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Flu Shot or Nasal Spray?

For decades we only had one type of flu vaccine, but these days we have a choice: the traditional flu shot or the newer nasal spray flu vaccine, FluMist. Either vaccine will help protect against the flu virus, but some people are better suited for the flu shot, while others will do better with the nasal spray. They offer about the same level of protection against the flu.

What’s the Difference Between the Flu Vaccines?

Both flu vaccines protect against various strains of the flu. The most significant differences are in how the vaccines are given and who is eligible to get them.

The Flu Shot

This vaccine is given by injection, usually into the upper arm. The flu shot is made from dead influenza virus and cannot give you the flu.  

Side effects: Usually very minor. The most frequent side effect of the flu shot is soreness in the arm; less common symptoms are mild fever and achiness. They may last one to two days.

The flu shot can be used in:

  • Adults and children from age 6 months and up

The flu shot should not be used in:

  • Anyone who developed Guillain-Barré syndrome within six weeks of getting a flu vaccine previously
  • Children less than 6 months old
  • People who have a serious illness with or without fever should delay getting the flu shot until their symptoms lessen.

It's long been advised that people with allergies to eggs should not get the flu shot. However, the American College of Allergy, Asthma and Immunology says the vaccine contains such a low amount of egg protein that it's unlikely to cause an allergic reaction in those with an egg allergy. If you have a severe egg allergy (anaphylaxis), talk to your doctor before getting the flu vaccine. Also, flu vaccines that do not contain eggs are available.  

High-dose flu shots are also available for the elderly as a way to better protect them from influenza. Some people also have the option of intradermal shots. This type of injection uses a smaller needle and only penetrates the top layer of the skin instead of down into the muscle. It's available for those between the ages of 18 and 64.   

Pros: The flu shot is available for babies 6 months of age or older and is considered safe for a larger age group than the nasal vaccine.

Cons: The flu shot requires injection with a needle, which makes it a tough sell for many children.

The Nasal Flu Vaccine (FluMist)

This flu vaccine is sprayed into the nose. While it is a live vaccine, the virus has been weakened so that it cannot cause the flu, though you may experience flu-like symptoms. 

Side effects: Usually minor, although they can be more severe than the side effects of the flu shot. In adults, side effects include runny nose, headache, sore throat, and cough; in children, side effects also include wheezing, vomiting, fever, and muscle aches.

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