Flu-shot shopping made easy

How to find the right vaccine for you, and where to get it

Published: August 28, 2014 06:00 AM

The symptoms come on fast and strong: muscle aches and pain, fever, headaches, and exhaustion. The flu can knock you out for weeks—and that’s if you’re a healthy young adult. For the young, the old, and those with weak immune systems, the risks of complications, such as pneumonia, are much higher.

The best way to protect yourself is to get vaccinated—soon. This year’s vaccine is the same as last year’s, but you still need a fresh one this season. If you get it now, it should protect you through April, when the virus subsides. The vaccine prevents the illness up to 80 percent of the time in adults younger than 65 and about half of the time in those 65 and older. If you do get sick, you usually contract a milder case. Here are five ways to combat the flu.

1. Consider the new ‘quadrivalent’ shot

The standard shot, called the trivalent, protects against three of the most common flu strains from last year: two influenza A (H1N1 and H3N2) viruses, and one influenza B virus. The quadrivalent version, which came out last year, protects against those plus another influenza B virus. The B strains are the ones most active at the end of the flu season in February and March. Manufacturers are making more of the quad­ri­va­lent vaccine this year, so you should be able to get it at your doctor’s office or a local pharmacy. But unlike the standard vaccine, not all insurers cover it, so you might have to pay out of pocket, about $38.

2. Don’t rush to get the high-dose vaccine

This vaccine, called Fluzone High-Dose, has four times the standard shot’s flu-antigen dose. And a manufacturer-supported study in the Aug. 14 issue of the New England Journal of Medicine found that it was slightly more likely than the standard vaccine to prevent the flu in people 65 and up. But the national Centers for Disease Control and Prevention says that the high-dose version might be more likely to cause side effects, including headache, muscle aches, and fever. So our medical experts say older people should weigh the possible risks and benefits of the vaccine when deciding which shot to choose.

The FluMist nasal spray goes right up the nose.

3. Get the nasal spray for kids

This vaccine, called FluMist, will protect children ages 2 through 8 better than the regular shot, the CDC says in a new-for-this-season recommendation. The downside: A second dose may be necessary a month later. Because it uses a “tamed” but still live flu virus, it is not for anyone with a suppressed immune system, the people who care for them, pregnant women, or people 50 and older.

4. Don’t wait to take anti-viral drugs if you’re at high risk

The drugs osel­tam­ivir (Tamiflu) and zanamivir (Relenza) can ease flu symptoms, reduce complications, and cut the chance of spreading the disease—if you start taking one within 48 hours of getting sick. But a CDC study out in July found that only about one in five high-risk patients got the drugs. “If you have symptoms and are in a high-risk group, ask your doctor for anti-viral drugs,” said Fiona Havers, M.D., of the CDC, who is one of the authors of the study. “Don’t wait three or four days.” You’re at high risk if you are 65 or older, are pregnant or delivered a baby within the last two weeks, have a chronic disease such as asthma, diabetes, or heart disease, have a suppressed immune system, are obese, or live in a nursing home or other chronic-care center.

5. Just say no to antibiotics for flu

The drugs work only against bacteria, and the flu is caused by a virus. Yet the same CDC study found that doctors gave antibiotics to 30 percent of people with the flu. “And that’s probably an underestimate,” Havers said. “The study just looked at three antibiotics.” Using those drugs when you don’t need them can make them less effective when they are necessary and increases the risk of hard-to-treat bacterial infections such as C. difficile.

Instead, go for the tried-and-true: plenty of sleep and fluids, and over-the-counter drugs. Acetaminophen (Tylenol and generic), ibuprofen (Advil and generic), and naproxen (Aleve and generic) reduce fever and headache and generally work better than products such as NyQuil and Theraflu, which contain medicines you probably don’t need.

—Sue Byrne

Where to go for your shot

It seems like you can get a shot just about everywhere these days: Not only your doctor’s office but also the corner drugstore, your church or synagogue, even the airport. So where should you go?

“Wherever it’s most con­venient,” said William Schaffner, M.D., chairman of the preventive medicine department at the Van­derbilt University School of Medicine in Nashville, Tenn., and an expert on flu vaccines. Community centers, workplaces, and drugstores that offer shots must adhere to the same standards of cleanliness as your doctor’s office. And don’t worry about getting bruised by a pharmacist. They’re trained in immunization technique and practice giving shots regularly. To find a vaccination shot near you, go to vaccines.gov and type in your ZIP code.

The vaccine should cost you nothing—no co-pay and no deductible. That has been the case with Medicare and Medicaid for decades, but now the ­Affordable Care  Act requires that insurers fully cover ­preventive care. That’s true whether you have insurance from your employer or an individual health plan you bought ­after 2010. But if you pick a ­location that doesn’t ­accept your insurance, you might have to pay up front and be reimbursed.

Editor's Note:

The article also appeared in the October 2014 issue of Consumer Reports magazine.

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