The Flu Shot
Convincing patients to get a flu shot is, hands down, one of the hardest sells I make every fall, and yet it's such an easy way to stay healthy. Let's go through the actual facts.
How Likely Are You to Get the Flu?
Each flu season, somewhere between 3% and 11% of the U.S. population gets sick with flu, depending on the severity of that particular year. It hits kids hardest: the median attack rate is about 9.3% for people 0 to 17, 8.8% for adults 18 to 64, and only 3.9% for adults 65 and older. However, it's the 65+ population that's affected the most severely when they do get the flu. Nationally, that adds up to an estimated 9.4 to 51 million illnesses, 120,000 to 710,000 hospitalizations, and 6,300 to 52,000 deaths every year.
What's Actually on the Market
There are more flu vaccine options than most people realize, and which one you get can make a difference. Personally, of the options available, I prefer Fluad, and when that isn't available, Flublok:
Standard-dose quadrivalent shot. The default option for most healthy people under 65.
High-dose (Fluzone High-Dose). Contains more antigen, preferentially recommended for adults 65 and older.
Adjuvanted (Fluad). Also preferred for 65 and older, uses an added ingredient to boost the immune response.
Recombinant (Flublok). Made without eggs or live flu virus at all, contains three times the antigen of a standard shot, approved for age 9 and up.
A newer mRNA-based flu vaccine, approved for adults 50 and older, appears to offer stronger protection. However, I don't currently recommend it, given the coverage and side effect profile.
Nasal spray (FluMist). A live, weakened virus. However, I don't recommend this option due to side effects and limited efficacy as you get older.
For anyone 65 or older, current guidance prefers the high-dose, adjuvanted, or recombinant version specifically, since they tend to work better in that age group.
How Effective Is It, Really?
Flu vaccine effectiveness typically falls somewhere between 40% and 60%, depending on how well that year's vaccine matches the strains actually circulating. Some years are better matched than others. But here's the part that matters most: even in a mismatched year, the vaccine still measurably reduces how severe your illness is if you do catch the flu, and reduces your risk of the outcomes that actually land people in the hospital.
Side Effects, and the Myth That Won't Die
Most side effects are mild and short-lived: soreness at the injection site, a low-grade fever, some fatigue or muscle aches, typically resolving within a day or two. Serious reactions are rare.
And I'll say this as plainly as I can: it is not possible to get the flu from the flu shot. The injectable versions contain either an inactivated (killed) virus or, in the case of the recombinant vaccine, no virus at all. Even the nasal spray, which does contain a live virus, uses one specifically weakened and cold-adapted so it can't replicate well enough in your body to cause illness. If you feel run down for a day after your shot, that's your immune system doing exactly what it's supposed to do, not an infection. If you've truly had the flu before, you know that a flu shot reaction doesn't come close to comparing to it.
How I Manage to Not Get the Flu
I'm asked this constantly. I see flu patients all day, every day, for months at a time, and people want to know how I stay healthy. My answer is always the same three things:
I wash my hands a lot at work.
I wear a mask when I know or suspect I'm around someone with the flu.
Most importantly, I get the flu vaccine every single year.
None of it is complicated. It's just consistent.
Due for your flu shot? Let's get it done at your next visit.
Sources: CDC, seasonal flu burden and attack rate estimates; The Medical Letter, "Influenza Vaccines for 2025-2026"; Therapeutic Research Center, "Know What's New With Flu Vaccines for 2026-2027."
