A new flu season begins with 10 vaccine choices

(September 23, 2018)

NOTE: If you are looking for information on the 2020-2021 flu season, see the article "2020-2021 Flu Season Amid COVID-19".

 September is the official start of the flu season, and most people who choose to get a vaccine will do so by the end of this month. According to the CDC's annual survey, 43% of adults and 59% of children received a flu vaccine during the 2017-2018 flu season. Last year, more people than in the previous year received flu shots during November, leading to more total doses given last flu season than in 2016-2017.

Number of flu shots given each month - AskaPatient.com

"High Octane" vaccine options available for seniors 65 and up
For the 2018-2019 flu season, besides regular flu shot options, two shots are available for seniors who would like to receive a vaccine that offers extra protection:

  • - the "high dose" flu shot (Fluzone High Dose) has four times the amount of antigen than in a regular shot. In 2016, almost 8.5 million Medicare beneficiaries received this version. Fluzone and Fluvirin (not offered this year) were the second and third most common vaccines taken among Medicare Part B recipients in 2016.
  • - the "adjuvanted" flu vaccine (Fluad) has an extra ingredient (an oil-in-water emulsion of squalene oil) that can create a stronger immune response to the vaccination. This is only the third flu season it has been available, and some pharmacies now offer this option to seniors instead of Fluzone High Dose. 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 for patients age 2 - 49
Last year, the FDA did not recommend FluMist, a live-vaccine nasal spray as a vaccine option due to its poorer performance. This year, with some changes to its formula, FluMist is again available as an option for people age 2 to 49.

Reduction in age recommendations: babies can now take Fluarix shots
For all three regular flu shots (see vaccines noted in chart below), the minimum age recommendation is now 6 months old instead of three years old. For Afluria (non-jet injected), the minimum age has been lowered from 18 to five.

No intradermal flu vaccines this season and most options are quadrivalent
Fluzone Intradermal (shot into the skin instead of the muscle) will not be offered this season. Also, most intra-musclular regular flu shots administered this season will be quadrivalent, protecting against four viruses: influenza A (H1N1) virus, and influenza A (h3N2) virus and two influenza B viruses.

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 option is available called Afluria, in both the trivalent and quadrivalent formulations. 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 vaccines available this season are preservative-free; only those stored in multi-use vials contain thimerosal.

Share your experience with your flu shot
Here is the list of all ten vaccines available this 2018-2019 flu season. Please share your experience with the vaccine by completing our new vaccine rating form.

Flu Vaccine Age Range       Rate
AFLURIA 5 and up; 18-64 for jet injection (no longer available in 2019-2020 season)
read Afluria reviews
5 and up; 18-64 for jet injection Add Rating
FLUAD 65 and up Add Rating
FLUARIX QUADRIVALENT* 6 months and up Add Rating
read Flublok reviews
18 and up Add Rating
read Flucelvax reviews
4 and up Add Rating
FLULAVAL QUADRIVALENT* 6 months and up Add Rating
65 and up Add Rating
read Fluzone reviews
6 months and up Add Rating

*Regular-dose, egg-based, intramuscular flu shot. This is the most common type of flu vaccine administered.

Sources and More Reading:

- Data on how many people receive flu shot. CDC article.

- 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) and recombinant vaccine (Flublok) production. Flublok is made using insect cells. Because of quicker production times, cell-based vaccine production could alleviate the possibility of shortages in the event of a flu pandemic.

- "This Flu shot is not like the others." Time report on cell-based vaccine Flucelvax, which was introduced in 2014. Flucelvax is produced in a matter of hours rather than months, and is manufactured using dog kidney cells.

- Here is a chart of the ten vaccines for this season:  https://www.askapatient.com/news/images/flu-vaccines-2018-2019.png

- Medicare Part B Public Spending Dashboard. Provides statistics on cost and number of patients receiving drugs (and vaccines) under Medicare Part B.

- Vaccine Adverse Event Reporting System (VAERS): 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).

- List of Influenza Vaccines: 2019 Influenza Vaccines Bookmark our list and then add your review after you get your flu shot.

- Read patient opinions about Shingrix shingles vaccine: Shingrix Vaccine Reviews