For many children and adults, the sight of a needle is unbearable, but this flu season the actual shot may be the only line of defense to stay protected from the virus.
The Centers for Disease Control and Prevention reported this summer it will not recommend the nasal spray form of the flu vaccine because it has been ineffective.
The CDC's Advisory Panel on Immunization Practices found no evidence that the spray was effective after it studied data from 2013 to 2016 from children ages 2 to 17 who took the nasal spray.
During the 2015-2016 season, the nasal spray's protection rate was only 3 percent. The actual flu shot was 63 percent effective.
"For this year, the American Academy of Pediatrics and pediatricians across the United States are recommending only the flu vaccine for children," said Dr. Maria Prodanovic, a pediatrician at Del Sol Medical Center.
Prodanovic said adults, too, should opt for the flu shot instead.
"Most pediatric offices have not even ordered FluMist, but will only be offering the flu shot which is a very safe and effective option," said Prodanovic.
In 2014, FluMist, made by AstraZeneca was recommended over the needle flu shot by ACIP and at one one point studies showed it outperformed the vaccine.
The nasal spray is not made from dead virus, but instead from a weakened form of the flu virus.
The CDC has not been able to pinpoint why the nasal spray form has been ineffective.
A flu expert with the CDC and member of ACIP theorized that when a fourth strain of influenza was added to the vaccine a few years ago, that may have weakened the body's response to another strain.
The traditional flu shot is recommended for everyone aged 6 months and older.
The CDC said in June that it would work with the makers of the flu vaccine to ensure there is no shortage during the demand of the flu season.
It is difficult to tell if doctor's offices are seeing any kind of shortage because most are just receiving its stock of the flu shot.
"Most of El Paso should be getting their flu vaccines now through the middle and the end of September," said Dr. Prodanovic.
The flu season varies every month but cases start to increase in October. The peak season is typically December through March.
Since 1982, flu season has peaked in February with the most cases reported.