Seasonal Flu Shots




* Please note that the seasonal flu is not the same as the H1N1/swine flu, the avian flu or bird flu.  For more information on these potential pandemic flu viruses, go to


(will automatically update from each fall)

What is the Seasonal Flu?

Influenza (commonly called the “flu”) is a contagious respiratory illness caused by influenza viruses. The flu can cause mild to severe illness and at times can lead to death. Although most healthy people recover from the flu without complications, some people, such as older people, young children, and people with certain health conditions, are at high risk for serious complications from the flu.




What are the Common Flu Symptoms?

Influenza usually starts suddenly and may include the following symptoms:

    • fever (usually high)
    • headache
    • tiredness (can be extreme)
    • cough
    • sore throat
    • runny or stuffy nose
    • body aches

Having these symptoms does not always mean that you have the flu. Many different illnesses, including the common cold, can have similar symptoms.




What are the Risks from the Flu?

In some people, the flu can cause serious complications.

Complications of the flu can include:

  • bacterial pneumonia
  • ear infections
  • sinus infections
  • dehydration
  • worsening of chronic medical conditions, such as congestive heart failure, asthma, or diabetes.




Who is Most at Risk?

Some people are at high risk for serious flu complications. These groups should consider getting a flu vaccine and/or talking to their doctor about what to do when flu season arrives.

  • people 50 years of age and older (some sources say 65+)
  • children 12-23 months of age
  • people with chronic medical conditions
    (for example: heart or lung disease, diabetes)
  • people living in long-term care facilities such as nursing homes

Every year in the United States, on average:

  • 5% to 20% of the population gets the flu
  • more than 200,000 people are hospitalized from flu complications
  • about 36,000 people die from the flu




How Does the Flu Spread?

The flu usually spreads from person to person in respiratory droplets when people who are infected cough or sneeze. People occasionally may become infected by touching something with influenza virus on it and then touching their mouth, nose, or eyes.

Healthy adults may be able to infect others 1 day before getting symptoms and up to 5 days after getting sick. Therefore, it is possible to give someone the flu before you know you are sick as well as while you are sick.




Protection Against the Flu

The single best way to protect yourself and others against influenza is to get a flu vaccination each year.

Two kinds of flu vaccine are available in the United States:

  • "flu shot"
    an inactivated vaccine (containing killed virus) that is given with a needle, usually in the arm. The flu shot is approved for use for most people including people with chronic medical conditions.
  • nasal-spray flu vaccine
    a vaccine made with live, weakened flu viruses that do not cause the flu.

Use of the Nasal Spray Flu Vaccine
Vaccination with the nasal-spray flu vaccine is an option for healthy persons aged 5-49 years who are not pregnant and healthy persons who live with or care for those in a high risk group. The one exception is healthy persons who care for persons with severely weakened immune systems who require a protected environment; these healthy persons should get the inactivated vaccine.




Who Should Get Vaccinated?

In general, anyone who wants to reduce their chances of getting the flu can get vaccinated.

However, certain people should get vaccinated each year either because they are at high risk of having serious flu-related complications or because they live with or care for high risk persons. During flu seasons when vaccine supplies are limited or delayed, the government will make recommendations regarding priority groups for vaccination.

People who should get vaccinated each year are:

  • People at high risk for complications from the flu, including:
    • children aged 6–59 months of age
    • people 50 years of age and older
      (Note: some information says 65+)
    • people of any age with certain chronic medical conditions
    • people who live in nursing homes and other long-term care facilities
  • People who live with or care for those at high risk for complications from flu, including:
    • caregivers or family members of persons at high risk for complications from the flu
    • caregivers or family members and out of home caregivers of children less than 6 months of age (these children are too young to be vaccinated)
    • health care workers
      (Note: if you hire home care workers or have others come into the home where they are in contact with a high risk person, inquire about whether they have been vaccinated.)
  • Anyone who wants to decrease their risk of influenza




Who Should Not Get Vaccinated?

Some people should not be vaccinated without first consulting a physician. They include:

  • people who have a severe allergy to chicken eggs
  • people who have had a severe reaction to an influenza vaccination in the past
  • people who developed Guillain-Barré syndrome within 6 weeks of getting an influenza vaccine previously
  • children less than 6 months of age (influenza vaccine is not approved for use in this age group)
  • people who have a moderate or severe illness with a fever should wait to get vaccinated until their symptoms lessen.

If you have questions about whether you should get a flu vaccine, consult your health-care provider.




When Should I Get Vaccinated?

October or November is the best time to get vaccinated, but you can still get vaccinated in December and later. Flu season can begin as early as October and last as late as springtime.

People still can be vaccinated after an outbreak of influenza has begun in a community. However, development of antibodies in adults after vaccination takes approximately 2 weeks.

Flu Graph




How Do I Keep From Getting the Flu or Giving it to Others?

Other than getting the recommended vaccination, there are other ways to help keep yourself from getting the flu and other common ailments such as colds and infections and may help to prevent the spread of these ailments if you already are infected.

  • Cover your nose and mouth with a tissue when you cough or sneeze; throw the tissue away after you use it.
  • Wash your hands often with soap and water, especially after you cough or sneeze. If you are not near water, use an alcohol-based hand cleaner.
  • Avoid close contact with people who are sick. When you are sick, keep your distance from others to protect them from getting sick too.
  • If you get the flu, stay home from work, school, and social gatherings. In this way you will help prevent others from catching your illness.
  • Try not to touch your eyes, nose, or mouth. Germs often spread this way.




What About Antiviral Medications?

Antiviral medications are most often used to help control influenza outbreaks in institutions, for example in nursing homes or in hospital wards, where people at high risk for complications from influenza are in close contact with each other. However, sometimes a doctor will prescribe an antiviral medication for an individual.

There are reasons your doctor may not want to prescribe an antiviral medication for you to help with your flu symptoms such as:

  • viral resistance
  • the need of the medications for a potential bird flu pandemic
  • and the fact that most people will recover from the flu on their own without medical intervention and without complications.

Those at high risk such as the elderly and those with chronic health conditions should consult with their doctor at the beginning of the flu season and should consider getting a flu shot for protection.

Four antiviral drugs

  • amantadine
  • rimantadine
  • oseltamivir
  • zanamavir

are approved for use in preventing and/or treating the flu. Antiviral medications can reduce influenza symptoms and may shorten the time you are sick by 1 or 2 days. They also may make you less contagious. They will not help symptoms associated with the common cold or many other influenza-like illnesses caused by viruses that circulate in the winter. These are prescription medications and you will need a prescription from a doctor.

There are different strains of influenza. They respond to different medications. So, all four of the antiviral medications may not be indicated for the flu strain predominant in any given year. Additionally, some flu strains have developed resistance to some medications. So, if your doctor tells you that antiviral medication is not appropriate for your situation, this may be the reason. There may also be side effects to consider. Side effects may be: nervousness, anxiety, difficulty concentrating, lightheadedness, and gastrointestinal side effects like nausea and loss of appetite. For people with long-term illnesses, more serious side effects, such as delirium, hallucinations, agitation, and seizures, can occur. Talk to your doctor about side effects if an antiviral medication is to be prescribed.

These prescription medications have certain limitations such as a defined timeframe within which they must be started. And, since these medications are currently our best medical defense against the bird flu, your doctor may be hesitant to prescribe them so we will have stock available should a bird flu pandemic occur. Also, frequent use of certain medications by the population can lead to the virus becoming resistant to the drug. When this happens, the drug is no longer effective. Then, those at high risk (such as people in long-term care facilities and those with chronic health conditions) who need the protection of the medication are not able to use it and their condition may be more dangerous as a result.

If your doctor does prescribe an antiviral medication, the treatment will last for 5 days and must be started within 2 days of illness. Therefore, if you get flu-like symptoms and are in a high risk category, seek medical care early.




What Do I Do if I Get Sick and Think I May Have the Flu?

It is very difficult to distinguish the flu from other infections on the basis of symptoms alone. A doctor's exam may be needed to tell whether you have developed the flu or a complication of the flu. There are tests that can determine if you have the flu as long you are tested within the first 2 or 3 days of illness.

If you develop flu-like symptoms and are concerned about your illness, especially if you are at high risk for complications of the flu, you should consult your health-care provider. Those at high risk for complications include:

  • people 50 years or older (some sources say 65+)
  • people with chronic medical conditions
  • young children.

If you get flu-like symptoms and decide to seek medical care, schedule an appointment as soon as possible. Antiviral medications may be prescribed and treatment must be started within 2 days of illness.


How to Treat Yourself at Home if You Get the Flu
If you get the flu:

  • get plenty of rest
  • drink a lot of liquids
  • avoid using alcohol and tobacco

Also, you can take medications such as acetaminophen (such as Tylenol®) to relieve the fever and muscle aches associated with the flu. If you are a grandparent caring for a grandchild, remember to never give aspirin to children or teenagers who have flu-like symptoms, particularly fever.




Do I Have to Pay for a Flu Shot?

You may be eligible for a free flu shot. A free flu shot may be available through:

  • local Health Departments (this would cover Medicaid recipients)
  • many insurance companies offer free flu shots as a part of their preventative medicine program (call your provider to inquire)
  • Medicare Part B recipients are eligible for free shots

Your flu shot is free, if you are enrolled in Medicare Part B and your health care provider accepts Medicare assignment. The Medicare program covers the flu shot and the cost of administration for beneficiaries. Medicare recipients do not have to pay coinsurance or a deductible under the flu shot benefit.

For Managed Care Plan members, most must get their flu shot from their Managed Care Plan. Check with your Managed Care Plan first.

For those covered under Medicaid, check first with your local social services or health department.

You can get a flu shot at your doctor's office. You may also be able to get a flu shot from your local health department or from other health-care providers. Medicare Part B will pay for the shot no matter where you get it, as long as the health care provider agrees not to charge you more than Medicare pays. To find local health care providers who accept Medicare as payment in full for the flu shot, you can also contact your Medicare Carrier (select state).

Be sure to ask the person giving the shot if there will be any cost to you.




Where Can I Locate a Flu Clinic?

Many communities and/or health organizations or insurance companies organize flu clinics to serve the maximum number of individuals in the most cost effective way. To find a clinic in your area, use the links provided below.

If you are on Medicare Part D Talk to your doctor about arranging for a free flu shot. Please note that often local aging agencies will arrange for flu shot clinics at local senior centers. Contact your local aging agency by contacting your Area Agency on Aging.
If you are on a Medicare Managed Care Plan talk to your plan representative.
If you use Medicaid contact your local Health Department.
If you have private health care insurance the company may pay for free flu shots. Contact your employer or your insurance company.




North Carolina

Blue Cross and Blue Shield of NC is North Carolina's largest insurer. They offer a preventative medicine program which includes free flu shots for members. Non-members can participate for a $25 fee. Clinics have been set up in large venues (regional clinics) and in grocery stores and drug stores (retail clinics). Most physician offices offer the flu shots through BCBSNC without charging a co-payment or office visit fee. Call 1-866-534-7330, visit their website, or use the links below to find a location to get a free flu shot.  Always ask about the fee beforehand.


Please note that none of the information provided here should be used as your sole source for decision making about this medical issue. Consult with your doctor or heath care professional.


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