Ask the Pharmacist

Q. What can you tell me about this year’s flu shots and when should I be looking at getting it?

A. This year, the flu vaccine selection is quite similar to previous seasons in that there are several versions to choose from. There are a number of quadrivalent vaccines (meaning that the vaccine provides protection against four different strains of the influenza virus), a high-dose quadrivalent and an adjuvanted trivalent vaccine, all of which are injected into the deltoid muscle.

There is also an intranasal vaccine called FluMist on the market but there are two problems that arise with that vaccine. First off, Public Health does not cover the cost of that vaccine so if you think you might prefer a nasal one over an injection, you are having to pay out of your own pocket for it. Secondly, it can only be purchased in units of 10 meaning many pharmacies are reluctant to order it in since it is non-returnable and the demand for the nasal spray is limited, at best.

So, if you are wondering which vaccine you could or should opt for, the government makes it somewhat easy in the sense that if you are younger than 65, you will get one of three publicly funded quadrivalent vaccines: FluLaval Tetra, Fluzone Quadrivalent (both of which can be given to anyone 6 months of age or older) or Afluria Tetra (can be given to anyone 5 years and older). They all deliver 15ug of hemagglutinin (the active component responsible for protecting you against the influenza virus) and are deemed equivalent. As an aside, pharmacies are unable to choose which vaccines we wish to have on hand for administering to the public. Public Health sends whatever they have in stock when pharmacies place an order for it.

There are two vaccines that are reserved for those individuals that are 65 years of age or older: A High-Dose Quadrivalent vaccine called Fluzone High-Dose Quadrivalent which delivers 60ug of hemagglutinin (note that this is 4 times stronger than the regular quadrivalent vaccine) and an Adjuvanted Trivalent which contains the regular dose of 15ug hemagglutinin but also contains a chemical referred to as an adjuvant which stimulates the body to create a stronger immune response. These “stronger” vaccines are reserved for seniors since their immune responses to normal vaccines tend to be diminished due to the effects of aging. In previous years, we were not able to supply every individual over 65 with the preferred vaccine as there was a short supply of them. We don’t know how that will play out for this season but if supply runs short, the regular dosed quadrivalent vaccine is much better than using nothing at all.

The flu shots are inactivated vaccines which means that you will not get the flu by receiving it. Some people may, however, feel under the weather for a day or two while their immune system is building up the proper antibodies to protect you. Just know that your body is doing what it needs to be doing and building up the proper immune response. The most common side effect of the vaccine is a sore arm for a short while but this is a far better side effect than having to deal with getting the flu.

There are many of us that are getting tired of rolling up our sleeves for the various covid vaccines and boosters and wonder if they should be considering a flu shot this year. It is hard to predict the future without the use of a crystal ball but it is thought that this fall/winter might prove to be difficult one and put an even greater strain on our health care system. Australia, is coming off a brutal influenza season and we often move in lockstep with them.

The pandemic is still among us and the Omicron variant continues to wreak havoc in the community and in various congregated living settings such as retirement homes and nursing homes. Each time a staff and/or resident contracts covid or influenza, for the safety of the other residents, they are forced to go into lockdown. Many people have only learned of “lockdown” during this current pandemic but it has actually been a common practice in congregated settings for many years in the event of an outbreak of a virus such as the flu.

Now that we are into the influenza season, it is just as important, perhaps even more important, to make the effort and get vaccinated against the influenza virus and when the timing is right, the next dose of the bivalent covid vaccine as well. People are much more involved in social activities (as we should be!), however, this does increase the risk of contracting a virus, especially now that the cooler weather is upon us and our activities are trending indoors once again. Perhaps we need to think about donning the mask in certain situations once again to protect yourself and others. For more information on this or any other topic, contact your pharmacist.