Seasonal Flu Shot
Note: “Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2019–20 Influenza Season” has been published. CDC recommends annual influenza vaccination for everyone 6 months and older with any licensed, influenza vaccine that is appropriate for the recipient’s age and health status, (IIV, RIV4, or LAIV4) with no preference expressed for any one vaccine over another. Content on this website is being updated to reflect this most recent guidance. More information about the upcoming 2019-2020 flu season is available.
The flu shot is a vaccine given with a needle, usually in the arm. The seasonal flu shot protects against the three or four influenza viruses that research indicates will be most common during the season.
CDC recommends use of any licensed, age-appropriate influenza vaccine during the 2018-2019 influenza season, including inactivated influenza vaccine [IIV], recombinant influenza vaccine [RIV], or live attenuated influenza vaccine (LAIV). No preference is expressed for any influenza vaccine over another. Both trivalent (three-component) and quadrivalent (four-component) flu vaccines will be available.
Trivalent flu vaccines include:
- One standard-dose trivalent flu shot (IIV3) manufactured using virus grown in eggs. This shot (Afluria) can be given either with a needle (for people aged 5 years and older) or with a jet injector (or people aged 18 through 64 years only).
- A high-dose trivalent flu shot (Fluzone High-dose), approved for people 65 years and older.
- A trivalent flu shot made with adjuvant (Fluad), approved for people 65 years and older.
Quadrivalent flu vaccines include:
- Standard-dose quadrivalent flu shots that are manufactured using virus grown in eggs. These include Afluria Quadrivalent, Fluarix Quadrivalent, FluLaval Quadrivalent, and Fluzone Quadrivalent. Different flu shots are approved for different age groups. Some are approved for children as young as 6 months of age. Most flu shots are given in the arm (muscle) with a needle. One quadrivalent flu shot (Afluria Quadrivalent) can be given either with a needle (for people aged 5 years and older) or with a jet injector (for people aged 18 through 64 years only).
- A quadrivalent cell-based flu shot (Flucelvax Quadrivalent) containing virus grown in cell culture (that is egg-free), which is approved for people 4 years and older.
- A recombinant quadrivalent flu shot (Flublok Quadrivalent) approved for people 18 years and older.
- What is the flu shot?
- Is there more than one type of flu shot available?
- Who should get vaccinated this season?
- Who should get vaccinated this season?
- Who should not get a flu shot?
- How effective is the flu shot?
- What are the risks from getting a flu shot?
- What are the side effects that could occur?
- Can severe problems occur?
- What should I do if I have had a serious reaction to seasonal influenza vaccine?
- Can the flu shot give me the flu?
- Why do some people not feel well after getting the flu shot?
- What about people who get a flu shot and still get sick with flu symptoms?
- What protection does the flu vaccine provide if I do get sick with flu?
- Egg Allergy
There are many vaccine options to choose from, but the most important thing is for all people 6 months and older to get a flu vaccine every year. If you have questions about which vaccine is best for you, talk to your doctor or other health care professional. More information on approved flu vaccines for the 2018-2019 flu season, and age indications for each vaccine are available in CDC’s Table: U.S. Influenza Vaccine Products for the 2018-19 Season.
Everyone 6 months of age and older should get a flu vaccine every season. This recommendation has been in place since February 24, 2010 when CDC’s Advisory Committee on Immunization Practices (ACIP) voted for “universal” flu vaccination in the United States to expand protection against the flu to more people.
Vaccination to prevent influenza is particularly important for people who are at high risk of serious complications from influenza. See People at High Risk of Developing Flu-Related Complications for a full list of age and health factors that confer increased risk.
More information is available at Who Should Get Vaccinated Against Influenza.
Different flu vaccines are approved for use in different age groups. In addition, some vaccines are not recommended for certain groups. Factors that can determine a person’s suitability for vaccination, or vaccination with a particular vaccine, include a person’s age, health (current and past) and any allergies to flu vaccine or its components.
Influenza vaccine effectiveness (VE) can vary from year to year. The protection provided by a flu vaccine depends on the age and health status of the person getting the vaccine, and the similarity or “match” between the viruses or virus in the vaccine and those in circulation. For more information, see Vaccine Effectiveness – How well does the Flu Vaccine Work.
The risk of a flu shot causing serious harm or death is extremely small. However, a vaccine, like any medicine, may rarely cause serious problems, such as severe allergic reactions. While severe reactions are uncommon, you should let your doctor, nurse, clinic, or pharmacist know if you have a history of allergy or severe reaction to flu vaccine or any part of flu vaccine. Almost all people who get influenza vaccine have no serious problems from it. For more information, see Influenza (Flu) Vaccine Safety.
The most common side effects from the influenza shot are soreness, redness, and tenderness or swelling where the shot was given. Low-grade fever, headache and muscle aches also may occur.
Life-threatening allergic reactions to flu shots are very rare. Signs of serious allergic reaction can include breathing problems, hoarseness or wheezing, hives, paleness, weakness, a fast heartbeat, or dizziness. If they do occur, it is usually within a few minutes to a few hours after receiving the shot. These reactions can occur among persons who are allergic to something that is in the vaccine, such as egg protein or other ingredients. While severe reactions are uncommon, you should let your doctor, nurse, clinic, or pharmacist know if you have a history of allergy or severe reaction to flu vaccine or any part of flu vaccine.
There is a small possibility that influenza vaccine could be associated with Guillain-Barré syndrome, no more than 1 or 2 cases per million people vaccinated. This is much lower than the risk of severe complications from flu, which can be prevented by flu vaccine.
Call a doctor, or get to a doctor right away.
Tell your doctor what happened, the date and time it happened, and when you got the flu shot.
Ask your doctor, nurse, or health department to file a Vaccine Adverse Event Reporting Systemexternal icon (VAERS) form, or call VAERS at 1-800-822-7967. Reports are welcome from all concerned individuals: patients, parents, health care providers, pharmacists and vaccine manufacturers.
No, a flu shot cannot give you the flu. Flu vaccines that are administered with a needle are currently made in two ways: the vaccine is made either with a) flu vaccine viruses that have been ‘inactivated’ and are therefore not infectious, or b) with no flu vaccine viruses at all (which is the case for recombinant influenza vaccine). In randomized, blinded studies, where some people got flu shots and others got saltwater shots, the only differences in symptoms was increased soreness in the arm and redness at the injection site among people who got the flu shot. There were no differences in terms of body aches, fever, cough, runny nose or sore throat.
More information about these studies is available at:
- Carolyn Bridges et al. (2000). Effectiveness and cost-benefit of influenza vaccination of healthy working adults: A randomized controlled trialexternal icon.
- Kristin Nichol et al. (1995). The effectiveness of vaccination against influenza in healthy working adultsexternal icon. New England Journal of Medicine. 333(14): 889-893.
The flu shot can cause mild side effects that are sometimes mistaken for flu. For example, people sometimes experience a sore arm where the shot was given. The needle stick may also cause some soreness at the injection site. Rarely, people who get the flu shot have fever, muscle pain, and feelings of discomfort or weakness. If experienced at all, these effects usually last for 1-2 days after vaccination, and are much less severe than actual flu illness.
It’s possible to get sick with flu even if you have been vaccinated (although you won’t know for sure unless you get a flu test). This is possible for the following reasons:
- You may be exposed to a flu virus shortly before getting vaccinated or during the period that it takes the body to gain protection after getting vaccinated. This exposure may result in you becoming ill with flu before the vaccine begins to protect you. (Antibodies that provide protection develop in the body about 2 weeks after vaccination.)
- You may be exposed to a flu virus that is not included in the seasonal flu vaccine. There are many different flu viruses that circulate every year. A flu vaccine is made to protect against the three or four flu viruses that research suggests will be most common.
- Unfortunately, some people can become infected with a flu virus a flu vaccine is designed to protect against, despite getting vaccinated. Protection provided by flu vaccination can vary widely, based in part on health and age factors of the person getting vaccinated. In general, a flu vaccine works best among healthy younger adults and older children. Some older people and people with certain chronic illnesses may develop less immunity after vaccination. Flu vaccination is not a perfect tool, but it is the best way to protect against flu infection.
Some people who get vaccinated may still get sick. However, flu vaccination has been shown in some studies to reduce severity of illness in people who get vaccinated but still get sick. A 2017 study showed that flu vaccination reduced deaths, intensive care unit (ICU) admissions, ICU length of stay, and overall duration of hospitalization among hospitalized flu patients. Another study in 2018 showed that a vaccinated adult who was hospitalized with flu was 59 percent less likely to be admitted to the Intensive Care Unit than someone who had not been vaccinated. Among adults in the ICU with flu, vaccinated patients on average spent 4 fewer days in the hospital than those who were not vaccinated. In addition, it’s important to remember that flu vaccine protects against three or 4 different viruses and multiple viruses usually circulate during any one season. For these reasons, CDC continues to recommend flu vaccination for everyone 6 months and older even if vaccine effectiveness against one or more viruses is reduced.
People with egg allergies can receive any licensed, recommended age-appropriate influenza vaccine (IIV, RIV4, or LAIV4) that is otherwise appropriate. People who have a history of severe egg allergy (those who have had any symptom other than hives after exposure to egg) should be vaccinated in a medical setting, supervised by a health care provider who is able to recognize and manage severe allergic reactions.