A Flu Shot for the Squeamish

Sept. 6, 2011— -- Squeamish about getting a flu shot? You may be in luck.

This fall, people seeking flu shots may be able to skip the big, scary needle and choose a new short-needle flu shot, called Fluzone intradermal.

Fluzone intradermal uses a shorter, thinner needle called a microneedle to give flu shots just under the skin, rather than deeper in the muscle like standard flu shots.

The shots' manufacturer, Sanofi Pasteur, said the microneedles are less than one-10th of an inch long and are about the width of a human hair. Standard flu shots are given with needles up to one and a half inches long.

Dr. William Schaffner, chairman of preventive medicine at Vanderbilt School of Medicine, said that when he tried a short-needle shot earlier this year, he barely felt it.

"It is truly ouchless," he said. "The immediate inoculation is virtually imperceptible."

He added that delivering the shot to the skin instead of the muscle can help patients avoid the deep muscle ache associated with a standard flu shot.

The shot delivers the vaccine to a layer of cells just underneath the surface of the skin, called dendritic cells. Dr. Ralph Tripp, professor of infectious diseases at the University of Georgia, said this is an ideal spot for a vaccine, since these cells deal directly with the body's immune system.

"These cells can substantially enhance vaccine presentation to the immune system," he said.

Earlier this year, the Centers for Disease Control and Prevention recommended that everyone over the age of 6 months should get a flu vaccination this year. Schaffner said the new short-needle option may help convince more people to get their flu shots.

"Whenever we do surveys concerning reluctance to get vaccinated, needle aversion is right at the top of the list, even among health care providers," he said. "Every time you reduce a barrier like this, you increase the likelihood that people will get vaccinated."

Although people may feel better about avoiding a longer needle, the side effects for short- and long-needle shots are about the same. According to the Food and Drug Administration, patients reported pain, redness and swelling at the site of the injections with both short and long needles, although these symptoms were a little worse in patients who used the short-needle shot. Other side effects included fever and some muscle aches.

The new shot saves more than discomfort at the doctor's office. It also uses less of the vaccine than a standard shot. But despite the lower dose size, clinical trials of the shot showed it to be just as effective.

"This is really great since it would mean that when vaccine is in short supply that we can manage to provide vaccine to more people," said Joan Nichols, who studies infectious diseases at the Galveston National Laboratory of the University of Texas Medical Branch.

The short-needle shot will not be as widely available as other forms of the flu vaccine. Sanofi, the maker of the short-needle shot, said it plans to ship a limited amount of the new microneedles in about a week, but they will be available nationwide.

The shot is approved only for adults ages 18 to 64, so it's not available for needle-shy kids. But children can avoid needles with the nasal spray form of the vaccine, called LAIV, which is approved for anyone ages 2 to 49. Adults over the age of 65 still have to rely on the standard long-needle shots, but special doses can give people in this group four times the immunity of a standard shot.

"It's wonderful to have choices," Schaffner said. "The hope is that having these choices will make getting the flu vaccine even more attractive."