Should I Get the Flu Shot?

Lauren Goldbeck, Alex Pew, Arista Jhanjee, Emma Roy, Kobi Khong, and Kousha Mohseni, MS, National Center for Health Research

Flu season starts in October and can last until May. Everyone 6 months or older is encouraged by the Centers for Disease Control and Prevention (CDC) to get the vaccine every year, unless they have allergies or other reasons that would make the vaccine dangerous.1 The flu usually peaks between December and March. The CDC recommends getting vaccinated by the end of October, but anytime during the flu season can still be helpful.

You can check if your office, school, or local government is giving free flu vaccines. If not, don’t worry!  Most (if not all) pharmacies and doctors’ offices have the vaccine available, and it is free (no co-pay at all) under nearly every insurance plan. Just call first to make sure the vaccine is available. The CDC also has a website where you can use your ZIP code to find a location that offers a flu shot near you: https://www.vaccines.gov/find-vaccines/

Thanks to the Affordable Care Act (Obamacare), health insurance companies must provide free preventive services like the flu shot.2 However, insurance companies can require you to go to certain places to get the shot, so it is a good idea to check with your insurance company first before getting your shot.

What’s New for 2022-2023?

After a few years of the pandemic, many people understand the importance of reducing infection with social distancing and masks, but as restrictions are loosened people are more at risk for the flu than they were in 2020-2021.  Our immune systems haven’t had practice combating the flu virus during the pandemic, which can lead to a more severe flu season in 2022 and later years. That’s why it is important to make sure you’re protecting yourself by getting this year’s flu vaccine and helping your friends and family stay safe.

You can get the flu vaccine and the COVID-19 vaccine or booster at the same time if you are eligible.3 However, people who get both vaccines at the same time have an increased chance of experiencing side effects, but those typically resolve within a few days. While not common, it is possible to get sick from the flu and COVID-19 at the same time, so being up to date with all your vaccinations is ideal.3

How Effective Is the Flu Vaccine in 2022-2023?

The most common flu viruses change every year. Since the new seasonal vaccine requires about 6 months to make, scientists change the flu vaccine every year. Vaccines are made with either three or four viral strains. The 2022-2023 vaccine differs from last year’s vaccine by a single strain. Scientists change the flu vaccine every year to try to make it as effective as possible against the new flu strains that are most common that year, but that can be difficult to predict.4

For the 2022-23 flu season, early evidence suggests that flu shots will reduce your risk of getting the flu by 40-60% and will also reduce the chances that you will need to be hospitalized.3 Although it’s far from perfect, it’s worth getting.

What is FluMist?

As parents are getting their kids ready for flu season, they need to decide whether their children (or themselves) should get a flu shot or a flu vaccine that comes in the form of a nasal spray. This spray, known as FluMist or LAIV (Live Attenuated Influenza Vaccine) sprays a live virus up your nose via mist and is an alternative for those who don’t like the idea of a flu shot. The CDC did not recommend FluMist for the 2016-2017 and 2017-2018 seasons because they rated the spray as ineffective during those years. After that, manufacturers have revised how they make FluMist, but there are currently no estimates about its effectiveness even though the CDC started to recommend it again.

People who should not get FluMist are the following:5

  • People over the age of 50 or under the age 2
  • Pregnant individuals
  • People with weakened immune systems
  • Individuals with chronic illnesses or weakened immune systems
  • Individuals with cochlear implants

The CDC and American Academy of Pediatrics encourage families to vaccinate young children to protect from the flu and the serious complications that the flu can cause.  However, experts agree that the best way to protect against different types of flu viruses is with the traditional flu shot. While the FluMist may be better than nothing, we recommend a flu shot whenever possible for you and your children.

If I Have Cancer or Am a Cancer Survivor, Should I Get the Flu Shot?

Yes, getting a flu shot is recommended for people with cancer and cancer survivors. It is also important for family members and close friends to get the shot as well. People with cancer or a history of cancer can get more severe flu symptoms that can result in hospitalization and serious conditions if they get the flu. In some cases, patients with certain cancers like leukemia, lymphoma, and myeloma as well as patients who have recently been treated with chemotherapy should preemptively take medication to treat the flu if friends and family around them show signs of the virus.8

People with cancer should get the flu shot and not the nasal spray, such as FluMist. This is because the shot uses dead or “inactivated” virus while the nasal sprays use live virus. Make sure to ask your physician is you have any questions.

If I’m Over 65, Is There Anything Different for Me?

As we age, the flu can be more dangerous, and vaccines are less effective because our immune systems are not as strong. You may have seen a “high-dose flu vaccine” advertised for people over the age of 65.  Should you consider it?

For the 2022-2023 flu season, the CDC has updated their recommendations. They recommend that people over the age of 65 get a higher dose and adjuvant flu vaccine.3 This means that the Fluzone High-Dose Quadrivalent, Flublok Quadrivalent, or Fluad Quadrivalent vaccine are the preferred vaccines by the CDC for those over the age of 65 for 2022-2023.6 The high-dose vaccine has four times as many flu proteins than the usual flu shot, and the data from the CDC has suggested that these are more effective than the standard flu vaccine for this age population.6,7 Individuals receiving the high-dose version also had more of the common side-effects from the flu shot, like a low-grade fever and soreness, but these typically resolve within 3 days of the injection.6

Adults ages 65 and older make up 50-70% of flu-related hospitalizations and 70-85% of flu-related deaths. It should be noted that facilities that offer flu shots may administer the high dose shot without asking patients what they prefer. If you are 65 or older and don’t want the high dose shot, you should say so when requesting a shot.

What Should I Do if I Have an Egg Allergy?

Many clinics or pharmacies that offer regular-dose flu shots also offer egg-free flu shots. The CDC has licensed two vaccines that are egg-free: the Flublok Quadrivalent (licensed for use in adults 18 years and older) and the Flucelvax Quadrivalent (licensed for use in people 6 months and older.)9

  • If your only reaction to eating eggs is hives, you can receive any flu vaccine.
  • If you have a severe reaction to eggs, including nausea/vomiting, changes in blood pressure, respiratory issues, and/or any reaction requiring medication or emergency medical attention (ex. anaphylaxis shock)
    • You can still receive any type of flu vaccine, even ones with eggs, but you should receive the vaccine in a medical setting and under the supervision of a provider who is trained to address allergic reactions.9

Can the Flu Shot Give Me the Flu?

No, the flu shot can’t give you the flu. The flu shot is made of proteins that come from dead viruses, so you can’t get infected. However, the flu shot can cause soreness, redness, or swelling around the injection site. It can also cause a low-grade fever or body aches.10

Things to Remember for Young Children

  • Children aged 6 months to 8 years who have never received a flu vaccine should get two doses of the vaccine. The two doses should be separated by at least 4 weeks.
  • Children aged 6 months to 8 years who have previously received 2 or more vaccine doses only need one dose this year.
  • Because FluMist contains a live flu virus, healthy children should only start using the spray at age 2, and only if they are unable to get the shot instead.1

Can I Still Get the Flu Even After Getting the Flu Shot?

Yes, you can still get the flu after getting the flu shot. There are many strains of the flu that could possibly infect you, and the shot doesn’t protect you against all strains. And as we said, it works better on people with stronger immune systems. Even if you do get the flu, it might be less severe if you’ve had the vaccine.

All articles on our website have been approved by Dr. Diana Zuckerman and other senior staff.

References

  1. Centers for Disease Control and Prevention. (2022, November 10). Preliminary In-Season 2021-2022 Flu Burden Estimates. Centers for Disease Control and Prevention. https://www.cdc.gov/flu/about/burden/preliminary-in-season-estimates.htm
  2. Centers for Disease Control and Prevention (2022, September 20). How Flu Spreads. Centers for Disease Control and Prevention. https://www.cdc.gov/flu/about/disease/spread.htm
  3. Flu: What To Do If You Get Sick | CDC. (n.d.). Retrieved November 17, 2022, from https://www.cdc.gov/flu/treatment/takingcare.htm
  4. How long does the flu last? (2016, December 8). Harvard Health. https://www.health.harvard.edu/staying-healthy/how-long-does-the-flu-last
  5. Centers for Disease Control and Prevention. (2021, August 26). Practice Good Health Habits. Centers for Disease Control and Prevention. https://www.cdc.gov/flu/prevent/actions-prevent-flu.htm