How to Find the Right Flu Vaccine

Decisions to decisions. How to choose from the wide variety available

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When you visit your doctor for your annual flu shot, don’t be surprised if he sounds more like your local bartender and asks, “What’s your pleasure?”

For the first time in decades, Americans will have a wide range of vaccine options this flu season. Since the 1940s, health-conscious citizens have pretty much had only one way of getting immunized: a shot containing three strains of the influenza virus. In recent years, a nasal spray and higher-dose vaccines were added.

But this flu season, there are seven ways to get immunized against influenza, so there’s a vaccine for practically everyone. “There has been some drumroll that vaccines aren’t performing quite as well as we want, so we better get in there to improve coverage,” says Dr. Greg Poland, director of the Mayo Clinic Vaccine Research Group. The Centers for Disease Control and Prevention (CDC), which distributes the vaccines made by pharmaceutical companies, says it’s not likely that every doctor, hospital or retail health care center will carry all seven varieties, but with a little research, you can probably find out where your vaccine of choice is given.

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Here’s the rundown on who should consider which vaccine:

Standard three-strain shot
The tried-and-true flu shot that protects against three strains of influenza will still be available and is recommended for everyone 6 months and older. This year’s version includes influenza strains H1N1 and H3N2, and an influenza B virus.

Four-strain shot
For the first time, a flu shot will protect against four types of influenza — two from the so-called A class of viruses and two from the B class. There are only two types of B-class influenza, which primarily causes illness in young children, so the new shot will offer protection against both. “This vaccine will give you greater likelihood of protection against what you might encounter during the flu season,” says Dr. Michael Shaw, associate director of laboratory science at the CDC’s influenza division. Eventually, this vaccine, called the quadrivalent shot, will replace the three-strain version, but probably not for a few more years.

While the quadrivalent vaccine does provide more protection against flu than the three-strain shot, doctors say the three-strain version is still effective and worth getting if your provider doesn’t stock the quadrivalent vaccine. Be prepared to pay more for the newer shot, however.

Nasal spray
Called FluMist Quadrivalent, this vaccine is squirted into the nasal passages and is most commonly used to immunize young children, who may be squeamish about needles. This year, the spray will protect against four strains of influenza, just like the quadrivalent shot.

(MORE: Why Pregnant Women Should Get Flu Shots)

Egg-free vaccine
About 4% of children and 1% of adults are allergic to eggs, and these individuals have generally skipped their yearly flu shots, since the influenza virus in the vaccines is grown in chicken eggs and carries traces of the egg proteins. But this year they will be able to get Flublok, the first egg-free flu vaccine, which contains influenza proteins from three flu strains cultured in caterpillar cells.

High-dose vaccines
Two shots will contain higher amounts of the influenza proteins that can jump-start flagging immune systems. Designed for those ages 65 and up, these shots can protect the elderly from dangerous complications resulting from influenza, which can include pneumonia and even death.

Well, almost. Fluzone Intradermal actually contains a panel of micro-needles rather than a single needle, and it’s the vaccine to choose if you’re at all nervous about getting stuck. This year’s version will protect against three strains of influenza.