Plenty of options when its comes to flu vaccines

Is there even such a thing as the “best one” when it comes to flu shots?

The number of choices available for getting immunized against influenza is unrivaled in the vaccine world. There are 10 varieties of flu vaccine made by multiple companies approved for use in the United States.

“Nothing approaches flu in terms of the numbers of products available and the number of different ways they are made,” says Paul Offit, a pediatric infectious disease specialist at Children’s Hospital of Philadelphia who also serves on the Food and Drug Administration advisory committee that determines which strains to include in the seasonal vaccine. “There are no other vaccines that offer so many choices.”

So, what’s a confused flushot seeker to do?

For most people, simply getting the flu vaccine — any flu vaccine — is what matters most, says David Cennimo, an infectious-disease specialist at Rutgers New Jersey Medical School in Newark. And in practice, most of us don’t really end up making a decision at all. Each clinic decides which varieties to carry, so by the time you get there the decision has been made.

Generally, the most standard flu shot is a quadrivalent vaccine, which comes in five varieties that contain the same four strains of influenza most likely to be circulating each season. The shot goes into a muscle, usually the arm. A woman who worked at a Target clinic said they have a few kinds but give most people “the regular one.” Pressed for more detail, she told me it was a quadrivalent variety called Fluzone.

Also available are three trivalent options, which contain three strains of influenza instead of four. Offit says one of them, approved for people ages 6 months to 64 years, will probably be phased out over time because it offers less protection than the quadrivalent versions. (If you have received a trivalent version, Offit says, there’s no harm in getting a second shot with the quadrivalent formulation.)

If you’re 65 or older, however, the other trivalent options are probably your best bet. One, the Fluzone HighDose, contains four times the number of viral particles that prompt the body to produce antibodies. The other, Fluad, contains a compound called an adjuvant, which induces the immune system to react more forcefully to the injection. Both types address the weakened immune response that happens with age.

On the other side of the age spectrum, kids who are 2 and up can get FluMist, a quadrivalent vaccine that includes bits of live virus (modified so that they can replicate in the nose but not replicate in the warm conditions of the lungs). The American Academy of Pediatrics has recommended shots over the nasal spray for kids, based on some evidence FluMist didn’t work particularly well in the winters of 2013-2014 and 2015-2016.

But manufacturer GlaxoSmithKline has reformulated a new version of the nasal spray that, Offit says, appears to be at least as effective as the shot.

CHICAGO TRIBUNE 2016 If your kids don’t like shots, a new version of the nasal spray appears to be at least as effective as the shot, says Paul Offit, a pediatric infectious disease specialist at Children’s Hospital of Philadelphia.