Flu season does not officially begin until October. But like holiday merchandise, vaccines are showing up earlier and earlier.
Retailers and public health experts peg the preseason vaccination trend to the 2009 H1N1 epidemic, which caught many by surprise. Since then, manufacturers have been releasing their products in August instead of October.
Last year's was one of the mildest flu seasons on record, said Dr. Lisa Grohskopf, a medical officer with the Centers for Disease Control and Prevention's influenza division. But she says consumers shouldn't get complacent; the CDC still recommends that everyone older than 6 months be vaccinated.
"We know the flu is unpredictable, so we can't say what this season will be like," Grohskopf said.
Federal statistics projected that drug manufacturers would make as many 149 million vaccine doses for this season. The CDC does not anticipate shortages. About 132 million immunizations were given in 2011-12, covering about 45 percent of adults.
More people are getting immunized at the same places where they buy their groceries or fill their prescriptions, rather than doctors' offices. Retailers usually are set up to process insurance billing on site so that customers with coverage or on Medicare pay nothing out of pocket. A CDC report found that in the 2010-11 flu season, about 18 percent of adults received their flu shots in stores, and 40 percent went to doctors' offices.
"We think it's fortunate you now can get a flu vaccine in a wide variety of places," Grohskopf said.
Here are answers to the most commonly asked flu questions.
Do I need to be vaccinated against the flu?
The CDC recommends that everyone age 6 months or older receive a flu vaccine. Those who most need immunization: seniors age 65 or older, pregnant women, patients with certain medical conditions and caregivers of patients who develop serious complications from contracting the flu.
How does a flu shot work?
Seasonal influenza vaccines combine inactive strains of three flu viruses. The formula, when injected, encourages your immune system to build antibodies that fight infection. The vaccine works against the three most commonly circulating flu viruses: influenza B, the H1N1 A strain and the H3N2 A strain.
Do I really need a vaccine every year?
Yes. Public health officials annually look at which flu viruses will be most prevalent and then set a vaccine formula designed to thwart those particular strains. So the formula can change from year to year.
What about children?
Children age 6 months through 8 years old who never have been immunized for the flu will need two shots, four weeks apart. Ask your doctor for details.
When does flu season start?
It typically begins in October and can last through May, with the season peaking in February. But flu is unpredictable, and seasonal peaks vary by region.
Why should I get vaccinated now instead of later this fall?
The CDC advises people to be vaccinated as soon as shots are available so that they'll be ready when flu season starts. Many providers began receiving vaccines this month, as manufacturers are shipping earlier. Shots given now should protect you through the season, and you won't have to worry about supply shortages later. It takes your body two weeks following the vaccine to form flu-fighting antibodies.
I hate needles! Can I take a flu pill instead?
Sorry, no. But now there is an intradermal vaccine that uses a pin-prick needle, about 90 percent smaller than the standard model. It injects under the skin rather than deep into the muscle, causing less arm-ache afterward. People ages 18 to 64 can have intradermal vaccines.
What about the new high-dose shot for seniors?
The Fluzone High-Dose for people older than 65 first became available in 2010. It has four times the antigen of a standard shot to boost the immune response, as the body loses the ability to produce antibodies as we age. More side effects have been reported with the high-dose vs. the regular shot. People who have severe egg allergies or who had a serious reaction to a standard flu vaccine should not get the high dose.
What about the nasal spray vaccine?
This vaccine is different from the shots in that it contains a live but weakened version of the flu virus. Healthy people ages 2 to 49 can use the spray. People with egg allergies, serious medical conditions or weakened immune systems — and their caregivers — should not use this vaccine or check with a doctor first.
Does Medicare or my insurance cover vaccines?
Flu shots are covered under Medicare Part B and most private insurance plans. There usually are no out-of-pocket costs to consumers, but ask your provider.
What are the risks?
Serious complications from flu vaccines are rare. Common mild problems include soreness or redness where the shot was given, fever, headache, fatigue and cough. Allergic reaction symptoms include difficulty breathing, fast heart rate, dizziness or hives. People with severe allergies, especially to eggs, should talk to their doctor before getting a shot.