The People's Perspective on Medicine

Which Influenza Vaccine Is Better for You?

Woman getting flu shot

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: There is also a Vaccine Injury Compensation Program. You can find more information at our website:

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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    Is something better than nothing? I am 82 so I should get the “65+” version of flu vaccine. Neither my doctor’s office nor my pharmacy have had that version available for over a month. The whole month of November has been lost for me. Can I opt for the regular version now, and add the “65+ ” later when/if it becomes available?

    Jerry, probably most experts would recommend you get the shot that is available to you now.

    If you have an intolerance to eggs, would the one that is egg-free, Flublok Quadrivalent, be appropriate?

    We get the shots at work. There is a question on the form asking if you are allergic to eggs. If you answer yes, will they bring Flublok Quadrivalent? (I always assumed they wouldn’t give you the shot.)

    The egg-free alternative is appropriate. We don’t know what the protocol is at your workplace.

    I avoided a flu vaccine for five or six years, as I it made me feel more ill each year. Finally I heard a physician mention on a local news broadcast that there was a vaccine for people allergic to egg. Knowing that I am allergic to egg albumen I looked into it. I had to search online, though. Most doctors, and certainly other health care professionals, are unaware of it. The Flublok Quadrivalent does not seem to be available locally but for the last five years I have been able to get one called Flucelvax which is not produced using eggs.

    I had symptoms of a heart attack after taking a pneumonia shot. The ER doc said it was from the pneumonia shot.

    Bah! Humbug!

    On September 25, 2019, I got my annual flu shot, Quad Flucelvax, which is a reasonable choice for a person of my age (74). It was not mentioned in the article.

    On November 18, 2019, I visited the physician who had administered the shot with what I believed was bronchitis. Before even seeing the MD, two quick screens were administered. The nurse came right back into the office and asked “Have you been traveling?” I responded that I had been attending a family reunion the previous weekend. “Ah,” she said. “Congratulations. You are our first flu patient this year.” It was influenza A. They thought I had contracted it at the reunion, but I reminded them that the roundtrip included four airplane legs and was more likely.

    I told the MD I wanted my money back, but he declined.

    (The bad news is that I mentioned that I had other symptoms beyond those of influenza and a thorough examination followed. The complete diagnosis was:
    Influenza A
    Pneumonia )

    My guess is that many who have reactions received their shot from an individual who did not administer it correctly. Injecting the needle at the right spot at the right depth is important. Today we have the flu shot being administered by a lot of non-medical personnel with little training.

    This further reinforces my decision NOT to get any flu vaccinations. Will continue with the same defenses I have been using for decades: Whole food diet, supplements and clean living with clean water. The side effects are incredible.

    I am healthy, healthy, and healthy.

    Are all the flu shots preservative-free now? Is there still other junk in them like glysphosate and formaldehyde. I don’t know if I should ask for preservative-free versions now or if it’s a given?

    I’m 61 and have two chronic autoimmune illnesses — dermatomyositis and Hashimoto’s, and vertigo to top it off. I’ve never had a flu vaccination out of concern that it could be an autoimmune trigger and because the vaccines in recent years have had very low success rates. What would you do in my shoes? Thank you.

    Experts suggest that you should skip live-virus vaccines (FluMist) but others should be safe and not trigger extra problems:

    I had the FluBlok quadrivalent this year. No reaction whatsoever. Don’t know if this is a good or bad sign.

    As long as aluminum and/or mercury are present in vaccines – I want no part in them.

    I’m a few years over 65, and both this year and last year, I have received the Fluzone High-Dose. My arm felt a bit sore for a day or two, but moving it a lot certainly helped, and this shot never hurt any more than any flu shot I’ve ever had. I encourage all Americans over 65 to get this shot, since it helps protect us against three different strains of flu. And we elders die of flu complications more than any other age group!

    A pleasure to read while awaiting my colonoscopy. Especially informative for a geezer wanabe like me.

    I had severe vertigo after my flue shot this year. The first night it was terrible. Then it was off and on for a month. I still get it occasionally .

    Gives insufficient info on content of flu jabs. What about the real controversy on the negative effects? What about natural alternatives? Ok-ish but lacks balance.

    I took the flu shot about five years ago on a Friday morning. We were scheduled to go on vacation that weekend and were coming home on Tuesday of the following week. By Friday afternoon I was lying on the couch with symptoms that felt like the flu. Needless to say, I did not make my vacation and was down for the count for two days. That was my first flu shot at age 55. I am now 60 and have not taken the flu shot since. It’s because I remember how I felt for those two days following that shot. On a further note, besides feeling bad after that shot, I have never experienced a bout with flu in my entire life. Everyone says that I will feel worse than that weekend if I get flu. What a choice! Sick as a dog for two days or possibly get protection from one of the many strains of flu out there. Also, the article did not address people in my age range.

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