There’s More Than One Flu Shot: Which Should You Get?

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Most people go in for a flu shot expecting they’ll get just that: An injection that protects against the flu. As it turns out, you have a bunch of options. There’s more than one way to gain immunity to the viruses making people sick this winter; depending on your age, health, and other concerns, you could choose the wrong one. Here’s what you need to know.

First, the flu is serious business: During the 2018-2019 flu season, although influenza activity was rated as “moderate,” it was recorded as the longest season in a decade for a total of 21 weeks, according to the Centers for Disease Control and Prevention (CDC). Its unusual length was attributed to two different strains of influenza A activity: H1N1 from October to mid-February, then H3N2 from mid-February throughout spring. In total, the agency estimated up to 42.9 million people got sick, 647,000 were hospitalized, and 61,200 died.

“The flu can start off with typical symptoms, but it can develop complications like ear infections and it can worsen chronic medical issues like asthma. The flu can infect anyone including healthy people. But the most at risk are people who are 65 years old and older and children 5 years old and younger,” says Robert Segal, MD, a New York-based cardiologist.

“The effectiveness of the flu vaccine decreases with time,” says Dr. Segal. “This is why it’s important to get vaccinated every year. This is not just to protect yourself, but to also protect those around you. It is also important to note that the flu virus mutates every year. Getting a yearly vaccine ensures that you are protected from the new mutation,” he explains. (Check out the 13 household items that can increase your risk of getting the flu.)

For the 2019-20 flu season, there are a total of six types of vaccinations available. Two vaccines developed for the 65-and-older crowd include a high-dose shot and one with adjuvant—a substance that can boost a person’s immune response to the virus. Discuss with your pharmacist or doctor which one makes the most sense for you.

If you’re 64 or younger, you can choose the quadrivalent (four-strain) shot or a trivalent (three-strain) shot, if that’s all your pharmacy offers: The quadrivalent shot is not as readily available, but the trivalent shot should do the trick provided you don’t have an immune-compromising condition like HIV. People 65 and over use trivalent. If you do get sick, here’s how long the flu could last.

In addition to the shot, Dr. Segal explains that there is a nasal spray available for the 2019-20 flu season. The spray is equally as effective as the shot, but experts don’t recommend it for all ages so there are some restrictions. “The flu nasal spray can generally be administered to those between 2 and 49 years old who are healthy,” says Dr. Segal. “It is not recommended for women who are pregnant. There are several other factors that physicians will consider such as allergies, immunocompromise, and a history of asthma when deciding to recommend the spray.”

And, notes Dr. Segal, with flu season in full swing, you should take precautions. Avoid contact with people who have symptoms, wash your hands regularly, use hand sanitizer, and remember to take care of yourself, too. Staying hydrated and eating well will help strengthen your immune system, he says. Next, check out the 11 things real doctors do to combat the flu.