Hello, ladies and gentlemen–I know you have been waiting with baited breath for my next installment of “The Flu and You,” so here we go.

I mentioned last time that we were going to discuss additional facts about the flu vaccine to dispel any fiction floating around and allow us to make a well-informed decision on what to do about the flu shot.

From my last installment, I hope I convinced you that most, if not everyone, should get a flu shot. What I want to talk about this week is the possible flu vaccine options that are available and how to choose the most appropriate option for you.

I will again be using information directly from the Center for Disease Control and Prevention’s (CDC) website, just as I did last week. If you need more information, feel free to visit that site here.

Without further adieu, here we go.

The flu vaccine is currently available in four main different “formulations” and they are (with recommendations):

1. Trivalent dose (the regular flu shot)
   1. This formulation has three different strains of the flu virus in it. It is universally agreed upon that this vaccine will give adequate protection to all individuals ages 2 and up.
   2. This is the ‘standard’ by which all the others are being judged, and is, at this time, completely adequate for seasonal flu.
   3. My personal feeling is that until these new flu options (below) are proven to be better than the normal trivalent, I would stick with the regular flu shot.
2. Quadravalent dose
1. This formulation has four different flu virus strains in it, which would allow for more coverage against an additional strain of the virus.
2. There is some thought that the presence of four strains in one combination could be problematic. An ongoing study is trying to show that this flu shot has the same amount of effectiveness as the regular trivalent one.
3. High-dose
1. This flu shot covers the same three strains of flu as the regular flu shot.
2. This shot differs in that it is targeted (or marketed, if you want) towards older individuals (>65 years old). It has a much higher concentration of active ingredients than the standard dosing.
3. The jury is still out on this formulation. Studies have shown that the high-dose shot causes a higher response from the immune system than the regular dose. The important thing to note is that a higher response from the immune system is great, but does that mean necessarily better protection? The answer, unfortunately, is we don’t know. There is a large study going on right now to determine this, and we will see…probably next year.
4. Intranasal live, attenuated (weakened)–and, yes, up the nose, but no rubber hose, I promise! This formulation is different from all of the others.
1. First, this vaccine is not an injection (yes, that’s right–no needles). It is a spray which shoots up into the nostril.
2. Second, it is a “live attenuated” vaccine. For those unsure of what that means, it is a technically alive, extremely weakened strain which will not provoke a response from your immune system (you will NOT get the flu from using this).
3. It is only approved for people aged 2 to 49 years.
4. You can get some mild, short-lasting symptoms, which could include:
1. Runny nose
2. Fever over 100 degrees
3. Sore throat

If I were pressed to make a decision on which flu shot to get, I would just (for now anyway) stick to the regular one. The regular flu shot is proven effective, and, as of now, the others are not proven to be any better. I hope this makes your choice as simple as mine.

As always, if you are unsure of which shot is right for you, feel free to contact us. We will steer you in the right direction. Stay tuned for my last hooray about flu shots next week when we explore my final topic… To… Be… Continued…