity through vaccination is the key to keeping it in check.

“There are a lot of misconceptions out there about the flu shot, but the fact is the flu can make you very sick,” says Dr. Bhavarth Shukla, an infectious disease specialist at the University of Miami Health System. “For example, according to the CDC, there were between 36,400 and 61,200 deaths annually from flu prior to the COVID-19 pandemic.”

But which is the best vaccination for you?

What is the quadrivalent flu vaccine?

The quadrivalent flu vaccine is now the standard flu shot for people ages 6 months to 64 years of age. As the name suggests, it protects against four types of the flu virus, two variations of influenza A and B.

Different preparations of the quadrivalent flu vaccine are appropriate for different people. Though most people can receive the standard injected dose, there is also a nasal spray that is appropriate for people who are not pregnant and between ages 2 and 49. People with an egg allergy, who only experience hives when eating eggs, can now take the standard flu shot. And for those who experience more severe egg allergy symptoms, there is a variation of the quadrivalent flu shot that is made without influenza viruses or eggs.

High-dose flu vaccine

People who are age 65 and older may not have as strong of an immune response as their younger counterparts.

As a result, the standard flu shot may not offer as much protection. For these individuals, the CDC notes that a high-dose vaccine known as Fluzone High-Dose may be appropriate. It has four times as much antigen as the standard flu shot for greater protection. Another option for those over 65 is known as FLUAD. It’s a flu shot with an adjuvant, which is an ingredient that creates a stronger immune response to the vaccination.

“If you are over the age of 65, your doctor may ask you if you would prefer the high-dose vaccine,” says Dr. Shukla. “They will likely discuss with you the differences between different vaccine types and potential benefits of the high-dose vaccine.”

The anti-flu delivery methods

There are different methods of delivering the vaccine beyond the standard injection. If you don’t like needles, your clinic may offer you the nasal spray. Remember, though, it is only recommended for those ages 2 to 49 and is not recommended for pregnant women or people with certain other medical conditions. There is also a device called a jet injector that can deliver the vaccination using a high-pressure stream of fluid to penetrate the skin rather than a hypodermic needle. Finally, there are intradermal flu vaccines, which use a shorter needle and inject the vaccine into the skin rather than the muscle. If you have problems with standard flu shots, you can ask your doctor about these options.

Talk to your doctor

Though there are multiple options for flu vaccines available, the reality is that the answer is usually fairly simple. Your doctor should be well-versed in all these options and be able to recommend the right flu vaccine preparation for you. “At this time, there is no vaccine preference outlined by the CDC,” says Dr. Shukla. “Their key message is to get a flu shot, and don’t wait if the high-dose variety is not available at your provider’s office.”

Find out more about vaccinations at uhealthclinics.com.

Wyatt Myers is a contributing writer for UMiami Health News.

Last reviewed in October 2023, by Ronald B. Goldberg, an endocrinologist with the University of Miami Health System.

Tags: Dr. Bhavarth Shukla, flu shot, high-dose flu vaccine

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