Getting a flu shot isn't a simple choice any more.
Today, medical providers offer a variety of options. Historically, the prevailing option has been the trivalent shot, which protects against three types of flu. This year, a late arrival on the market is a quadrivalent shot that protects against four types of flu.
Intermixed with these two types of shots are multiple options, a few of which include FluMist; an intradermal shot; and a high-dose flu shot manufactured for people 65 and older.
Sheryl Aufenkamp, director of pharmacy at Sanford Aberdeen Medical Center, and Alvin Haugen, pharmacy director for Avera St. Luke's, said having a variety of flu shots available makes it more challenging to order the shots and prepare for customer demands.
"You're guessing what your population will be," Aufenkamp said. "You don't want to overbuy or under buy."
Regardless of which flu shot is administered, Aufenkamp said the important thing is to get a flu shot.
"Neither the CDC (Center for Disease Control) or ACIP (Advisory Committee on Immunization Practices) prefers one vaccination over another at this time, so the most important thing is to get a flu vaccine as soon as possible," Aufenkamp said.
Haugen said the intradermal shot uses a smaller needle and is injected directly into the skin instead of the muscle. It also uses fewer antigens.
Aufenkamp said she hasn't seen many requests for that particular shot. While it's marketed for those who don't like needles, she said, those customers tend to select FluMist, which is also an option. She has had some demand for the high-dose vaccine.
A limited supply of the high-dose shot is available, said Aufenkamp, explaining that not every provider is convinced it's more effective than a traditional flu shot.
Haugen said the idea behind the high-dose flu shot is to give the immune system a higher amount of antigens to provide a better response rate to the flu. The shot contains four times the normal level of antigens. While it is available from the manufacturer, Haugen said, Avera hasn't ordered it. If one of the area's clinics is interested in the vaccine, it can be ordered. A quick look at the manufacturer's website by Haugen indicated about a two-week wait for new orders.
"It has not been proven as any more effective," said Haugen, explaining that studies evaluating the effectiveness of the shot will be completed in 2014.
There's also a cost difference. Haugen said the high-dose shot is about two and one-half times more expensive than a traditional flu shot.
Barb Buhler, public information officer for the South Dakota Department of Health, said the state offers only the trivalent flu shot at Community Health Nurse offices.
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