Which Flu Vaccination is for Me?

September 30, 2014

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: Three-component (trivalent) formulations, four-component (quadrivalent) formulations, high dose preparations,  injectable regular-length needle, intradermal short needle, standard preparation, 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.

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 chicken eggs to be produced. It can therefore be manufactured more quickly, but does have a shorter shelf life than other preparations. 

            The many “faces” 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.  The CDC notes that most of the vaccine that will be available for the public this year will be the three-component (trivalent) injectable preparation. It is anticipated that next year, it may be a four-component product. Most 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. 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  that is used on 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 can read a lot about influenza, but all you really need to know is that a flu vaccination can help to protect your from flu and its complications (like pneumonia and even death.) It is easy to get, inexpensive and safe. District residents (Bethany, Hamden, North Haven and Woodbridge) can contact Quinnipiack Valley Health District, 203 248-4528, if you have questions or contact QVHD through dculligan@qvhd.org