Seasonal Flu Shot

exclamation square light iconGetting a flu vaccine is more important than ever during 2020-2021 to protect yourself and the people around you from flu, and to help reduce the strain on healthcare systems responding to the COVID-19 pandemic.

What is a flu shot?

An influenza (flu) shot is a flu vaccine given with a needle, usually in the arm. Seasonal flu shots protect against the three or four influenza viruses that research suggests may be most common during the  upcoming season.

The composition of flu vaccines have been updated for the 2020-2021 flu season.

Is there more than one type of flu shot available?

Yes. There are different flu vaccine manufacturers and multiple influenza vaccine products licensed and recommended for use in the United States.

CDC recommends use of any licensed, age-appropriate influenza vaccine during the 2020-2021 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-ingredient) and quadrivalent (four-ingredient) influenza vaccines will be available.

Trivalent flu vaccines include:

A trivalent flu shot made using an adjuvant (an ingredient that helps create a stronger immune response), approved for people 65 years of age and older.

Quadrivalent flu vaccines include:

Standard-dose quadrivalent influenza shots that are manufactured using virus grown in eggs.  These include Afluria Quadrivalent, Fluarix Quadrivalent, FluLaval Quadrivalent, and Fluzone Quadrivalent. Different influenza shots are licensed for different age groups. These four vaccines are approved for people 6 months of age and older. Most influenza shots are given in an arm muscle with a needle. One quadrivalent influenza shot (Afluria Quadrivalent) can be given either with a needle (for people aged 6 months and older) or with a jet injector (for people aged 18 through 64 years only).

quadrivalent cell-based influenza shot (Flucelvax Quadrivalent) containing virus grown in cell culture, which is licensed for people 4 years and older. This vaccine is egg-free.

Recombinant quadrivalent influenza shot (Flublok Quadrivalent), an egg-free vaccine, approved for people 18 years and older.

A quadrivalent flu shot using an adjuvant (an ingredient that helps create a stronger immune response), approved for people 65 years of age and older.

A quadrivalent high-dose influenza vaccine (Fluzone High-Dose), licensed for people 65 years and older.

A live attenuated influenza vaccine (FluMist Quadrivalent), which is given intranasally.  This vaccine is approved for people 2 through 49 years of age.  Live attenuated influenza vaccine should not be given to people who are pregnant, immunocompromised persons, and some other groups.

There are many flu 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 2020-2021 flu season, and age indications for each vaccine are available in CDC’s Table: U.S. Influenza Vaccine Products for the 2020-2021 Season.

Who should and who should not get a flu vaccine?

Everyone 6 months of age and older should get a flu vaccine every season with rare exception. More information on who should and who should not get a flu vaccine is available.

How effective is the seasonal flu shot?

Influenza (flu) vaccine effectiveness (VE) can vary. The protection provided by a flu vaccine varies from season to season and depends in part on the age and health status of the person getting the vaccine and the similarity or “match” between the viruses in the vaccine and those in circulation. During years when the flu vaccine match is good, the benefits of flu vaccination will vary, depending on factors like the characteristics of the person being vaccinated (for example, their health and age), what influenza viruses are circulating that season and, potentially, which type of flu vaccine was used. For more information, see Vaccine Effectiveness – How well does the Flu Vaccine Work. For information specific to this season, visit About the Current Flu Season.

What are the side effects that could occur?

Common side effects from a flu shot include soreness, redness, and/or swelling where the shot was given, headache (low grade), fever, nausea, muscle aches, and fatigue. The flu shot, like other injections, can occasionally cause fainting.

Can severe problems 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 influenza vaccine or any part of flu vaccine.

There is a small possibility that flu vaccine could be associated with Guillain-Barré syndrome, generally 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.

What should I do if I have had a serious reaction to seasonal 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.

Why do some people not feel well after getting a flu shot?

Flu vaccine side effects are generally mild and go away on their own within a few days. Some side effects that may occur from a flu shot include soreness, redness, and/or swelling where the shot was given, headache (low grade), fever, nausea, muscle aches, and fatigue. The flu shot, like other injections, can occasionally cause fainting.

What about people who get a seasonal flu vaccine and still get sick with flu symptoms?

There are several reasons why someone might get flu symptoms, even after they have been vaccinated against flu.

  1. One reason is that some people can become ill from other respiratory viruses besides flu such as rhinoviruses, which are associated with the common cold, cause symptoms similar to flu, and also spread and cause illness during the flu season. The flu vaccine only protects against flu, not other illnesses.
  2. Another explanation is that it is possible to be exposed to flu viruses, which cause flu, shortly before getting vaccinated or during the two-week period after vaccination that it takes the body to develop immune protection. This exposure may result in a person becoming ill with flu before protection from vaccination takes effect.
  3. A third reason why some people may experience flu  symptoms despite getting vaccinated is that they may have been exposed to a flu virus that is very different from the viruses the vaccine is designed to protect against. The ability of a flu vaccine to protect a person depends largely on the similarity or “match” between the viruses selected to make the vaccine and those spreading and causing illness. There are many different flu viruses that spread and cause illness among people. For more information, see Influenza (Flu) Viruses.
  4. The final explanation for experiencing flu symptoms after vaccination is that flu vaccines vary in how well they work and some people who get vaccinated still get sick. When that happens, though vaccination has been shown in several studies to reduce severity of illness in those people who get vaccinated but still get sick.

What protection does a flu vaccine provide if I do get sick with flu?

Some people who get vaccinated may still get sick. However, flu vaccination has been shown in several 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% less likely to be admitted to an intensive care unit (ICU) 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 four 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.

Special Consideration Regarding Egg Allergy

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. Two completely egg-free (ovalbumin-free) flu vaccine options are available: quadrivalent recombinant vaccine and quadrivalent cell-based vaccine.

Vaccine Information Statements (VIS)

Flu VISs are no longer updated every year. The edition dated 8/15/19 should be used for the current flu season.

Several formats including PDF available

Access VIS Here