Who should get a flu shot, and what is the best shot for different people to have?
It's September, which means that it's time to think about getting your flu shot again this year. But who should get the shot, and which shot is best?
Everyone 6 months and older should get a flu shot. However, it is especially important for young children, pregnant people, people who are 65 years of age and older, people with chronic health conditions, and residents of nursing homes and long-term care facilities.
What do flu shots protect against?
Each year’s vaccine is updated to protect against the 3 or 4 influenza strains expected to circulate most widely (commonly two influenza A strains and one or two influenza B strains).
Flu shots do not protect against illnesses caused by other viruses (like COVID-19, RSV, or the common cold).
What kinds of flu vaccines are available?
Great — here’s a breakdown of the main types of flu vaccines:
Standard-Dose Flu Shot
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Who it’s for: Most people ages 6 months and older.
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How it’s made: Inactivated (killed) flu viruses or recombinant technology.
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How it’s given: Injection into the muscle (usually the arm).
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Notes: The most common option; widely available at doctor’s offices, pharmacies, and clinics.
High-Dose Flu Shot
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Who it’s for: Adults 65 years and older.
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How it’s made: Inactivated virus, but with 4x the antigen (the part that stimulates the immune system).
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Why it’s used: Older adults tend to have weaker immune responses, so a stronger dose gives better protection.
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Brand examples: Fluzone High-Dose Quadrivalent.
Adjuvanted Flu Shot
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Who it’s for: Adults 65 years and older.
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How it works: Includes an adjuvant (an ingredient that boosts immune response).
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Why it’s used: Helps older adults mount a stronger defense against the flu.
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Brand example: Fluad Quadrivalent.
Nasal Spray Flu Vaccine
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Who it’s for: Healthy, non-pregnant people ages 2–49 years.
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How it’s made: Live, weakened flu viruses (not inactivated).
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How it’s given: Mist sprayed into the nose.
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Who should not get it: Pregnant people, immunocompromised individuals, children under 2, adults 50+, and people with certain medical conditions (like asthma).
Summary of Recommendations
| Vaccine Type | Who Can Get It | How It’s Given | Key Features | Who Should Avoid |
| Standard-Dose Flu Shot | Everyone 6 months+ | Injection | Most common option; updated yearly for circulating strains | People with severe allergies to vaccine ingredients |
| High-Dose Flu Shot | Adults 65+ | Injection | 4x more antigen to improve immune response in older adults | Under 65 years old |
| Adjuvanted Flu Shot | Adults 65+ | Injection | Contains an adjuvant (immune booster) for stronger protection | Under 65 years old |
| Nasal Spray Flu Vaccine | Healthy, non-pregnant people ages 2–49 | Nasal spray | Needle-free option; live weakened virus | Pregnant people, immunocompromised, kids <2, adults 50+, certain conditions (e.g. asthma) |
| Vaccine Type | Who Can Get It | How It’s Given | Key Features | Who Should Avoid | Preferred Recommendation |
| Standard-Dose Flu Shot | Everyone 6 months+ | Injection | Most common option; updated yearly for circulating strains | People with severe allergies to vaccine ingredients | Recommended for most people if no special risk factors apply |
| High-Dose Flu Shot | Adults 65+ | Injection | 4x more antigen for stronger immune response | Under 65 years old | Preferred for adults 65+ (shown to provide better protection than standard-dose) |
| Adjuvanted Flu Shot | Adults 65+ | Injection | Includes adjuvant (immune booster) | Under 65 years old | Preferred for adults 65+ (also provides stronger protection than standard-dose) |
| Nasal Spray Flu Vaccine | Healthy, non-pregnant people ages 2–49 | Nasal spray | Needle-free; live weakened virus | Pregnant people, immunocompromised, kids <2, adults 50+, certain conditions (e.g. asthma) | Acceptable alternative for healthy, eligible people who want to avoid a shot |