A sign telling customers that they can get a flu...

A sign telling customers that they can get a flu shot in a Walgreen store is seen in Indianapolis on Tuesday, Sept. 16, 2014. Credit: AP / Darron Cummings

The leaves are changing color, but there are other signs autumn is here: specifically, the signs reading "Flu Shots Available" at pharmacies, major retailers and supermarkets.

Flu season typically begins in mid-October, but no one can yet say how severe the 2014-2015 season will be. "It's too early to predict, but if we go by past years, we know that it tends to peak in January," says Dr. Maria Torroella Carney, chief of geriatric and palliative medicine at North Shore-LIJ Health System. "This is the time to get the flu shot to get your antibodies in place."

For adults 65 and older, there is a relatively new vaccine that may be more effective than the standard flu shot. The Fluzone High-Dose vaccine received FDA approval in 2009, but it has rolled out slowly over the past few years. This year, the high-dose vaccine is readily available. The theory behind Fluzone is that, because immune systems decline with age, a higher amount of antigens in the vaccine better stimulates older adults to produce protective antibodies. A recent study in the New England Journal of Medicine found that the high-dose vaccine was "24 percent more effective than the standard-dose vaccine" in protecting seniors against flu. As for side effects, researchers noted the high-dose vaccine may cause more arm soreness at the site of the injection than the standard shot.

The Centers for Disease Control and Prevention recommends that everyone six months and older get an annual flu vaccination, especially those 50-plus. The CDC says it "has not expressed a preference" whether seniors get the high-dose or the standard dose shot, a stance seconded by Carney. "I'm not encouraging one over the other yet," she says.

Medicare and most private insurance plans cover flu shots at a doctor's office, so for many people there will be no out-of-pocket costs. Chain store pharmacies take most, but not all, insurance plans, so check before you go there. The high-dose vaccine is more expensive, but, again, Medicare covers it completely. As for the more convenient — and less painful — FluMist nasal spray vaccine, the CDC does not recommend it for anyone 50 and older because that vaccine contains live flu virus. Both the high-dose and standard dose flu shots contain an inactivated virus, which is considered safer for older adults.

The government-sponsored Vaccine Finder (nwsdy.li/flushot) will help locate an outlet near you dispensing flu shots. The interactive map can be filtered to include high-dose shots.

For more information from the CDC, including recommendations and warnings, go to nwsdy.li/cdcflu.

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