Americans seeking a flu vaccine this year will be able to choose from
more than a dozen varieties, including some available for the first
There will be shots injected in the arm and vaccines sprayed
into the nose; ones that protect against three strains of flu and
others that protect against four.
There will even be 21st-century shots made in cell cultures, rather than eggs, a technology used since the 1950s.
does make for a dizzying amount of choices," says Lisa Grohskopf, a
medical officer at the Centers for Disease Control and Prevention.
The CDC recommends everyone over the age of 6 months receive a flu shot, even if they're allergic to eggs.
may have to shop around to find exactly the vaccine they want, however,
given that few doctors will stock every shot, says H. Cody Meissner,
who heads the division of pediatric infectious diseases at the Floating
Hospital for Children at Tufts Medical Center in Boston.
People also may be ineligible for some vaccines because of their age.
Choices this year include:
• Quadrivalant vaccine. For
the first time, some flu vaccines will protect against four strains of
influenza, rather than the usual three, says Andrew Pekosz, associate
professor at Johns Hopkins University's Bloomberg School of Public
Traditionally, flu vaccines protect against two
types on influenza A and one type of influenza B. Including a second
strain of influenza B should provide broader protection, Pekosz says.
the CDC expects there to be up to 139 million doses of influenza
vaccine this year, only about 30 million will be quadrivalent.
FluMist intranasal sprays will be quadrivalent, says Melissa Garcia,
spokeswoman for manufacturer MedImmune. FluMist is approved only for
those ages 2 to 49.
Other quadrivalent flu shots are approved for anyone over 6 months.
• Cell-culture vaccines. Flu
vaccines are traditionally cultured in eggs, which makes production
very slow, Pekosz says. "During the 2009 H1N1 pandemic, we had to wait
for chickens to lay more eggs," he says.
This year, for the
first time, vaccines made from viruses grown in animal cells will be
available, Pekosz says. The viruses used in flu shots are killed so that
they cannot cause the flu. FlucelVax, made by Novartis, is approved for
those over 18.
One of the main advantages to a cell-culture
vaccine is that manufacturers can quickly ramp up production in a
pandemic, Pekosz says.
Cell-culture vaccines have already been
used to protect against rotavirus, polio, smallpox, hepatitis, rubella
and chickenpox, according to the CDC. They're used in flu shots in
several European countries, as well.
• Recombinant protein vaccine. The new FluBlok vaccine is made through genetic engineering. And, like FlucelVax, it's also egg-free.
of starting with a whole virus, scientists create the vaccine using
only a small piece of virus, a hemagglutinin protein, according to
Protein Sciences, which makes FluBlok. Researchers grow the proteins in
cells, then purify them before putting them into the vaccine.
FluBlok is approved for adults 18 to 49.
may want to consider a cell-culture or recombinant flu vaccine for
people with egg allergies, according to the American Academy of
But the academy notes that most people with egg
allergies, even those who break out in hives, can safely receive
conventional flu shots. People with severe egg allergies - which cause
breathing problems - should stay at the doctor's office for 30 minutes
of observation after getting a vaccine.
• High-dose vaccines. Although
the elderly are among those most likely to die from the flu, they're
far less likely than others to benefit from a standard flu shot, Pekosz
says. That's because the immune system - like the joints, eyesight and
hearing - tends not to work as well as people age.
shots approved for those over 65 aim to overcome this problem by
including four times the usual level of immunity-producing antigens,
Because these vaccines contain more of the proteins
that stimulate the immune system, they could be expected to produce
more side effects, such as soreness in the arms.
A sore arm "is
usually a good thing, because it shows that your body is responding to
the vaccine, and it shows that your immune cells are coming" to the
injection site, Pekosz says.
• Intradermal shots. These shots are designed for needle-phobic adults ages 18 to 64, Pekosz says. They
have shorter needles that penetrate just the skin, rather than
traditional intramuscular shots, which go into the muscle, he says.
These shots also use a lower dose of vaccine, so they cause fewer
Yet Pekosz says people shouldn't delay
vaccination to look for their favorite shot. The CDC hasn't said that
one vaccine is any better than another. And the American Academy of Pediatrics notes that any flu shot is better than nothing.
least 154 children died of the flu last season, according to the CDC.
Most weren't vaccinated. And nearly half of those who died had no
underlying condition to put their doctors or parents on alert, Meissner