Nurse B.K. Morris gives a flu shot to Winifred Quinn during a press event on the flu vaccine on Sept. 17 in Washington, D.C.

Which vaccine to choose

One option this year is a needle-free device called a jet injector that forces the vaccine into a stream of fluid that penetrates the skin. It is recommended for adults 18 to 64. The CDC said it can result in some of the same soreness as a traditional shot.

The nasal spray is the most widely known alternative to the traditional shot, and can be used by healthy people ages 2 to 49.

Other choices are targeted to different age groups and health conditions and include the intradermal, or skin-deep, shots that use tiny needles; a version for people allergic to the chicken eggs used in brewing most flu vaccine; and a high-dose version for people 65 and older, whose immune systems typically don’t respond as robustly to flu vaccine as younger people’s.

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An estimated 60 people in the Chattanooga metro area will die from the flu or its complications this season, according to government statistics.

To change that trend, health officials now are recommending that everyone — not just vulnerable populations — get the vaccine.

"The more people we have vaccinated, the more likely we are to keep flu out of the community," said Sharon Goforth, an influenza specialist with the Hamilton County Health Department. "If it keeps coming and running into folks who are immune, it has no place to go."

In the past, health officials emphasized flu shots for anyone over 65, children and health care workers. But they've realized that left lots of other people getting the flu and spreading the virus.

There is reason to hope this flu season will be less severe than last year. Changes are being made to the vaccine itself to make it more effective.

The flu virus mutates rapidly, so in the eight months it takes to produce and distribute millions of doses of the vaccine across the U.S., the virus may change to a different form.

That's what happened last year, according to the Centers for Disease Control and Prevention. As a result, the flu shot was only about 13 percent effective against the most deadly form of the virus, although it was 50-60 percent effective against other strains.

Scientists have to decide what strains of the flu virus to protect against in the winter and spring.

They do that by looking at what strains of the flu virus are currently out there south of the equator, where their fall and winter mirrors our spring and summer. If a particular strain of the virus is causing a lot of problems in Brazil or Australia, for example, it's likely to move north and cause similar problems.

Medical officials also examine the handful of flu cases that occur in the U.S. during the spring to see which strain is the worst offender.

If they're fortunate, the strains they choose to fight against won't change too much before the vaccine is actually given out, and that appears to be the case this year.

CDC officials say the most common versions of the virus they are seeing now in patients match closely the strains that the vaccine is targeted at.

"We're using better genetic tools and bigger computers," said Dr. Mark Anderson, an infectious disease specialist and director of Infection Prevention at CHI Memorial Hospital. "We're getting better at it, but as it stands, we still have good years and not-so-good years."

No matter how effective the vaccine is, getting a flu shot is better than not getting one, officials said. Most are covered by private and government health insurance, often without a co-pay. For those paying out of pocket, prices can range between $32 and $40.

"We may not totally stop you from contracting the flu, but we don't want you to die from the flu," said the health department's Goforth.

Health officials still will focus their efforts on the elderly, children and health care workers.

About 90 percent of all influenza-related fatalities are among those 65 and older.

Children are not only vulnerable to the disease; they are also among the most likely people to spread it, since they tend to mingle with other children who may be infected and then take the virus home to their families.

Health care workers are likely to be in contact with those who are chronically ill, whose immune systems are already weakened.

Besides a flu shot, the two other primary ways to avoid the flu are simple: wash your hands and avoid people who are sick.

The virus is spread by physical contact, either from touching something already contaminated by the virus or breathing in the virus from other people who are coughing or sneezing.

"If you are sick enough to stay home from work, don't take that extra day to recover and go to the grocery store and the mall and spread it around," Goforth said.

Contact Steve Johnson at or 423-757-6673 or on Twitter @stevejohnsonTFP.