2019-2020 Flu Season Begins with 9 Vaccine Choices

Note: if you are looking for information on 2020-2021 flu season, please see "Flu Vaccines for 2020-2021 Amid the COVID-19 Pandemic"

(September 26, 2019)

September is the official start of the flu season, and most people that choose to get a vaccine will do so by the end of October. According to the CDC, during the 2018-2019 flu season, about 169.1 million flu vaccines were given, a nine percent increase over the previous year. See chart below for a comparison of number of flu shots given in the last three flu seasons:
2016-2018 Number of Flu Vaccines Distributed in Millions

Here is the list of all nine vaccines available this 2019-2020 flu season.
 Flu Shot Options for 2019=2020 Flu Season - AskaPatient.com

What's different this season?

All regular flu shots administered this season (except Fluad and Fluzone High Dose for seniors, which are trivalent) will be "quadrivalent". This represents about 81% of the vaccine supply this season. According to the CDC, quadrivalent vaccines (IIV4s) contain one virus from each of the two influenza B virus lineages (Yamagata and Victoria), and two influenza A viruses, whereas trivalent vaccines (IIV3s) contain one influenza B virus from one lineage (for 2019-20, a Victoria lineage virus) along with two influenza A viruses. IIV4s are designed to provide broader protection against circulating influenza B virus strains. However, the CDC and FDA do not express a preference for either quadrivalent or trivalent vaccines.

Special vaccine options available for seniors 65 and up

For the 2019-2020 flu season, besides regular flu shot options, two shots are again available for seniors who would like to receive a vaccine that offers extra protection:

1.      the "high dose" flu shot (Fluzone High Dose) has four times the amount of antigen in a regular vaccine.

2.      the "adjuvanted" flu vaccine (Fluad), which has an extra ingredient (an oil-in-water emulsion of squalene oil) that can create a stronger immune response to the vaccination. This is the fourth flu season it has been available. Product availability can vary among different stores, pharmacies, and health care settings, so you will need to check around for your preferred vaccine option.

FluMist is back again for patients age 2 - 49

In the 2017-2018 season, the FDA did not recommend FluMist, a live-vaccine nasal spray as a vaccine option due to its poorer performance, but it was available in 2018-2019. FluMist Quadrivalent is again available as an option for people age 2 - 49 in the 2019-2020 flu season.

Reduction in age recommendations: babies can now get Afluria brand flu shot

For all three regular flu shots (see vaccines noted in chart below), the minimum age recommendation is 6 months old instead of three years old. For Afluria (non-jet injected), the minimum age has been lowered from age 5 to age 6 months. All children younger than age 3 receive a lower dose of the vaccine, however.

Jet injector option available for patients age 18 - 64

If you don't like receiving the regular flu shot in your arm muscle, a jet injector version of Afluria is available in the quadrivalent formulation. A high-pressure, narrow stream of fluid is used to penetrate the skin with the vaccine. Because the vaccine is stored in multi-use vials, it contains the preservative thimerosal.

Most of the flu vaccines will be preservative-free

Most of the vaccines available in the 2019-2020 season are preservative-free; only those stored in multi-use vials (such as multi-use vials of Fluzone quadrivalent, multi-use vials of Flulaval quadrivalent and the jet injector version of Afluria) contain the preservative thimerosal. The CDC projects that approximately 85% of vaccine supply produced for the 2019-2020 flu season will be thimerosal-free.

Most people have no or very minor side effects from their flu shot. Some might have the minor effect of a slightly stuffy nose after receiving the live nasally administered vaccine. Other people might have a preference for one type of vaccine (for example cell-based instead of egg-based) over another.

How much flu vaccine will be available this season?

For the 2019-2020 season, manufacturers have projected they will provide between 162 million and 169 million doses of vaccine for the U.S. market, and 80% of that will be quadrivalent, egg-based vaccine types. Flu vaccine supply updates will be provided as they become available at the CDC at Seasonal Influenza Vaccine & Total Doses Distributed.

Share your experience with your flu shot.

Please share your experience with your vaccine by completing our new vaccine rating form.
Links provided below to view ratings or add your review.

Flu Vaccine
(production type)



Preservative present if shot obtained from a multi-use vial instead of a single-dose syringe.
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6 months and up; 18-64 for jet injection

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No preservatives;  prefilled single-dose syringes only.

65 and up

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Preservative present if shot obtained from a multi-use vial instead of a prefilled syringe.

6 months and up

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(genetic recombining process)
No preservatives;  prefilled single-dose syringes only.
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18 and up

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Preservative present if shot obtained from a multi-use vial instead of a prefilled single-use syringe.

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4 and up

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Preservative present if shot obtained from a multi-use vial instead of a prefilled single-use syringe.

6 months and up

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(egg-based live weakened virus administered in single-use nasal spray)
No thimerosol preservative.

2 and 49

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No preservatives; single-use prefilled syringes only.

65 and up

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(egg-based) Preservative present if shot obtained from a multi-use vial instead of a prefilled syringe.

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6 months and up

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*These are the most commonly available vaccines, all shots.


Sources and More Reading:

- List of 2019-2020 Influenza Vaccines reviews and rating forms: 2019 Influenza Vaccines Note that reviews with dates from 2018 are from the 2018 flu season.

- Information on the previous flu season, 2018-2019: https://www.askapatient.com/news/influenza-vaccines-for-2018-2019.asp

- Information on 2017-2018 flu season: https://www.askapatient.com/news/flu-prevention-and-treatments-for-2017-2018.asp

- Discussion of differences in options and dosages this flu season compared with last: CDC 2019 Flu FAQ.

- Data on how many people receive flu shot. CDC articles provide historical data and projected forecasts for this upcoming 2019-2020 flu season.

- How flu vaccines are made: Article from the CDC explains the 70-year old process of making vaccines from chicken eggs. Also explains techniques used for newer cell-based (Flucelvax) vaccines and recombinant vaccines. Cell-based vaccine production could alleviate the possibility of shortages in the event of a flu pandemic, because of quicker production times.

- Vaccine Adverse Event Reporting System: https://vaers.hhs.gov/reportevent.html

- VAERS is co-managed by the Centers for Disease Control and Prevention (CDC) and the U.S. Food and Drug Administration (FDA).

- Health Map Vaccine Finder: Map of Flu Shot Availability (note: CDC does not sponsor this service, as it is not comprehensive and sometimes has inaccuracies. But it can be helpful in locating stores or other establishments that offer flu shots).

- Related topic: Reviews for Shingles Vaccine: Shingrix Vaccine Reviews