By Dr. Richard Rupp and Bridget Hawkins, Ph.D.  

Dear Vaccine Smarts,
My doctor told me I should wait to get my flu shot because the protection lasts only a few months and the flu season peaks in January, but I keep seeing commercials that say I should get my flu shot right away. When should I get my flu shot and which one should I get?
Xavier,
Houston

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Dear Xavier,

Protecting yourself from the flu by getting a flu vaccine each year is a good idea.

The recommendation is to get vaccinated as soon as the vaccine arrives in your area.

It’s been established that a vaccine given now will protect for the entire flu season, and there’s no reason to delay.

You don’t want to wait until the flu finally arrives in your area because it typically takes your body two to three weeks to produce the antibodies needed to fight off the virus.

That being said, late vaccination is better than no vaccination.

The question about which vaccine you should get is much more complicated.

Your health-care provider will know which is best for you but we will run through a few of the choices.

The standard flu vaccine protects against influenza types A and B and is given by injection into the muscle. It’s a “trivalent” vaccine, meaning it protects against three influenza strains (two A strains and one B strain).

New this year are the “quadrivalent” vaccines, which protect against two A strains and two B strains.

If you have a choice, it’s better to get the quadrivalent vaccine because of the extra Type B protection.

People 65 or older may want to get the “high — dose” flu vaccine, which contains about four times more vaccine.

Research has shown that the elderly have a better immune response to the high-dose vaccine but research is still under way to see if the higher dose leads to improved protection.

Those 18 to 64 who dislike muscle injections may prefer the “intradermal” flu vaccine, which is given with a small needle just under the skin.

Interestingly, a smaller dose of the vaccine is required compared to the standard vaccine because giving it under the skin produces a stronger immune response.
 

Why? Because there are more immune-system cells in and under the skin than deep in the muscle.

The “nasal” vaccine is a good choice for those 2 to 49 years of age who hate needles.
 

The live, but weakened virus is sprayed into the nose (unlike the injected vaccines that are made from dead influenza virus). Because it is live, it should not be given to pregnant women or those with severe immune problems. For children under the age of 5 with a history of wheezing, it should be discussed with their health-care provider because it may cause them to wheeze.

So which gives better protection — the injectable or the nasal vaccine?
 

So far, studies indicate that the injectable provides the best protection for adults and the live nasal vaccine is superior in children.
 

There is one more option that’s new this year, called “Flublok.”

It’s not grown in chicken eggs like the other flu vaccines, and is a good option for healthy adults 18 to 49 years of age, especially those with egg allergies.

Clearly, there are a lot of choices when it comes to flu vaccines. Luckily, there’s a flu vaccine for just about everyone.
 

Your health-care provider knows which one is right for you.

All of the vaccines will provide protection from now through the entire flu season.

The key is to get vaccinated — the sooner the better — to protect yourself and your loved ones.
 

Dr. Richard Rupp is a pediatrician and member of UTMB’s Sealy Center for Vaccine Development. Bridget Hawkins, Ph.D., is the assistant director of the Sealy Center for Vaccine Development. This column is supported by a UTMB President’s Cabinet Award to provide information about vaccines. Visit www.utmb.edu/scvd/vaccinesmarts for more information.