Why you need a flu shot every year
You might have gotten a flu shot last year. Nearly half of American adults did. But guess what: You have to start all over again this year. Last year’s vaccine is about as timely as last week’s meme.
The first reason is that there isn’t just one flu virus, explains Michelle Barron, MD. She’s the senior medical director for infection prevention and control at UCHealth in Denver. “It’s actually a family of viruses,” she says.
The second reason is that the flu viruses themselves change every year, says Adolfo Garcia-Sastre, PhD. He’s the director of the Global Health and Emerging Pathogens Institute at Icahn School of Medicine at Mount Sinai in New York City. That makes it easier for new strains to bypass your immune system.
That variability makes the flu virus different from measles or chicken pox — and it’s why the flu shot isn’t a one-and-done thing, says Dr. Barron. Here is a rundown of the factors that go into making a yearly flu vaccine and how to find the one that will protect you best.
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The flu virus can change, a little or a lot
Scientists call these changes “drift and shift.” Drift is more common. It’s what happens when the virus makes copies of itself. “Imagine if, instead of having a copy machine, you had to write the same sentence 1,000 times,” Dr. Barron explains. “At some point, you’re going to make an error. And that mistake is repeated because you’re tired.”
Usually, those tiny changes are minor. But over time, they add up. So older versions of the flu vaccine won’t provide good protection anymore.
Shift is when a virus jumps to humans from animals, such as from pigs or birds. That’s more dramatic. In that case, the virus has never been seen in humans before. That’s what happened during the 2009 swine flu pandemic. So scientists had to scramble to develop a vaccine for it.
What happens around the globe is important
Every 6 months, new flu strains affect half of the globe. When it’s summer in the U.S., it’s winter in countries in South America, parts of Africa and Australia. That means it’s flu season for those areas of the world.
The reverse is true, too. When it’s summer in the southern hemisphere, it’s winter here, in Europe and in other northern countries. That’s when flu season hits hardest in the U.S.
That’s important information for the scientists who are making this year’s vaccine. U.S. scientists pay attention to the strains of flu that circulated the most in the southern hemisphere earlier in the year. Then they make a vaccine to protect against those strains.
Scientists in the southern hemisphere do the same thing. They observe the flu virus strains that affected people in the north. Then they come up with a vaccine for the next flu season based on those circulating strains.
The flu vaccine may not be exact
All of the flu vaccines this year are known as “quadrivalent.” They protect against 2 influenza virus A strains and 2 influenza B strains. A and B strains affect humans the most.
But picking the right strains is like betting on a horse race, explains Dr. Barron. “Most of the time, the winner is going to be what you predicted based on the odds,” she says. “But every now and then, out of left field, your 100-to-1 chance comes through.”
But a partial match is better than none at all, she notes. Even if you come down with the flu after your shot, your likelihood of getting very sick goes down. That’s especially true of people over 65 years old and little kids. And that’s good news, since they’re the ones who are most likely to go to the hospital with complications from the flu.
Recommended reading: Are you ready for cold and flu season?
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There are many types of protection out there
Injections aren’t the only way to get vaccinated against the flu. A nasal spray vaccine is available for kids and adults under 50. There are also several different types of shots. Most flu vaccines are produced using an egg-based manufacturing process. There are also some egg-free options for folks (including babies) who have egg allergies.
Your choices include:
- For everyone over 6 months old: Standard-dose flu shots (Afluria® Quadrivalent, Fluarix® Quadrivalent, FluLaval® Quadrivalent, Fluzone® Quadrivalent)
- For those over 6 months old with egg allergies: Cell-based flu shot, egg-free (Flucelvax® Quadrivalent)
- For people over 18 who have egg allergies: Recombinant flu shot, also egg-free (Flublok® Quadrivalent)
- For people 65 and older: High-dose flu shot (Fluzone® High-Dose Quadrivalent)
- Also for people 65 and older: Adjuvanted flu shot (Fluad® Quadrivalent)
- For kids over age 2 and adults up to age 49: Flu nasal spray (FluMist® Quadrivalent)
Dr. Barron recommends getting whichever vaccine is available at your doctor’s office or pharmacy — unless you have an egg allergy or another special circumstance. All of the vaccines protect against the same 4 strains, she adds.
Being 65 or older is another special circumstance. The Centers for Disease Control and Prevention recommends that folks over 65 get 1 of 3 vaccines: Flublok Quadrivalent, Fluzone High-Dose Quadrivalent or Fluad Quadrivalent. Studies have shown these formulations to be more effective among older adults, who typically have weaker immune systems.
Yearly shots may soon be a thing of the past
Flu shots have been made the same way since 1940. But that’s changing.
UCHealth is doing research on an mRNA shot (like the COVID-19 vaccines). It may give you better protection than the traditional flu shot, says Dr. Baron.
Meanwhile, Garcia-Sastre is working on a universal flu vaccine. “It won’t matter if the virus changes. The vaccine will still protect you,” he says. And it might keep protecting you for 3 to 4 years.
But until those vaccines are available, you’ll just have to roll up your sleeve again. And know you’re doing the best thing for your health this winter.
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Facts about flu shots: Centers for Disease Control and Prevention
This flu season: Centers for Disease Control and Prevention
Who needs a flu vaccine: Centers for Disease Control and Prevention