Why Are Enhanced Flu Vaccines Recommended for Seniors?
As individuals age, the immune system's effectiveness can decline, a process known as immunosenescence. This natural weakening means that older adults, especially those aged 65 and older, are at a higher risk of developing serious flu-related complications that can lead to hospitalization or even death. Because of this diminished immune response, a standard-dose flu vaccine may not provide the same level of protection as it would for a younger person. Enhanced flu vaccines are designed to create a more robust immune response, offering a stronger defense against the influenza virus for seniors.
The Three Preferentially Recommended Flu Shots
For the 2022-2023 flu season and subsequent seasons, the Centers for Disease Control and Prevention (CDC) and its Advisory Committee on Immunization Practices (ACIP) began giving preferential recommendations for specific vaccines for adults 65 years and older. While any age-appropriate flu vaccine is better than none, these three options are considered superior for this demographic due to their enhanced ability to stimulate the immune system.
1. High-Dose Inactivated Flu Vaccine (Fluzone High-Dose Quadrivalent)
This vaccine contains four times the amount of antigen as a standard flu shot. The increased amount of antigen is intended to trigger a more powerful immune response in older adults, boosting the body's defenses. Studies have demonstrated that this vaccine can reduce the risk of flu-related complications and hospitalizations compared to standard-dose options.
2. Adjuvanted Inactivated Flu Vaccine (Fluad Quadrivalent)
Fluad contains an adjuvant, an additional ingredient (squalene-based) that helps create a stronger immune response to the vaccine. The adjuvant helps the immune system respond more effectively to the vaccine, providing better protection for seniors. Like the high-dose vaccine, studies have shown that it may lower the risk of flu-related hospitalizations compared to standard-dose alternatives.
3. Recombinant Flu Vaccine (Flublok Quadrivalent)
Unlike the other options, this vaccine is created using a recombinant technology that does not use chicken eggs in its manufacturing process. It is a good choice for those with severe egg allergies. Studies have shown that older adults who receive this vaccine also respond better than those who receive standard-dose shots.
Comparing Flu Shots for Adults 65+
| Feature | Fluzone High-Dose Quadrivalent | Fluad Quadrivalent | Flublok Quadrivalent | Standard-Dose Flu Shot |
|---|---|---|---|---|
| Antigen Strength | 4x standard dose | Standard dose + Adjuvant | Higher antigen dose | Standard dose |
| Mechanism | More antigen for stronger response | Additive for stronger immune response | Uses recombinant protein technology | Traditional |
| Egg-based | Yes | Yes | No (egg-free) | Yes (for most versions) |
| Preferentially Recommended for 65+ | Yes | Yes | Yes | No |
| Availability | Widely available | Widely available | Available, often at pharmacies | Widely available |
Potential Side Effects and Safety
All three preferentially recommended vaccines are safe and effective for adults 65 and older. The side effects are generally similar to those of a standard flu shot and tend to be mild and short-lived. Common side effects may include:
- Pain, swelling, or redness at the injection site
- Headache
- Muscle aches
- Fatigue
- Low-grade fever
Side effects for the high-dose and adjuvanted vaccines may occur more frequently or be slightly more intense than with standard-dose shots, but these effects are temporary and indicate that your immune system is responding to the vaccine as intended. The health benefits of protection against serious illness far outweigh these minor, transient side effects.
What if a Preferentially Recommended Vaccine Isn't Available?
While the CDC prefers high-dose, adjuvanted, or recombinant vaccines for seniors, the most important thing is to get vaccinated. If one of the preferentially recommended vaccines is not immediately available at your provider or pharmacy, you should still proceed with getting a standard-dose flu shot. A standard-dose vaccine still offers protection against the flu, and any flu shot is significantly better than no flu shot at all. Health experts stress that you should not wait to receive a vaccine if a standard-dose option is the only one available.
The Importance of Annual Vaccination
Flu viruses are constantly changing, which is why flu vaccines are updated each season to protect against the strains most likely to be circulating. Additionally, the immunity provided by a flu shot decreases over time, necessitating an annual vaccination to maintain the best possible protection. The best time for most people to get their flu vaccine is in September or October. For older adults, it is especially important not to get the shot too early (e.g., in July or August), as immunity might wane before the end of the flu season. It's best to consult your doctor or pharmacist to determine the optimal timing for your specific health needs.
Conclusion: Choosing the Right Flu Shot for You
For a 70-year-old, the best options are the high-dose, adjuvanted, or recombinant flu vaccines, as recommended by the CDC for those aged 65 and older. These are specifically designed to provide a more robust immune response to counteract the natural weakening of the immune system that occurs with age. When visiting your doctor or pharmacist for your annual shot, ask for one of these enhanced options by name. However, if one of these is not available, getting a standard-dose flu shot is still highly recommended. A conversation with your healthcare provider can help you determine the best option based on your overall health, any allergies (particularly egg allergies), and local availability. Always remember that getting your annual flu shot is one of the most effective steps you can take to protect yourself from serious influenza illness.
