Flu shots can be a difficult topic in the vegan community. The internet has a lot of misinformation about vaccines in general, and flu shots in particular, which can make the topic controversial in the best of situations.
In a vegan context, the conversation is complicated by the fact that flu shots are generally made with eggs. This leads to heartache, as people have to choose between what’s best for their own and their family’s health, and being true to values that they have worked hard to live by. This can lead to motivated reasoning, where people may choose to believe that vaccines are ineffective or unsafe, rather than face the ethical dilemma.
I think it’s important to foster appreciation for science and objectivity within the vegan community, even when that means facing facts that we’re not wild about. Flu shots are a safe, effective technology, and we should seriously consider getting these vaccinations, even though they are generally not vegan.
Why should I get a flu shot?
Flu shots are associated with better performance in a broad array of health outcomes. Flu shots provide about 50% protection against getting the flu in any given year. (That is, vaccinated people get the flu half as frequently as those who are not vaccinated.) While this is less than the complete immunity given by some vaccinations, it still makes a meaningful difference to individual and community health.
The flu is particularly damaging to groups at high risk of flu complications, such as young children, the elderly, pregnant women, and people with various chronic diseases*.
It’s important to recognize that vaccinations, flu and otherwise, are not a strictly personal decision. Your choice to vaccinate or not affects those you come into contact with, and society more broadly. Even if you are not at high risk of flu complications, some of those that you come into contact with may be. By getting a flu shot, you are helping to protect your community members.
Why aren’t flu shots vegan?
Influenza viruses only grow in animal tissue, which means that animal products are required to produce them. The standard method of producing vaccines involves growing the virus in fertilized eggs. The CDC explains:
These vaccine viruses are then injected into fertilized hen’s eggs and incubated for several days to allow the viruses to replicate. The virus-containing fluid is harvested from the eggs. For flu shots, the influenza viruses for the vaccine are then inactivated (killed), and virus antigen is purified*.
The final vaccine is the isolated antigen — the virus proteins that the body recognizes as foreign, and develops an immunity toward. It’s these proteins, rather than the virus itself, that results in immunity.
Are there any alternative methods of making flu shots?
Yes! This is an area where there has been a lot of recent progress, partly because the existing egg-based production system is slow and difficult to scale. Because the technology has changed so quickly, vegan communities may not be up to date on the new flu vaccines.
In 2012, a “cell-based” flu vaccine was approved. This vaccine strategy still uses eggs to grow an initial virus culture, but uses cultured animal cells to grow the the much larger amount of virus needed for vaccination. This avoids the majority of the egg use in the vaccine production process. At time of writing, there is only one cell-based flu vaccine in the US: Flucelvax*.
In 2013, a recombinant flu vaccine was approved. This strategy does not use eggs at all. Instead, the virus protein that triggers immune response is isolated, and genetically added to a virus that grows well in vitro on cultured insect cells. Once the virus has grown, the antigen is filtered out as usual, producing a vaccine. There is one recombinant flu vaccine approved in the US: FluBlok. The has FDA expanded its approval to cover all adults over 18 years old*. (Previously it was approved for adults ages 18-49.)
There continues to be a lot of research in this area, and I came across research toward plant-based recombinant flu vaccines* while writing this post. It seems likely that vaccines will be more vegan-friendly in the future, in order to solve some of the technical limitations of egg-based vaccines.
So are these vegan?
Yes, more or less.
I’m comfortable calling the FluBlok vaccine vegan. I haven’t verified that its production uses no animal products, however this vaccine strategy does not require animal products fundamentally. Regardless whether it is strictly vegan, it is moving vaccines away from using eggs, which is something I’m happy to support.
I also think that Flucelvax worth supporting. Even though Flucelvax it is arguably not vegan (since it participates in the CDC process of delivering virus grown in eggs to vaccine manufacturers), the cell-based approach has different strengths and weaknesses compared to the recombinant approach, and this approach could easily lead to effective vegan vaccines in the future that could overcome potential weaknesses of the recombinant approach. (More on this below.)
I think that vegans should get flu shots, including conventional flu shots when vegan versions are not available or are not medically appropriate for them. Vaccines save lives, including the immunocompromised and those who cannot get vaccines for medical reasons. We can all help them by getting vaccinated. If you’re able to get one of the new vaccines, you can participate in moving the science forward toward vegan solutions.
Update: Getting a Vegan Flu Shot in 2015 (in the US)*
Last year, I wrote the above, covering the science, and some of the reasons why flu shots, and recombinant flu shots in particular, are a good idea. The science hasn’t changed much since then, but vegan flu shots are a bit easier to find. This update covers getting FluBlok, the recombinant flu vaccine approved in the US, in 2015.
How to find FluBlok
Most major pharmacy chains (eg. Walgreens) still do not carry FluBlok. Here are some places you can find FluBlok this year:
Target Pharmacies – The biggest change from last year may be that Target pharmacies now carry FluBlok. No appointment necessary, but it may be wise to call ahead. I had no trouble getting a FluBlok flu shot at a Target Pharmacy, but they indicated that they only had a few doses left. They take insurance, otherwise the vaccine costs around $30.
Passport Health Clinics – Passport Health offers FluBlok by appointment, also for around $30. I got a FluBlok flu shot at Passport Health last year, and this is described in last year’s article. (SF residents: Passport Health has moved to Laurel Heights since last year.)
Some clinics and smaller pharmacies may carry FluBlok. You can use HealthMap Vaccine Finder* to find pharmacies that carry FluBlok. I recommend calling and asking though, as some clinics that are marked as carrying it may be out of stock, and some data may be entered incorrectly. (For instance, Pharmaca in San Francisco is marked as carrying recombinant vaccines, but I’ve contacted them twice, and they explained that their supplier does not provide FluBlok, so they do not carry it.)
Asking for FluBlok
Even pharmacies that carry FluBlok may not know it by that name. If the pharmacy you contact hasn’t heard of Flublok, try asking for the “recombinant” or “egg-free” vaccine. If you’re not sure, you can always ask your pharmacist what the manufacturer of their vaccine options is.
You may be asked multiple times if you have an egg allergy, since that is the common reason for requesting FluBlok (or the “egg-free” flu shot, as it is often referred to). You can answer truthfully, even if they ask repeatedly. They are very likely simply trying to make sure you filled out the paperwork correctly, and that you did not misunderstand the form. They are probably not trying to pressure you out of that vaccine type, even if it may seem that way.
(I was asked if I ate eggs, “even in cookies”, and I informed them that I did not, but that it was not due to an allergy. That seemed to be sufficient.)
As far as I’m aware, anyone can request FluBlok. Most insurance plans will cover it regardless of egg allergy status, and it’s only around $30 if you pay for it yourself.
I’ve focused on FluBlok, since I think it’s an interesting technology, however Flucelvax is also a technology worth supporting. Flucelvax is another vaccine grown in vitro in cell cultures, rather than in eggs, for production. Flucelvax uses virus samples delivered from the CDC in chicken eggs, but does not use eggs in its manufacturing process, so the process has a tiny, but nonzero egg footprint.
Moving medicine forward
A lot of medicine is not entirely vegan. I do not recommend avoiding medicine, especially medicine with serious public health implications such as vaccines, regardless of animal product content. For instance, I recommend conventional flu shots when recombinant flu shots are not available (including for children, for whom alternatives are not yet approved).
However sometimes we have the opportunity to help push medicine forward — toward biotechnology and away from animal products. Flu shots are currently such an opportunity, and vegans should embrace and advocate for recombinant flu shots.
In addition to reducing animal use, these technologies could overcome weaknesses in the conventional egg-based process — vulnerability to changes in egg supply, long delay to ramp up production, slow response to virus mutation, inability to respond quickly to an outbreak, and losing vaccine efficacy in “reassortment” process that adapts the virus to growing in eggs.
Recombinant flu shots also demonstrate why I would like vegans to be open to biotechnology. Recombinant genetic techniques gave us insulin for diabetics without needing to take it from slaughtered animals. Current research projects may give us DHA (an omega-3 fatty acid not found in plants) in canola oil, B12 in plant foods, and even dairy made from yeast. Opposing biotechnology and delaying these projects could do real harm to animals.
One of the ways that we will reduce our use of animals is by using biotechnology to replace animal products in medicine and food. We should be open to this technology as a community, and should support biotech projects that reduce animal use.
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