Influenza Vaccination
About
(Please note: Initially, I wrote this vaccination information with links to the CDC's website, regarding vaccine information, diseases and surveillance in the United States. However, on February 8th, 2025, Robert F. Kennedy Jr. elected as the Secretary of Health and Human Services, directed that the CDC post less frequent surveyllance reports and has changed some vaccine recommendations. Some older background information has also been eliminated from the CDC website. Therefore, the general information here may be a mix of some older practical information (that is still be applicable) which may seem outdated mixed with some more current information. Additionally, some earlier links may be broken.
When to get the flu vaccination: People should get their flu vaccines every year, in the early fall, or otherwise if indicated by their primary care provider, the CDC, their employer or school. The CDC estimates about 36,000 annual deaths from the flu (and pneumonia secondary to flu) in the US. Every year, I see some very sick people from the flu—men and women of all ages. Besides protecting against secondary pneumonia, it also helps protect us against other secondary infections caused by the flu, like meningitis.
From my experience and knowledge, this is typically a very good annual vaccine to get for most people. It typically covers the four most common circulating strains of flu (2 strains of A and 2 strains of B). The strains are determined by scientists who look at the most common circulating strains in other countries where the flu season arrives before influenza hits in the US. From there, they decide on the vaccination that will be needed for our flu season Sometimes the scientists hit the mark and sometimes not quite. In fact, the flu vaccine is only 40 to 60% effective at protecting someone from getting the flu (tthe vaccine this year was a mismatch of the most predominant strain subclade K but, while it may not be totally effective, it has been shown to decrease the risk of severe flu symptoms in most people). Moreover, not everyone has an optimal immune response to the vaccine: Most older people naturally do not produce as many antibodies in response to the vaccine, so they have less protection when exposed to the flu. This would include older people, those with immune compromise, and those with other risk factors. Additionally, the flu shot wears off a little bit each month. According to the University of Minnesota, nearly 6 weeks after the flu shot is given, it starts to wear off by about 9% each month - so becomes weaker as time passes So, if you are wondering why your flu shot did not work this year, these reasons might explain things I would still get it because a 50% less chance of getting the flu is better than none.
Overall, the flu vaccination is a pretty well-tolerated vaccine - sometimes a person has a bit of a sore arm or, as mentioned, may feel a little bit ill the day after with a low-grade fever, but nothing like a full-blown flu. If you have any questions about possible reactions to the flu vaccine, discuss it with a healthcare provider before you get it. Also, see contraindications (who should not get a flu shot).
FORMS: IM (Intramuscularly - a flu "shot" and there is also a nasal spray (FluMist [live virus]). The latter can be given to healthy people 2-49 years of age however, because FluMist is a live vaccine, there are important limitations on who can get this.
Dosage/Strengths: There are also different-strength flu shots for different people. There is a regular-strength quadrivalent vaccine, and there are high-dose vaccines (Fluzone with four times the antigen as the regular dose and effective against four strains) recommended for people 65 and older (who tend to have a less reactive immune response to the regular vaccine). Ask a healthcare provider or a pharmacist which one is right for you.
NOTE: Asmentioned, the flu shot may make you feel a bit "under the weather" for a day or two, but under normal circumstances, it does not give you the flu (I often think of those exposed to those with the flu when they are in a line waiting at their doctor's office or in line at a pharmacy for their flu shot!)
The best times to get a flu vaccination are in September and October. It lasts for approximately six months. A second flu vaccine may be covered after six months "if medically necessary" (vague terminology - In other words, check with your insurance company to be sure it is covered)
Q&A
I pass out when I get shots. Should I avoid getting them?
Passing out when you get a shot is not that uncommon. First, discuss this with a healthcare provider. Most of these reactions are vasovagal reactions. Most of the time, your mind is just fine about it, but your body does not like it one bit. Once you decide to get the vaccine, be sure to hydrate before and tell the person giving you the vaccine that you sometimes pass out when you get it. The person giving you the vaccine will accommodate your problem by laying you down before you get the vaccination. They will give you the shot and keep an eye on you afterward.
I am immune compromised. Should I get vaccinated?
Those with immunocompromising conditions or on medications that cause potential immune compromise should talk to an immunologist before getting a live virus vaccination because they may not be able to fight off the potential disease that the live virus can cause.
Does Insurance cover vaccinations?
Although insurance is supposed to cover preventive services, it sometimes does not. Call your insurance company to see if they cover the ones you want and ask where they are covered. Some are only covered in medical facilities like doctors' offices or clinics, and others are only covered at pharmacies (i.e., shingles). They are the COVID-19, flu, pneumococcal, and hepatitis B vaccines.
Traditional Medicare is especially tricky: As of this writing, it only covers Hepatitis B for beneficiaries who are at medium or high risk for the virus and Tdap for those with a documented injury.
The other four vaccines—shingles, RSV, Tdap, and hepatitis A—are covered by Medicare Part D, the optional prescription drug program available to people with Traditional Medicare or Medicare Advantage plans. Again, be sure to ask your insurance company if they are covered and where. If you do not do this correctly, you can end up with a hefty vaccination bill.
I have heard that I should NOT take Tylenol or Ibuprofen (Advil, Motrin) after a vaccination - that it will dull my immune response. Is this correct?
Most sources agree that it is acceptable for adults to take ibuprofen or Tylenol (acetaminophen) after a vaccination for side effects: Those medicines will not cause a problem with immune response. That being said, if your side effects are not too bad and you do not need to take those medications, you feel you can weather through the side effects, try to do that. Use a cool cloth at the site for soreness, move the arm you got the injection a lot, and dress in cool clothing if you feel hot. Still, if you need the medications for side effects, take them.
For more information about vaccines see the CDC
*Disclaimer: The material above is for informational purposes only. This information is not intended to diagnose, treat, or cure a condition. The uses listed above are tentative; some have or are undergoing research trials, but many are not FDA-approved. You must investigate these supplements further before deciding to use them. Check interactions and contraindications on sites like Drugs.com or WebMD. Do not attempt to treat a serious condition like liver, kidney problems, high blood pressure, heart, cancer, diabetes, or thyroid issues without discussing it with a healthcare provider first. If you are pregnant, do not use supplements without discussing it with your healthcare provider.