Flu Vaccination: Just Get One!

September 22, 2015

Getting a flu vaccine used to be easy. You asked for a flu vaccine and you got one! Now there are many forms and preparations made by six different companies: Three-component (trivalent) formulations, four-component (quadrivalent) formulations, high dose preparations,  injectable regular-length needle, intradermal short needle, standard preparation (grown in an egg culture), egg-free preparation, nasal preparation….there are many ways to get a flu immunization! However, regardless of the preparation or method of delivery, the bottom line is the same: Everyone 6 months and older should get a flu vaccination every year.

The difference between a trivalent and quadrivalent vaccine is that there is an additional component added to protect against a second type of B flu strain. However, because of the manufacturing changes associated its production, not all vaccines will have the four components this year. According to the CDC, about 76 million doses of the approximately 153 million doses made this year will be quadrivalent. The quadrivalent preparation might cost more than the trivalent preparation. 

Currently, neither the Centers for Disease Control (CDC) nor the Advisory Committee on Immunization Practices (ACIP) have expressed a preference of one vaccine form over another.   They do, however, advise that the guidelines and recommendations for the administration of each preparation must be followed. For example, the nasal preparation should only be administered to persons between the ages of 2 and 49 who are healthy and not pregnant. The intradermal (short needle preparation place under the skin instead of into the muscle) may be used only in adults 18-64 years of age. Fluzone High-Dose, manufactured by Sanofi Pasteur, Inc., is designed specifically for people 65 years and older. Fluzone High-Dose vaccine contains four times the amount of antigen (the part of the vaccine that prompts the body to make antibody) contained in regular flu shots. The additional antigen is intended to create a stronger immune response (more antibody) in the person getting the vaccine. Flublok is intended for use in persons between the ages of 18 and 49. It is a good choice for people who have severe allergy to eggs, as it does not contain egg protein.

            The many kinds of vaccination may seem confusing but your health care provider (or agency that provides the vaccine) should know what preparation you can or should receive. The choice of product will also be dependent on what preparations are available and appropriate.  All of the nasal preparation will be the four-component (quadrivalent) however the nasal preparation makes up only a small portion of the flu vaccines produced and has a limited pool of recipients. While you may prefer one form over another (provided you meet the criteria) you should not wait to get a flu shot if the form you prefer is not available. What seems to happen every year is that people wait until flu begins to peak and find out that vaccine is no longer available.

            Many people have concern over the preservative, thimerosal, which is used in some preparations of the flu vaccine. Thimerosal is a mercury-derivative that has been used as a preservative for over 50 years. It is not the same form of mercury that is found in fish. Research has shown that there is no association between thimerosal and autism, despite what you may have heard. However, because flu manufacturers can now make the vaccine preparation without using it, many have begun to do this. This was not for safety concerns, but rather as a response to the public’s desires.

            You may hear controversy about the effectiveness of flu shots. While there is some truth to this (it is not a 100%), it is currently the best tool we have to protect against the flu and its complications. In fact, the more people who get a flu shot, the greater the immunity in a community. It is easy to get (available at pharmacies, health care provider offices, big box stores and at community sites. It is inexpensive and covered by most health insurances. Its track record for safety is excellent.  

District residents (Bethany, Hamden, North Haven and Woodbridge) can contact Quinnipiack Valley Health District (QVHD) by phone at 203 248-4528 or email dculligan@qvhd.org  if you have questions about flu vaccines. Note: QVHD does not administer flu vaccinations at this time.