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The end of summer means flu season is near. Now there is a new quadrivalent vaccine that offers more protection against more strains of flu for both kids and adults aged 2 to 50, and a high-dose vaccine that is more likely to work for older adults.

Flu viruses can be transmitted from person to person as soon as temperatures begin to fall, and most doctor's offices in the USA have been offering influenza vaccinations since the first week in September. This year the new and improved prevention for the flu promises greater protection against more strains of the flu, but not all vaccines are equal.

What's different about this year's flu shots and nasal sprays?

Epidemiologists never know which strain of flu will become epidemic, so in previous years the most commonly offered flu shot protected against two strains of in the influenza A virus and one strain of the influenza B virus, a total of three strains of the virus. This year, all of the nasal sprays protect against two strains of influenza A and two rather than just one strain of influenze B virus, for a total of four. Also, the dosage of the vaccine in the immunizations is higher than in prior years.

Why do public health officials make such a big deal about flu shots?

Some people are more likely to get really bad cases of flu than others. Every year, between 3 and 5 million people worldwide have to be hospitalized for influenza, and between 250,000 and 500,000 die. In the United States, death rates are extremely variable, from 3,000 to 49,000 per year. But the bottom line is, flu can kill. The more people who are immunized, the fewer people who can spread the disease to those who are most vulnerable.

Who is most likely to get a severe case of the flu?

People who have compromised immune systems, especially people who take drugs for cancer or autoimmune diseases like rheumatoid arthritis, and people who have HIV, tend to get especially severe symptoms, as do people who have diabetes. Most deaths from flu, however, occur in people over the age of 65.

I'm not in a high-risk group. Why do public health officials want me to take a shot?

The truth is, flu shots don't, as you may have suspected, always prevent the flu. They are most likely to prevent the flu in healthy children and healthy adults, the same people who are most likely to get out and about and spread it, because their symptoms will be relatively mild. Vaccinating healthy people protects sick people.

Will everybody get the new, stronger flu shots?

No. The vaccine that covers four strains of flu is widely available, but isn't available at every immunization location. All nasal vaccines, since they are intended for healthy people, cover four strains. Otherwise, to get the quadrivalent vaccine, you have to ask. In general, public health officials have planned to allocate the 30 million available doses of the four-in-one vaccine to healthy people aged 2 to 50.

So, if I'm in a risk category, I won't get the quadrivalent vaccine?

Not unless you ask for it. Your doctor or pharmacy may run out relatively soon. If you are at risk for especially bad symptoms, however, it's better to get the older, three-in-one vaccine than no vaccine at all.

What about the high-dose vaccine?

The high-dose vaccine is 24% more likely to prevent flu than the regular vaccine, but it only covers three strains of the disease. The high-dose shot is recommended for seniors, people over 65, for whom flu shots are less likely to work at the lower doses. The high-dose vaccine may prevent heart attacks in the elderly. Influenza involves the whole body and can precipitate heart disease. The stronger shots may prevent this problem.

I hate the big needles they use for flu shots.

Ask about the new, small-needle option.

I just don't take flu shots.

OK, but please wash your hands frequently, especially when you go out or come in from public places. You will be less likely to catch flu and less likely to spread it if you do.

  • Centers for Disease Control and Prevention. Quadrivalent Influenza Vaccine Questions & Answers. http://www.cdc.gov/flu/protect/vaccine/quadrivalent.htm. 19 September 2013. Accessed 24 September 2013.
  • Photo courtesy of Naval Surface Warriors by Flickr : www.flickr.com/photos/navalsurfaceforces/8004172630/

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