The influenza vaccine is now available in two forms--the traditional "flu shot" and the just released "FluMist" nasal spray vaccine. The shot is a killed virus preparation and cannot cause the flu, contrary to popular notion. The only down side to vaccination is that it is not necessarily 100% protective. At the very least, if you are vaccinated, you can count on much less severe illness than if you are not vaccinated. Almost anyone older than 6 months of age can (and should!) be vaccinated. Persons who have had anaphylactic reactions to egg and those with histories of allergic reactions to flu shots are the only ones who shouldn't be vaccinated. This shot is almost painless. We have elected not to offer the FluMist (the nasal spray) at our office. It is much more expensive than the shot. It is contraindicated for those with asthma and for anyone under five and over 48 years of age and anyone with immune deficiency problems. It is a live virus vaccine, and it is not unusual for someone to feel mildly ill for a couple days after vaccination. We charge $22 for a flu shot. We willingly give flu shots to family members of our patients, since protection is better when the entire "herd" gets immunized, just please speak to our front desk about billing issues first. Children under 9 years of age who have never been vaccinated should receive a booster dose one month after the first one. Ideally, vaccination should be completed by December, since it isn't unusual for flu epidemics to start as early as that month. However, we administer vaccine through the early winter months, for sure.