Wondering about timing on flu shot.

Not that I have heard of.

Get it now. I need to get my kids and MIL in to get theirs very soon.

KidDoc said:

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Yes it has.

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With the new practice, are y'all doing nurse visits just for flu shots?

trouble said:

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KidDoc said:

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Yes it has.

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With the new practice, are y'all doing nurse visits just for flu shots?

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Yup!

KidDoc said:

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trouble said:

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KidDoc said:

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Yes it has.

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With the new practice, are y'all doing nurse visits just for flu shots?

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Yup!

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Excellent! Thank you

We get ours mid September every year

You can get an idea of influenza activity (and also COVID-19 and RSV activity) from wastewater data at:

https://www.cdc.gov/wastewater/respiratory-viruses/state.html?cove-tab=0

Under "View U.S. state and territory data," tab over to "Influenza A" and "Texas." The most recent report was from the week of September 20th, when viral levels were very low.

Friend of a friend tested positive last week. Got mine today.

I hadn't thought about flu season yet but some of the water chicklets' classmates have been out with it recently, so here we are. Question for the medical professionals: I have the impression that like flu season peaks in January/February. Does that track with what you see?

dubi said:

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EliteElectric said:

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We get ours mid September every year

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Since they last about 6 months, I usually delay until mid October to protection into the spring.

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That's only about a week or so away!

waterchick said:

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I hadn't thought about flu season yet but some of the water chicklets' classmates have been out with it recently, so here we are. Question for the medical professionals: I have the impression that like flu season peaks in January/February. Does that track with what you see?

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Yes. Seeing cases this early is very odd.

KidDoc said:

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dubi said:

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EliteElectric said:

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We get ours mid September every year

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Since they last about 6 months, I usually delay until mid October to protection into the spring.

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This is my normal plan. When cases started to show up a month ago I got mine early.

Sadly flu vaccine is pretty poor at preventing cases and spread. It is very good at preventing death and hospitalization in high risk people. We could really use a better flu vax.

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Isn't the new flu vaccine an MRNA vaccine, or did I hear that incorrectly? I thought the new flu shot with the MRNA was supposed to be better.

MelvinUdall said:

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KidDoc said:

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dubi said:

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EliteElectric said:

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We get ours mid September every year

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Since they last about 6 months, I usually delay until mid October to protection into the spring.

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This is my normal plan. When cases started to show up a month ago I got mine early.

Sadly flu vaccine is pretty poor at preventing cases and spread. It is very good at preventing death and hospitalization in high risk people. We could really use a better flu vax.

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Isn't the new flu vaccine an MRNA vaccine, or did I hear that incorrectly? I thought the new flu shot with the MRNA was supposed to be better.

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There is a new mRNA shot but the data is not impressive. The efficacy of all flu vaccines is generally poor. You should primarily get one if you have a significant risk of severe flu.

From OpenEvidence query:




mRNA influenza vaccines have shown modestly superior relative efficacy versus standard-dose traditional vaccines in head-to-head phase 3 trials, driven chiefly by stronger responses against influenza A strains, while influenza B protection has been a recurring weak point. Two platforms are furthest along Moderna's mRNA-1010 (now FDA-approved, marketed as Mflusiva for those 50 and used in older adults) and Pfizer's modRNA candidate.[url=https://pubmed.ncbi.nlm.nih.gov/42807221][1][/url][url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3dd1c6d2-b054-4803-bb21-460b1b090d4c][2][/url][url=https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2026.17069?utm_source=openevidence&utm_medium=referral][3][/url]

Key efficacy data (relative vaccine efficacy [rVE] vs comparator)

Trial / vaccine
Population
Comparator
Relative efficacy
ReferencesmRNA-1010 (phase 3, 202425 season)
Adults 50 yr
Licensed standard-dose
26.6% (95% CI 16.735.4), met prespecified superiority
[url=https://pubmed.ncbi.nlm.nih.gov/42807221][1][/url], [url=https://doi.org/10.1056/nejmoa2516491?utm_source=openevidence&utm_medium=referral][4][/url]
mRNA-1010, same trial
Adults 65 yr
Standard-dose
27.4% (95% CI 12.140.0)
[url=https://doi.org/10.1056/nejmoa2516491?utm_source=openevidence&utm_medium=referral][4][/url]
Pfizer modRNA (phase 3, 202223)
Adults 1864 yr
Licensed inactivated
34.5% (95% CI 7.453.9), superiority met
[url=https://pubmed.ncbi.nlm.nih.gov/42807221][1][/url], [url=https://doi.org/10.1056/nejme2514597?utm_source=openevidence&utm_medium=referral][5][/url], [url=https://doi.org/10.1056/nejmoa2416779?utm_source=openevidence&utm_medium=referral][6][/url]
Pfizer modRNA, same program
Adults 65 yr
Standard-dose
5.8% (95% CI 47.223.8), failed noninferiority
[url=https://pubmed.ncbi.nlm.nih.gov/42807221][1][/url]


Efficacy against influenza A vs B is the central distinction. Both mRNA platforms consistently generate higher HAI antibody titers and higher strain-specific efficacy against influenza A (H1N1, H3N2) than inactivated comparators. Against influenza B, early mRNA formulations produced similar or lower HAI responses than traditional vaccines.[url=https://doi.org/10.1056/nejme2514597?utm_source=openevidence&utm_medium=referral][5][/url][url=https://doi.org/10.1056/nejmoa2416779?utm_source=openevidence&utm_medium=referral][6][/url][url=https://doi.org/10.1038/s41467-023-39376-7][7][/url] In the mRNA-1010 50 trial, efficacy was more balanced across strains after formulation optimization: A/H1N1 29.6%, A/H3N2 22.2%, B/Victoria 29.1%.[url=https://doi.org/10.1056/nejmoa2516491?utm_source=openevidence&utm_medium=referral][4][/url] The Pfizer trial season was dominated by influenza A, so B-strain efficacy could not be robustly assessed.[url=https://doi.org/10.1056/nejmoa2416779?utm_source=openevidence&utm_medium=referral][6][/url]

The following figure from the pivotal mRNA-1010 phase 3 trial (Leroux-Roels et al., NEJM) shows the cumulative incidence of RT-PCRconfirmed influenza-like illness, with early and sustained separation favoring mRNA-1010 over the standard-dose comparator:

Figure 2 First Occurrence of Protocol-Defined Influenza-like Illness Caused by Any Influenza A or B Strain. Shown are the cumulative case numbers for the first occurrence of RT-PCRconfirmed, protocol-defined influenza-like illness that began at least 14 days after trial vaccination and continued through the end of the influenza season, caused by any influenza A or B strain, regardless of vaccine match. The median follow-up was 6 months. Relative vaccine efficacy was calculated as (1hazard ratio [mRNA-1010 vs. standard-dose comparator])100. The relative vaccine efficacy and the 95% confidence interval were based on a stratified Cox proportional-hazards model with the vaccine group as a fixed effect, with adjustment for the randomization stratification factors: age group (50 to <65 years or 65 years) and status with respect to influenza vaccination during the previous influenza season (received or not received). Efron's method was used to handle ties.

Context on magnitude. For reference, licensed predominantly egg-based vaccines had absolute effectiveness of roughly 3654% during the 20242025 season.[url=https://doi.org/10.1056/nejme2514597?utm_source=openevidence&utm_medium=referral][5][/url][url=https://doi.org/10.1056/nejmoa2516491?utm_source=openevidence&utm_medium=referral][4][/url] The rVE figures above represent an incremental advantage over those standard-dose products, not absolute efficacy e.g., the modRNA 28.7% end-of-season rVE translated to an estimated absolute efficacy of ~6067%.[url=https://doi.org/10.1056/nejmoa2416779?utm_source=openevidence&utm_medium=referral][6][/url]

Older adults and enhanced vaccines the key unresolved comparison. The clinically important open question is whether mRNA vaccines beat the enhanced products (high-dose, adjuvanted, recombinant) that are already preferentially recommended for adults 65, not just standard-dose shots. mRNA-1010's ~27% rVE in 65 is comparable to what high-dose vaccines achieve over standard-dose, suggesting broadly similar benefit rather than clear superiority.[url=https://pubmed.ncbi.nlm.nih.gov/42807221][1][/url][url=https://doi.org/10.1056/nejmoa2516491?utm_source=openevidence&utm_medium=referral][4][/url][url=https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2026.17069?utm_source=openevidence&utm_medium=referral][3][/url] The mRNA-1010 FDA approval in 65 rests on immunogenicity (noninferiority/superiority of HAI responses vs high-dose Fluzone), an accelerated-approval surrogate endpoint; clinical outcome superiority over enhanced vaccines remains to be demonstrated.[url=https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=3dd1c6d2-b054-4803-bb21-460b1b090d4c][2][/url][url=https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2026.17069?utm_source=openevidence&utm_medium=referral][3][/url]

Mechanistic/immunologic advantages potentially favoring mRNA include persistent germinal center responses (up to 26 weeks), broader antibody repertoire diversification against drifted A strains, stronger CD4+/CD8+ T-cell responses, egg-free high-fidelity antigen matching, and faster manufacturing/strain updating.[url=https://doi.org/10.1056/nejmoa2416779?utm_source=openevidence&utm_medium=referral][6][/url][url=https://doi.org/10.1038/s41590-026-02569-5][8][/url][url=https://doi.org/10.1038/s41590-026-02565-9][9][/url][url=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13101425/][10][/url]

Trade-offs. mRNA vaccines are more reactogenic higher rates of injection-site pain, fatigue, headache, and myalgia (mirroring mRNA COVID-19 vaccines), though adverse events are predominantly mild-to-moderate and transient.[url=https://pubmed.ncbi.nlm.nih.gov/42807221][1][/url][url=https://doi.org/10.1038/s41467-023-39376-7][7][/url][url=https://jamanetwork.com/journals/jama/fullarticle/10.1001/jama.2026.17069?utm_source=openevidence&utm_medium=referral][3][/url] Weaker influenza B immunogenicity in earlier formulations is the other recurring caveat.[url=https://doi.org/10.1056/nejme2514597?utm_source=openevidence&utm_medium=referral][5][/url][url=https://doi.org/10.1038/s41467-023-39376-7][7][/url]


Would you like to explore how mRNA flu vaccines compare head-to-head against enhanced (high-dose or adjuvanted) vaccines in older adults?

References
[ol]

mRNA-based Seasonal Influenza Vaccines: An Overview of Immunogenicity, Efficacy, and Safety. Domnich A, Orsi A. Frontiers in Immunology. 2026;17:1965512. doi:10.3389/fimmu.2026.1965512.

Mflusiva. Food and Drug Administration (DailyMed).

What to Know About the mRNA Flu Vaccine, Newly Approved by the FDA. Rubin R. JAMA. 2026;336(10):817-819. doi:10.1001/jama.2026.17069.

Efficacy and Safety of an mRNA Seasonal Influenza Vaccine in Adults. Leroux-Roels I, Huang G, Ferguson M, et al. The New England Journal of Medicine. 2026;394(18):1803-1813. doi:10.1056/NEJMoa2516491.

An Early Look at mRNA Vaccines to Prevent Influenza. El Sahly HM, Atmar RL. The New England Journal of Medicine. 2025;393(20):2048-2050. doi:10.1056/NEJMe2514597.

Efficacy, Immunogenicity, and Safety of Modified mRNA Influenza Vaccine. Fitz-Patrick D, McVinnie DS, Jackson LA, et al. The New England Journal of Medicine. 2025;393(20):2001-2011. doi:10.1056/NEJMoa2416779.

Safety and immunogenicity of a phase 1/2 randomized clinical trial of a quadrivalent, mRNA-based seasonal influenza vaccine (mRNA-1010) in healthy adults: interim analysis. Lee IT, Nachbagauer R, Ensz D, et al. Nature Communications. 2023;14(1):3631. doi:10.1038/s41467-023-39376-7.

mRNA-based influenza vaccine expands the B cell response breadth in humans. Matz HC, Yu TG, Dixit K, et al. Nature Immunology. 2026;27(8):1666-1677. doi:10.1038/s41590-026-02569-5.

Diversifying the antibody response to influenza virus with an mRNA-based vaccine. Nature Immunology. 2026;27(8):1551-1552. doi:10.1038/s41590-026-02565-9.

mRNA vaccines for infectious diseases advances, challenges and opportunities. Pardi N, Krammer F. Nature Reviews. Drug Discovery. 2024;23(11):838-861. doi:10.1038/s41573-024-01042-y.

[/ol]

Yup. The boys only get it because Grammy has cardiac issues and children are nasty little petri dishes.

Thanks for the info…I haven't had the flu shot in years, and knock on wood I haven't ever had the flu, even when it was going around the house with my kids…

MelvinUdall said:

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Thanks for the info…I haven't had the flu shot in years, and knock on wood I haven't ever had the flu, even when it was going around the house with my kids…

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Same here.

I had it 2 years in a row and that's what motivated me to start taking the shot

If the influenza virus would quit mutating each year, we could have a very strong vaccine.

As it is, the CDC and manufacturers have to essentially use their expertise and make an educated guess early in the year.

EliteElectric said:

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I had it 2 years in a row and that's what motivated me to start taking the shot

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In the last 20 some odd years, the one year I did NOT get the flu shot, I got the flu...and I sword NEVER AGAIN to skip it.

75AG said:

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If the influenza virus would quit mutating each year, we could have a very strong vaccine.

As it is, the CDC and manufacturers have to essentially use their expertise and make an educated guess early in the year.

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Flu is not going to change- now making a vaccine that targets a part that does not mutate frequently seems like a good idea.

But I am not a vaccine developer so no idea how hard it is to do so.

I worked a career first for a vaccine manufacturer and then for the industry. I was always told that annual influenza vaccine development guidance was issued by the WHO, FDA/CDC and other experts early in the year. Sometimes they got it, sometimes they missed. So my term of "guessing " was a poor attempt of explanation.

It's hoped that because of egg-derived vaccine development "misses", mRNA influenza vaccine can be made more quickly, and can be more specific to that year's strain.

And how I've exhausted my knowledge on the topic.

Isn't there a large vaccine/biosynth industry here in College Station? Are those people working on a better flu vaccine??

EliteElectric said:

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I had it 2 years in a row and that's what motivated me to start taking the shot

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Oh if I had it even once I would take it, my kids were miserable when they had the flu. I am certainly not judging anyone that gets the Flu shot, I have just been fortunate to never had the flu, and I am 52.

The parts the show the least mutational change are the parts that code the internal proteins. Unfortunately, antibodies can only see the outside proteins, which are the part that mutates the fastest, so instead your immune system has to identify them within the cell via antigen presentation and killer t-cell activation. So a vaccine against the internal proteins would be universal, but people would still get (mildly) ill due to cells getting infected and then destroyed by the t-cells. It is an active area of research, e.g.

https://www.science.org/doi/10.1126/sciadv.adc9937

https://ivr.cidrap.umn.edu/universal-influenza-vaccine-technology-landscape

KidDoc said:

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waterchick said:

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I hadn't thought about flu season yet but some of the water chicklets' classmates have been out with it recently, so here we are. Question for the medical professionals: I have the impression that like flu season peaks in January/February. Does that track with what you see?

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Yes. Seeing cases this early is very odd.

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Is it? I think I read every annual strain comes out of some area in Asia around Siberia. Can't imagine these things are on timelines as we understand them. That said a pharmacist at CVS did tell me around late August that it would hit early but didn't say why.