When I went to a pharmacy to get a flu shot last year, I was offered a choice: a vaccine with three different strains of influenza virus for about 30 dollars or, for just $ 10 more, four strains. It sounds vague as an infomercial of late television.
We stood by the counter, confused. Did not I want any strain? I thought a new vaccine was developed every year and that it was more effective for a few years than others. What I missed?
As it turns out, the choice I was given was not unusual. Until a few years ago, the typical influenza vaccine included three strains of the virus in what is known as the trivalent vaccine: two strains of influenza A, one of influenza B. Now, many influenza abduction factors add a second strain B create a quadrivalent vaccine that offers less protection.
More stems the better, right? I paid for the additional strain B. The vaccine experts we talked later said that it was a good choice for me, but that does not mean it would be better for everyone. Centers for Disease Control and Prevention said they did not prefer a vaccine against another. Its guidelines are based largely on age and other characteristics (such as pregnancy or chronic illness).
This year there are about six types of vaccines. Whether your employer or insurer pays for it or if you do, it's worthwhile studying options to determine which one is likely to protect you the most.
How serious is the flu?
There were more than 80,000 influenza-related deaths in the United States last winter. Elderly 65 were nine out of 10, but the flu also killed 180 young children and adolescents, according to the CDC.
Despite the risks, according to the CDC estimates, only 37.1% of adults aged 18 or over were vaccinated in the last season of influenza, down 6.2 percentage points over the previous year, and 58% of children between 6 months and 17 received at least one shot.
What type should I get?
The type of shooting you should get is generally based on your age.
Older people often have lower immune responses to the vaccine, so experts suggest that those aged 65 and older receive either a high dose, four times the usual dose, or an adjuvant shot , an ingredient that stimulates the immune response.
These special formulations are 3 to 10 percent more effective for those aged 65 and over, "said Dr. Paul Offit, professor of pediatric infectious disease at Philadelphia Children's Hospital. Both are currently only available in trivalent formulations.
Anyone else from 6 months to 64 may be better off getting a quadrivalent shot, experts said. Quadrivalent vaccines are widely used – between 114 million and 124 million out of the 163 million to 168 million doses projected to be available for the current flu season, according to the CDC – but do not expect one.
"It is better to cover up with the trivalent vaccine than to wait or look for the quad," said Dr. Frank Illuzzi, medical director at CityMD, an emergency care chain.
For younger people, including children afraid of needles, the nasal spray vaccine that has live viruses – but attenuated or weakened – may be a good option, "said Dr. Gregory Polonia, Mayo Vaccine Research Group's director.
Spray, available in a quadrivalent formula this season, is approved for people aged 2 to 49 who are not pregnant.
CDC has not recommended spray in the last two seasons because it was ineffective two years earlier. But the wording has been changed and is again on the list of recommended options. The American Academy of Pediatrics said it recommended the shot as its first choice, however, for children.
What about the side effects?
In the past, people with egg allergies had to take special precautions when taking flu photos because many of the viruses used in the vaccines are grown in eggs. From the influenza season 2016-17, those with a history of "allergies to eggs of any severity" can get any authorized flu vaccine corresponding to their age group, says CDC. Those with a history of severe allergic reactions – more than hives – should obtain the vaccine in a medical setting.
Some people worry if the flu shots contain thimerosal, an additive containing ethylmercury that is no longer used in children's vaccines. Thimerosal is still used to help prevent germination in multiple-dose vaccine vials. Vaccine and CDC experts say this use is safe. But because many flu photos are a single dose, timerozal is often not a problem for adults.
How effective are the flu shots?
Efficacy varies every year. Since it takes at least six months to make and distribute the photos that become available in September, scientists have to get to know what the strains will be running and, therefore, what to include in a vaccine long before. At that time – and even as vaccines are produced – circulating viruses can move, reducing the effectiveness of the vaccine. It is an imperfect science.
"We are doing everything we can," said Offit, who is also on the Advisory Committee of the Food and Drug Administration, who recommends the strains to be included. "But try to anticipate what will happen six months from now on."
Sometimes, he said, the experts are guessing wrong. In the 2014-15 season, the vaccine was only 19% effective. In the last season of influenza, the overall efficacy of the influenza A and B influenza vaccine was estimated at 40%. In other words, it reduces the risk of needing medical care for the flu by 40%, according to the CDC.
What does it cost?
Most people with health insurance that comply with the Law on Affordable Care are entitled to a flu vaccination without co-payment or co-insurance. Make sure you consult with the insurer; you may be asked to take a photo from your doctor or some providers.
Images of Medicare influenza beneficiaries are listed in Part B; Beneficiaries do not pay for anything as long as the doctor or other provider accepts Medicare.
Medicaid covers influenza shots for children and young adults up to the age of 20. Eligible adults for Medicaid are also generally covered.
If you are not covered, the prices vary depending on the type of vaccine. Walgreens said that more than 90% of the customers they vaccinated are secured. Those who are not, can expect to pay $ 40.99 for a quadrivalent shot, while both options for those aged 65 and older – high and adjuvant – each cost $ 69.99 .
At CVS, the quadrivalent is $ 41.99, and the high dose is $ 66.99.