Flu shots by the end of this month are advisable. For the 2018-2019 season, the CDC recommends the nasal spray flu vaccine (live attenuated influenza vaccine or “LAIV”) for influenza vaccination of persons for whom it is otherwise appropriate. The nasal spray is approved for use in non-pregnant individuals, 2 years through 49 years of age. There is a precaution against the use of LAIV for people with certain underlying medical conditions. All LAIV will be quadrivalent (4-component). Find more information about the 2018-2019 influenza season from the CDC.