Ask the Pharmacist
October 26, 2017
Q: I am a senior looking to receive my flu shot this year. I have heard something about a stronger version that I should consider getting. What can you tell me about it?
A: This is a question that we and our colleagues have received several times already this year as our pharmacy, and many of the other local pharmacies and clinics, conduct their annual flu shot campaigns.
While most people understand that the flu shot changes each year depending on which strains of the virus are more likely
to be prevalent in Ontario, many do not know that there are, in fact, multiple versions of the flu vaccine that differ in significant ways.
Before we get into these differences, it is important to note that the government does not pay for all versions of the vaccine. If you are 18 or older, the government will pay only for the traditional trivalent form of the vaccine. If you’d like one of the newer varieties, you will have to pay for it yourself.
How much you ask? Well it depends on which specialized one you ask for, but the high-dose trivalent that is being talked about in the media will run you between $65 to $80, and the trivalent that has been given a “boost” will be in the $20 to $30 range.
The other challenge is that neither of these vaccines is currently available due to manufacturing or distributor “issues.” As such, most of us will receive the basic vaccine that as we mentioned above, is the trivalent version.
There are two brands of it: Fluviral and Influvac. They are called trivalent vaccines because they each contain three different virus strains; two against the most-likely flu A viruses, and one dedicated to defend against the flu B virus experts think will make its way over here from Asia.
While vaccine effectiveness varies depending on how accurate our predictions are, as well as a host of individual factors, most researchers believe our standard vaccinations reduce the risk of flu illness by 40-60 per cent most years. Just as importantly, the vaccine seems to reduce the risk of requiring hospitalization due to contacting the flu by a similar percentage and may be especially effective in those who are diabetics.
Other benefits of all varieties of the flu vaccine are: they seem to reduce the severity of the illness should you happen to become infected, they reduce the risk of childhood flu-related mortality, and they do a very effective job in protecting women both during and after pregnancy, as well as their newborns, due to the passing of antibodies in the womb.
Children and adolescents (age six months to 17 ) receive a different version of the flu vaccine called a quadrivalent form - because it protects against one extra strain of an Influenza B virus. The reason why children and teens get extra protection against B viruses is simply because they seem to be far more susceptible to the B strains than adults are.
One side note, pharmacies are not allowed to vaccinate anyone under the age of five so these children must see their family physician to receive a flu shot.
Then, we come to the much-publicized, high-dose trivalent flu vaccine, known as Fluzone High-Dose. While it is more effective than the version the government pays for, it is not staggeringly so. It likely prevents one more case of the flu for every 200 patients vaccinated with it when compared to the standard version.
Along with its hefty price tag, it has the additional disadvantages in that it appears to cause more local reactions (arm soreness, redness, etc.) and flu-like symptoms than the normal flu vaccine does.
Then there is Fluad, a trivalent vaccine that has had an adjuvant added to it in order to boost your immune response. It sounds good in theory but at this time, it is too early to say if it actually works any better although an observational study conducted during the 2011-2012 season showed that in a small sample size of people (282 seniors), Fluad was 63-per-cent more effective than regular dose flu shots.
The reason the government does not pay for the high-dose or quadrivalent vaccines for everyone is likely due to economics. As holders of the public purse (at least when not cancelling gas plants, mangling e-health or hiring the thousandth consultant), the government has had to make hard decisions about where to spend the limited tax money at its disposal. At this point in time, it’s hard to make a financial case that the more expensive vaccines are worth the extra costs that are associated with them.
The key, regardless of which vaccine you’d prefer, is to get out and get vaccinated over the next couple of weeks. Do this, not only for your sake, but even more so for the high-risk people you will come into contact with this holiday season, such as children under age five, people over age 65, those with diabetes, heart disease, cancer, lung disease, and those who are pregnant.
For more information about this or any other health-related questions, contact the pharmacists at Gordon Pharmasave, Your Health and Wellness Destination. Also check the website at www.gordon-pharmasave.com/ and the Facebook page at www.facebook.com/GordonPharmasave/?fref=ts
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