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Why You Should Get Your Flu Vaccine Now: 2021-2022 Updates

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Sep 7, 2021.

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Many of us continue to work or learn from home this fall due to COVID-19, but the flu vaccine is still an important preventive measure every year. No doubt, if you have your choice between getting the flu or not, you should prefer the latter.

The flu season can result in millions of lost work days at a cost of billions of dollars. Although the CDC says people should get a flu vaccine when available -- and best by the end of October -- many people wait or never get it at all. But you can get the flu vaccine anytime throughout the flu season if you miss the earlier dates in Sept. or Oct.

And it's important to know that this year, you can get your flu vaccine and COVID-19 vaccine at the same time, if needed. This will save you a trip and offer possibly life-saving protection.

How well does the flu vaccine work?

Usually flu vaccination reduces the risk of flu illness by between 40% and 60% during seasons when the flu viruses are well-matched to the flu vaccine.

Vaccine effectiveness varies from year to year, based on the match of the circulating flu types to the strains contained in the vaccine. Flu vaccine effectiveness estimates for last year are not available yet, but a record number of influenza vaccine doses (193.8 million doses) were distributed in the U.S. during 2020-2021 flu season.

It's important to know that each year the flu vaccine is never 100% effective in preventing flu. But it drastically reduces your chances of getting it (and passing it on to others), and it lessens the severity of symptoms if you are infected with the virus.

Last years flu season was very mild, probably due to flu vaccine uptake as well as COVID social distancing, mask wearing, school closures, telecommuting, and hand washing by the general public.

FluMist Quadrivalent 2021-2022

FluMist Quadrivalent is a needle-free option approved for use in certain populations between the ages of 2 to 49 years. FluMist Quadrivalent is a liquid that is sprayed into the nose. FluMist Quadrivalent is also known as Quadrivalent Live Attenuated Influenza Vaccine (LAIV4).

Two doses of the nasal flu vaccine (each, at least 1 month apart) may be required in children ages 2 years through 8 years who never been vaccinated for influenza.

LAIV4 for the 2021-2022 season will contain four influenza virus strains: A (H1N1) virus, A (H3N2) virus, B Yamagata lineage, and B Victoria lineage.

FluMist Quadrivalent is not to be used in children under 2 years old because they have an increased risk of wheezing (difficulty with breathing) when using this vaccine. Tell your doctor if you or your child are currently wheezing, or if your child has a history of wheezing if under 5 years old.

Who should NOT get FluMist Quadrivalent?

FluMist Quadrivalent should not be used:

  • in children under 2 years old because they have an increased risk of wheezing (difficulty with breathing) when using this vaccine.
  • have a severe allergy to eggs or to any inactive ingredient in the vaccine
  • have ever had a life-threatening reaction to any flu vaccine
  • are 2 through 17 years old and take aspirin or medicines containing aspirin. Children or adolescents should not be given aspirin for 4 weeks after getting FluMist Quadrivalent unless your healthcare provider tells you otherwise.

Tell your doctor if you or your child are currently wheezing, or if your child has a history of wheezing if under 5 years old.

There are additional warnings for people who may not be able to get this nasal vaccine, ask your doctor if you fall into any of those groups. If you or your child cannot take FluMist Quadrivalent, you may still be able to get an influenza shot. Talk to your healthcare provider about this.

The Flu Vaccines and Kids

Each year thousands of children under the age of 5 are hospitalized due to influenza. Children younger than 5 -- but especially children under 2 years -- are especially at risk of severe flu infection. Children with health problems like asthma or diabetes are at an especially high risk of developing complications.

In the 2021-2022 flu season, the shots available will include either the use of the inactivated influenza vaccine (IIV4s) or the recombinant influenza quadrivalent vaccine (RIV4) for everyone aged 6 months or older based on eligibility.

  • Children aged 6 months through 8 years who require 2 doses should receive their first dose as soon as possible after the vaccine becomes available, and the second dose ≥4 weeks later.
  • Children who need only one dose can be vacinated soon after the vaccine is available.
  • Persons aged 9 years or older need only one dose for 2021-22.
  • The nasal spray flu vaccine FluMist Quadrivalent, a live attenuated quadrivalent vaccine, is also noted in the CDC recommendations and is approved for children and adults aged 2 to 49. Children 2 years to 8 years may require 2 vaccine doses (given at least one apart) depending upon vaccine history.

The 2021-2022 Flu Vaccine Composition

This flu season each vaccine is quadrivalent, meaning it contains 2 type A flu viruses (H1N1 and H3N2) and 2 type B flu viruses (Victoria and Yamagata). Strains can change from year-to-year, and that's one reason why you need a flu shot each fall.

This year, the strains include two updates compared to last years vaccines. Both the influenza A(H1N1) and the influenza A(H3N2) vaccine virus components were updated.

Strains in the 2021–22 U.S. influenza vaccines are:

Quadrivalent, egg-based vaccines: A/Victoria/2570/2019 (H1N1) pdm09-like virus; A/Cambodia/e0826360/2020 (H3N2)-like virus; B/Washington/02/2019- like virus (B/Victoria lineage); B/Phuket/3073/2013-like virus (B/Yamagata lineage).

Cell- or recombinant-based quadrivalent vaccines: (Flublok and Flucelvax): A/Wisconsin/588/2019 (H1N1) pdm09-like virus; A/Cambodia/e0826360/2020 (H3N2)-like virus; B/Washington/02/2019-like virus (B/Victoria lineage); B/Phuket/3073/2013-like virus (B/Yamagata lineage).

Quadrivalent Vaccines: A Boost of Protection

Quadrivalent vaccine injections add an additional B strain to the 3 recommended strains in the trivalent flu vaccines and protects against A and B strains of influenza (4 strains total). This flu season, all available vaccines in the U.S. are quadrivalent.

  • The quadrivalent vaccines Fluarix, FluLaval, Fluzone, and Afluria are all approved for individuals 6 months of age or older. These are all quadrivalent inactivated influenza vaccines (IIV4s) injections that are egg-based.
  • Fluzone High Dose Quadrivalent is available for those 65 years of age and older. It's also an inactivated, egg-based injection. Fluad Quadrivalent is also used in those 65 years and older and it's a standard dose, adjuvanted-egg-based injection. An adjuvant is an ingredient used in some vaccines that helps it to work better: it creates a stronger immune response in people receiving the vaccine.
  • Flublok Quadrivalent, a recombinant formulation, can be used in adults 18 years and older and is inactivated but not egg-based.
  • Flucelvax Quadrivalent injection can be used in those 2 years and older. It's cell culture-based and inactivated but contains no egg proteins.
  • FluMist Quadrivalent live attenuated influenza vaccine (LAIV4) nasal vaccine is a live attenuated nasal spray vaccine but also contains egg proteins.

The Flu Vaccine is Affordable and Convenient

The flu vaccine has never been easier to get.

  • You don't have to wait in long lines or make a future appointment -- the flu vaccine can be found at most independent pharmacies and major retailers such as Costco, CVS, Target, Walgreens, and Walmart.
  • Your primary care doctor may offer them, too.
  • Drive-through vaccination sites may be available; call your local pharmacy.

Across the country, most pharmacists are now licensed to immunize, meaning they can give you the vaccine with little waiting. In addition, pharmacies or clinics will accept insurance for the vaccine which results in little or no copay to you.

If you have don't have insurance, check to see if your local or state health clinic or employer is offering free vaccines. Even if you have to pay, the average $30-$50 cash price is well worth the price.

College students and others living in close quarters are especially susceptible to the flu, just like COVID-19. Students may be offered the flu vaccine at little to no cost in the campus clinic. College students should make it a priority to get their flu vaccine each fall.

Seniors Can Get Even More Protection

Seniors are an especially high-risk group for severe flu, hospitalization, and death due to influenza complications like pneumonia. Boosting the immune system with one of the below vaccines may be preferred for this age group, but vaccination should not be delayed if a specific product is not readily available.

  • Fluzone High-Dose Quadrivalent vaccine, from Sanofi, is specifically made for adults 65 years of age and older and is egg-based.

  • Fluad Quadrivalent, from Seqirus, is also for adults 65 years and older and is egg-based. Fluad contains the adjuvant squalene (MF59), a naturally occurring substance found in humans, animals and plants. Adjuvants are incorporated into some vaccine formulations to boost the immune response.

  • Flublok Quadrivalent, from Sanofi, is used in adults 18 years and older and contains 3 times the active ingredients of other quadrivalents. It is not egg-based.

Yes: You Need A Flu Vaccine Every Year

Unfortunately we cannot predict the severity of the flu season, and flu vaccine effectiveness does not last from year to year. In fact, each year, public health experts research which flu strains are most likely to be circulating. The strains that make up the annual flu vaccine each year may change, as they did this year.

In addition, studies have shown that the body's ability to fight off the flu after a vaccine wanes over time, so that's another reason why you need a vaccine each year -- preferably by the end of October. But remember: it takes 14 days for immunity to build up in your body to fight the flu virus, so don't expect immediate protection.

What if you have put off the flu vaccine until December, or even later? It's never too late to get the vaccine to protect yourself and those around you, so visit your healthcare provider as soon as you can.

One Shot Can Help Protect You and Your Newborn

The U.S. Advisory Committee on Immunization Practices (ACIP) recommends an annual flu vaccine for anyone 6 months of age or older, including pregnant women, if they are eligible. Influenza vaccine can be administered at any time during pregnancy, before and during the influenza season.

Plus, there's an added value to the seasonal flu vaccine for pregnant women -- not only does it protect them against the flu and lower the risk of hospitalization, it also helps to protect their newborn infants for up to the first few months of life -- at a time when infants are too young to receive the vaccine themselves.

Pregnant women may receive any licensed, age-appropriate influenza vaccine, as recommended by the CDC. Influenza vaccine can be administered at any time during pregnancy. According to the CDC, FluMist nasal vaccine (LAIV4) should not be used in women who are pregnant but can be used after childbirth.

Early Fall is the Perfect Time

Flu season can start early, and it takes about two weeks after receiving your vaccine for the full antibody effect to develop and provide flu protection. That’s why it’s better to get vaccinated in the fall, before the end of October ideally, before the flu season really kicks in. Flu vaccines are usually available by mid-September in most years.

But it's never too late to get the flu vaccine if you miss out in the fall. Seasonal influenza disease usually peaks in January and February most years, but can occur late or early. This year, the CDC notes that flu season could be early due to low circulating virus and immunity from 2020, most likely due to protective measures from the COVID pandemic.

Be sure to get re-vaccinated each fall.

Can I Get a Flu Vaccine if I am Allergic to Eggs?

If you are allergic to eggs you can still be protected in most cases, even though most flu shots and the nasal spray flu vaccine are made using egg-based technology.

However, a previous severe allergic reaction (anaphylaxis) to any influenza vaccine, regardless of the component suspected of being responsible for the reaction, means you should not receive that vaccine in the future. But there still may be an appropriate flu vaccine you can use.

Talk with your doctor if you are not sure if a previous reaction you've had is considered severe, and which vaccines may be appropriate for you now. You may need to receive your vaccine in a medical setting with a healthcare provider who can recognize and manage a severe allergic reaction.

Egg-Free Vaccines for 2021-2022

There are 2 egg protein-free flu vaccines available for the 2021-2022 flu season:

  • Flublok Quadrivalent, from Sanofi Pasteur, is a recombinant vaccine and does not contain any egg proteins. It can be used in people 18 years and older.
  • Flucelvax Quadrivalent, from Seqirus, is a standard dose, cell culture-based vaccine and can be used in people 2 years and older.

Other vaccines than these two listed above may contain trace amounts of egg proteins. Talk to your healthcare provider if you have an egg allergy.

Hate Shots? You're Not Alone

Please do not skip the flu vaccine just because you hate getting a shot. You are not alone - rougly 1 in 4 adults were shown to have a fear of needles in one survey. There are other options.

  • FluMist Quadrivalent is a needle-free vaccine that is sprayed in the nose. It is approved for children and adults ages 2 to 49 years, but there are certain groups that can't use FluMist, so check with your doctor.

Afluria Quadrivalent from Seqirus can be used with the Stratis needle-free jet injector.

  • Anyone 18 through 64 years of age who can get Afluria may ask for needle-free Afluria, but check with your doctor, clinic, or pharmacy to be sure they have the jet injector first. It's not necessarily pain-free, but the shot creates a narrow stream of fluid that goes through the skin, without a needle, given in one-tenth of one second.
  • Children 6 months through 17 years and adults 65 and older should receive Afluria Quadrivalent only by needle and syringe.

Can I Get a Flu Vaccine if I Have COVID-19?

  • If you think you have been recently exposed to COVID-19, call your healthcare provider before you go in to receive your flu vaccine.
  • According to the CDC, if you are in isolation for COVID-19 or in quarantine for known or suspected exposures, you should wait to get your flu vaccine if going will pose a risk of COVID exposure risk to others in the vaccine setting.
  • If you are feeling ill from COVID, with or without a fever, postpose your flu vaccine until you have recovered. In some cases, persons who are mildly ill may be vaccinated but call your doctor first to determine if you should wait to get the flu vaccine until you have recovered from COVID.

Take the recommended precautions to protect yourself from COVID-19 while getting your flu vaccine.

Influenza (flu) and COVID-19 are both contagious respiratory illnesses, but they are caused by different viruses. The flu and COVID viruses will both be spreading at the same time this flu season. It is possible to have flu and other respiratory illnesses like COVID-19 at the same time, and there is a single test now available to determine if you have one or both.

Getting a flu vaccine will not protect you against COVID-19 (and vice versa); however, flu and COVID vaccination can help to keep you out of the hospital and help keep you alive. Plus, you'll be less likely to spread these viruses to others. Less people with severe flu or COVID symptoms will also help to conserve space in healthcare facilities, medical personnel and other needed resources.

According to the CDC, in 2021 - 2022 flu vaccines and COVID-19 vaccines can be given at the same time, but in different sites. COVID-19 vaccines may now be administered without regard to timing of other vaccines.

Learn More: COVID-19, Flu, Cold or Hay Fever - Which One Do I Have?

Audenz: Protection for a Future Bird Flu Pandemic

In February 2020, the FDA approved Audenz (influenza A (H5N1) monovalent vaccine, adjuvanted) from Seqirus. Audenz is an inactivated, cell-based influenza vaccine designed to protect against influenza A (H5N1) in the event of a H5N1 (Avian (bird) flu) global pandemic. It is not currently found in other U.S. flu vaccine products. The U.S. government will stockpile this vaccine and distribute it in the event of an outbreak. Outbreaks of bird flu have occurred in Asia, Africa, North America and parts of Europe.

  • Audenz is approved in people 6 months of age and older at increased risk of exposure to the influenza A virus H5N1 subtype contained in the vaccine.
  • Audenz is given as 2 different shots. The two doses are given as an intramuscular (IM) injection 21 days apart. It is important you complete the two-dose immunization series if you need the vaccine.
  • Audenz contains an adjuvant that increases the effectiveness of the vaccine and is developed using cell-based technology.

Common side effects with Audenz in adults may include injection site pain, fatigue (feeling tired), headache, generally feeling unwell (malaise), joint and muscle pain, and nausea (stomach upset). Allergic reactions can occur and appropriate medical treatment must be available to manage possible anaphylactic reactions following administration of the vaccine.

History Has Proven: The Flu is a Monster

If you've ever had the flu, you know it's not your average virus. The illness can land you flat on your back and its effects can span 2 weeks or longer. Now, with COVID in the mix, it's even more of a concern.

For children under two, seniors, and people with chronic health conditions like:

the flu can be especially severe or even fatal. Dehydration, worsening of health conditions, and pneumonia are just a few of the possible complications.

And, NO, the flu vaccine CANNOT cause the flu (just in case you are trying to use this excuse in a last ditch effort). The vaccine is made up of inactivated (killed) or weakened viruses that have no ability to infect the lungs.

So, go on -- you're out of excuses -- fight off the monster known as the flu today and get your vaccine.

Finished: Why You Should Get Your Flu Vaccine Now: 2021-2022 Updates

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Further information

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