What to Know About Afluria (Influenza Vaccine Jet Injector)

Afluria is an influenza vaccine administered by a jet injector using a high-pressure, narrow stream of liquid to penetrate the skin rather than a needle. For those who dislike or have a fear of needles, but who also don't want a vaccine sprayed up their nose, it is another choice for flu vaccination. Unlike the Afluria flu vaccine itself, the jet injector is only approved for use in certain adults.

The Afluria flu vaccine is intended to prevent influenza infection. It works by stimulating your immune system to produce antibodies that will attack the flu strains included. Then, when you are exposed to the flu virus, your body may be able to fight it off so you are not infected or have a milder case.

The flu strains covered change from year to year, depending on which types of influenza are predicted to be circulating. For the 2019 to 2020 season, the Afluria quadrivalent vaccine included two influenza B virus lineages (Yamagata and Victoria), and two influenza A virus lineages (Brisbane H1N1 and Kansas H3N2).

Originally indicated for those ages 18 to 64, Afluria was approved by the U.S. Food and Drug Administration (FDA) in October 2018 for any individual age 6 months or older. However, this expansion only relates to the drug itself—not the mode of delivery.

Results from clinical trials indicate the jet injection is not any less effective than the traditional flu vaccine. That means that, in studies, it worked as well as the regular flu shot. Like typical flu shots, efficacy varies depending on the year and from person to person.

The Centers for Disease Control and Prevention (CDC) recommends annual influenza vaccination for everyone 6 months and older. There is no stated preference for any licensed influenza vaccine that is appropriate for one's age or health status.

Afluria is not a live-attenuated vaccine, so there are no restrictions for those who are pregnant or have weakened immune systems. If you have an egg allergy, it is still recommended that you receive the flu vaccine. People with a severe egg allergy with any symptom other than hives after being exposed to eggs should be vaccinated in a medical setting in case of a reaction.

The Afluria vaccine is the only flu vaccine approved for use in the jet injector. However, there are other flu vaccine options delivered by different methods.

Other choices for flu vaccines include:

• Standard-dose influenza vaccines: Fluarix Quadrivalent, FluLaval Quadrivalent, and Fluzone Quadrivalent
• FluMist Quadrivalent: A nasal spray that has live-attenuated flu virus. It is approved for those who are not pregnant and ages 2 to 49 years. It is not recommended for people with certain medical conditions.
• Fluad trivalent influenza shot: This is made with an adjuvant to increase the immune response. It is available for people 65 years and older.
• Fluzone High-Dose influenza vaccine has four times as much flu antigen in order to produce a better immune response. It is available for people 65 years and older.
• Flucelvax Quadrivalent is grown in an egg-free cell culture and is available for people ages 4 years and older.
• Flublok Quadrivalent is an egg-free vaccine that is approved for those aged 18 years and older.

The dosage for children ages 6 months through 35 months is 0.25 milliliters (mL) per dose. The dose volume for all persons 3 years of age or older is 0.5 mL per dose. All listed dosages are according to the drug manufacturer.

The dose will only be administered via jet injector if you are in the proper age group (18 to 64 years). Otherwise, you will receive it via a shot.

You should receive the influenza vaccine each year, preferably at the start of the flu season so you are protected through it. The effectiveness wears off in a few months, and the vaccine formulated for the next flu season should provide better coverage for the strains predicted to be circulating.

During clinical trials, side effects of the flu vaccine by jet injector were similar to those administered by traditional injection.

Common side effects that may last up to seven days include:

• Tenderness
• Swelling
• Pain
• Redness
• Itching
• Bruising
• Body aches
• Malaise (general feeling of tiredness/weakness)
• Headache

The jet injector flu vaccine comes in a multi-dose vial, so it does contain thimerosal. Note, however, that no reputable studies have linked this additive to any dangerous or concerning conditions (including autism).