Why seniors need enhanced flu protection
As people age, their immune systems naturally become weaker, a process known as immunosenescence. This can reduce the body’s ability to mount a strong immune response to a standard-dose flu vaccine, leaving older adults more vulnerable to severe flu-related complications. In most flu seasons, seniors aged 65 and older bear the greatest burden of severe flu disease, including a higher risk of hospitalization and death. To address this, specialized flu vaccines have been developed to provide enhanced protection for this at-risk population.
The three types of flu vaccines recommended for seniors
The Centers for Disease Control and Prevention (CDC) and its Advisory Committee on Immunization Practices (ACIP) have issued a preferential recommendation for certain flu vaccines for adults aged 65 and older. These vaccines are considered potentially more effective than standard-dose options for this age group. The three recommended types are:
- High-Dose Quadrivalent Flu Vaccine (Fluzone High-Dose Quadrivalent): This vaccine contains four times the antigen of a standard-dose flu shot. This higher dose aims to stimulate a stronger immune response in older adults.
- Adjuvanted Quadrivalent Flu Vaccine (Fluad Quadrivalent): This vaccine includes an ingredient called an adjuvant (MF59) to enhance the immune response. It has shown greater effectiveness against flu-related hospitalizations compared to standard doses.
- Recombinant Quadrivalent Flu Vaccine (Flublok Quadrivalent): This egg-free vaccine contains three times the antigen of other standard-dose vaccines for a stronger immune response. It's a suitable option for those with severe egg allergies.
Choosing the right senior flu shot
While the CDC preferentially recommends these three enhanced vaccines, it doesn't favor one over the others. The most crucial factor is getting vaccinated. If a preferred option isn't available, seniors should receive any other age-appropriate inactivated flu vaccine.
Comparison of CDC-recommended flu vaccines for seniors
| Feature | High-Dose (Fluzone HD Quadrivalent) | Adjuvanted (Fluad Quadrivalent) | Recombinant (Flublok Quadrivalent) |
|---|---|---|---|
| Mechanism | Contains four times the amount of antigen found in standard flu shots to produce a stronger immune response. | Contains an adjuvant (MF59) to boost the body’s immune response to the vaccine. | Manufactured without eggs, contains three times the antigen to promote a stronger immune response. |
| Approval | Approved for people 65 years and older. | Approved for people 65 years and older. | Approved for people 9 years and older (including adults 65+). |
| Egg-Free? | No, typically manufactured using eggs. | No, typically manufactured using eggs. | Yes, completely egg-free. |
| Potential Efficacy | Studies indicate improved immune response and better protection against influenza compared to standard doses. | Shown to be more effective than standard-dose vaccines at preventing hospitalizations. | Studies indicate a stronger immune response in older adults compared to standard doses. |
| Common Side Effects | Mild, temporary side effects like pain, headache, muscle ache, and tiredness may be slightly more frequent than with standard doses. | Mild, temporary side effects like injection-site pain, headache, and muscle aches may be slightly more frequent than with standard doses. | Generally mild, localized side effects such as soreness at the injection site. |
Important considerations for seniors
Discuss your medical history with your healthcare provider to determine the best vaccine option. Key considerations include:
- Egg allergies: The recombinant vaccine (Flublok) is completely egg-free and safe for those with severe egg allergies.
- Chronic health conditions: Those with chronic conditions face a higher risk of complications and need optimal protection.
- Timing of vaccination: Aim for September or October to ensure immunity lasts through the peak flu season.
- Other vaccines: The flu shot can often be given alongside other recommended vaccines.
Conclusion: Choosing the best protection
For older adults, an enhanced flu vaccine is preferable to a standard-dose one. The CDC preferentially recommends high-dose, adjuvanted, or recombinant flu vaccines for those 65 and over due to their ability to stimulate a stronger immune response in aging immune systems. While comparative effectiveness among these three is still being studied, getting one of them is the strongest course of action. If a preferred vaccine is unavailable, any standard-dose flu shot is still better than no vaccination. Consult with a healthcare provider to make the best choice. More information can be found on the CDC website.
