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Which Influenza Vaccine Is Better for You?

Getting an influenza vaccine seems straightforward. You go to your doctor’s office and a nurse administers a flu shot. These days you can also get jabbed in the arm at your local pharmacy.

In truth, though, there are more decisions than most people realize. According to our count, there are nine different influenza vaccines for the 2019-2020 flu season.

Which Influenza Vaccine Should It Be?

For people who hate shots, there is a live attenuated vaccine, FluMist Quadrivalent nasal spray. The FDA has approved it for people between two and 49 years of age. A few years ago, there were questions about its effectiveness. However, this year FluMist is expected to protect people against circulating viruses.

How Old Are You?

Older people are not always well protected against influenza by standard flu shots. (As you may have noted, FluMist is not recommended for people 50 and older.) Manufacturers have boosted the dose in a couple of injected vaccines. Fluzone High-Dose protects against three different strains of flu. It has four times the antigen of a normal vaccine and is only approved for people 65 and older.

Are You Allergic to Eggs?

Flublok Quadrivalent protects against four varieties of influenza and is approved for people at least 18 years old. This vaccine has three times the antigen of a standard dose vaccine and is produced without using eggs or influenza virus. That makes it appropriate for people with egg allergies. For such individuals, this is an important consideration.

In addition, older people might benefit from a vaccine with an adjuvant. Fluad is a trivalent vaccine that has squalene oil added to increase the immune response. Such an addition is termed an “adjuvant.”

Influenza Vaccines for the Very Young:

For young children, recommended vaccines all provide protection against four strains of influenza. Afluria Quadrivalent is approved for babies who are at least six months old. So are Fluarix, FluLaval and Fluzone (standard dose). Flucelvax is approved for people at least four years old. Babies under six months of age aren’t normally vaccinated. To protect them, others in their households, both adults and children, should be sure to get their flu shots.

Protecting the Pregnant:

Pregnant women are more susceptible to influenza and should be vaccinated. They should, however, avoid the live-attenuated vaccine, FluMist. This nasal spray is also inappropriate for people with compromised immune systems.

Reactions to Flu Shots:

What are the downsides of the influenza vaccine? The most common side effects are pain and tenderness at the site of injection. Fluzone High-Dose and Fluad may both be more likely to trigger such reactions.

People may also experience headache, muscle aches, runny nose, fever and malaise. We have also heard from hundreds of individuals who experienced severe shoulder pain following a flu shot. This may be because the person giving the shot did it wrong and damaged the bursa, tendons or ligaments of the shoulder.

Here is one such story:

“I received my mandatory flu shot in October 2017 in my left arm. I used ice to numb my shoulder so I wouldn’t feel the pain, and it worked. But the next morning I was awakened by severe pain in my shoulder. The lymph nodes under my arm were swollen and painful. I had limited range of motion and couldn’t touch my right shoulder.

“Over the next few months, the pain intensified and traveled down to my wrist. Six months later, I’m still in pain. My range of motion has improved but the pain is constant.”

Report Your Reaction:

People who have had serious reactions to the influenza vaccine can report them: https://vaers.hhs.gov/index.html. There is also a Vaccine Injury Compensation Program. You can find more information at our website: www.PeoplesPharmacy.com.

As the 2019-2020 flu season picks up steam, it’s appropriate to take steps to protect yourself. We hope that the vaccines used this year will be more effective than those available in recent years.

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About the Author
Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies..
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