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Do Seniors Get A Different Flu Shot

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Flu Shot FAQ with Dr. Sree

Manufacturers have increased flu shot production to meet the high demand for the 2020-2021 season. According to the CDC, between 188 million and 200 million doses will be distributed. All vaccines will be quadrivalent , most will be thimerosal-free or thimerosal-reduced vaccines and about 18% of flu vaccines will be free of eggs.

What You Need To Know About Fluad And Fluzone High Dose The New Flu Vaccines For Over

In an attempt to avoid a repeat of last year’s horror flu season, Health Minister Greg Hunt announced the Government would fund two new flu vaccines in 2018 to try to better protect the elderly.

While influenza affects people of all ages, infections among the elderly are more likely to require hospitalisation or cause serious complications such as pneumonia and heart attacks.

Of the 1,100 Australians who died last year from flu-related causes, 90 per cent were aged 65 and over.

The two free vaccines for over-65s work in different ways: FluZone High Dose is a high-dose version Fluad adds an additional ingredient to boost its effectiveness.

Both are recommended for use only in people aged 65 and over. But neither is perfect. And it’s important to remember flu vaccines are, at best, only partially protective.

What To Know About Flu Shots For Older Adults

Q: Is the flu vaccine effective for older adults?

A: You may have heard people say that the flu shot doesnt work in older people. This is not entirely correct.

Now, its true that flu vaccine is usually less effective in older adults because aging immune systems tend to not respond as vigorously to the vaccine. In other words, older adults tend to create fewer antibodies in response to vaccination. So if they are later exposed to flu virus, they have a higher chance of falling ill, compared to younger adults.

But less effective doesnt mean not at all effective. For the 2017-2018 flu season, the CDC estimates that vaccination prevented about 700,000 influenza cases and 65,000 hospitalizations, for adults aged 65 and older.

For more on the effectiveness of influenza vaccination in older adults, see:

To provide more effective vaccination to aging immune systems, vaccine makers have developed stronger vaccines against the flu, which I explain in the next section.

Q: Are there flu shots specifically designed for older adults?

Yes, over the past several years, vaccine makers have developed vaccines that are designed to work better with an aging immune system. Most research studies to date show that these stimulate aging immune systems to produce more antibodies to influenza. Theres also some evidence that these vaccines reduce the risk of being hospitalized for influenza.

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How Do Flu Vaccines For Seniors Work

As we age, our immune systems do not function as well as they once did. Flu immunizations for seniors are designed to help our bodies better fight infection with more antibodies. These antibodies will support the immune system in fighting off infection.

The CDC reports that 80 to 90 percent of all flu-related deaths are among those over 65. Flu vaccinations for seniors are designed and recommended to help keep those 65+ safe all year long.

Why Do Older Adults Need A Different Flu Shot

Flu Shots for Seniors: Types, Cost, and More

It is no secret that our bodies go through a handful of changes as we age. One of things that many people dont think about is what happens to the immune system. Older adults tend to have a weaker immune system and are therefore at higher risk for infection. With flu season coming around the corner it is important that we make sure everyone gets the flu shot best suited for them. For adults older than the age of 65 it is recommended to get the high-dose flu vaccine. The high dose vaccine contains higher amount of viral protein intended to result in a stronger immune response than the regular flu vaccine.1

There are many factors that affect the level of risk an individual has for developing a serious infection from the influenza virus. One important factor to consider is age. For adults 65 years and older, there is a high risk of developing complications from the influenza virus sometimes requiring hospitalization. Studies produced by the Center of Disease Control, estimate that this age group results in 70% to 85% of flu-related deaths and 50% to 70% of flu-related hospitalizations each year.2 When provided the regular flu vaccine over the senior one, studies found that older adults had 50% to 75% fewer antibodies than the younger population.3

  • Flu & People 65 Years and Older. . Centers for Disease Control and Prevention: US Department of Health and Human Services 2021 May 6 . Available from:
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    Which Flu Vaccines Are Right For Seniors

    Standard flu shot: The standard flu shot contains inactivated, or dead virus and is safe for ages 6 months and older who have not experienced contraindications to the vaccine.

    Live Attenuated Influenza Vaccine nasal spray: The LAIV contains live but weakened influenza virus and is sprayed into the nose. This vaccine is NOT recommended for persons over 50 years of age.

    Quadrivalent flu vaccine: The quadrivalent flu vaccine was created to protect recipients against four different flu viruses: two influenza A viruses and two influenza B viruses. For many years, flu vaccines only protected people against three strains of the flu virus, or were trivalent. When they were trivalent, the vaccines protected people against two A viruses but just one B virus. Adding protection against an additional B virus provides for even broader protection. Standard-dose quadrivalent shots are approved for people 3 years and older. However, as mentioned above, the quadrivalent nasal spray vaccine is NOT approved for people 50 and older.

    High dose influenza vaccine: Seniors can choose a higher-dose vaccine that is designed specifically for people age 65 and older. Fluzone high-dose vaccines contain four times the amount of antigen found in regular flu shots. Because aging decreases the bodys ability to have a good immune response after vaccination, the additional antigen is intended to create a stronger immune response and thus better protection against the flu. Learn more here.

    Who Should Get A High

    Flu vaccines for seniors are only approved for individuals over the age of 65. It is not recommended for those with a history of severe allergic reaction to the flu shot or to other vaccine ingredients. If you are concerned about which flu vaccine is right for you, speak with your primary care physician.

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    Senior Flu Shot Types

    The following flu vaccines are recommended for adults 65 and older only. Talk to your doctor about which senior flu shot is right for your loved one.

    • Fluzone High-Dose Quadrivalent is a vaccine made up of four different flu strains likely to cause the flu in the upcoming season. The higher dose of flu virus antigen in the Fluzone High-Dose Quadrivalent vaccine stimulates a stronger immune response, making it more effective in preventing the flu in seniors than other regular flu vaccines. One study comparing it to the standard flu vaccine also showed the higher-dose vaccine can reduce the need for respiratory-related hospitalizations.
    • Adjuvanted flu vaccine contains an additive called an adjuvant. The adjuvant in this vaccine is made with aluminum salts and stimulates a stronger immune response when compared to other standard flu vaccines. This vaccine is usually made up of three different strains of the flu, like other standard flu vaccines, but a quadrivalent adjuvanted vaccine is also available now.

    Type Of Flu Vaccine For Older People

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    You will be offered the adjuvanted Quadrivalent Influenza Vaccine . It’s also known by the brand name Fluad Tetra. This is a 1 dose vaccine.

    Fluad Tetra is the recommended flu vaccine for people aged 65 and older. As we get older, our immune systems may not respond to vaccines the same way. ‘Adjuvanted’ means that the vaccine has an extra ingredient that makes it more effective for people aged 65 and older.

    But, it is also safe to get the Quadrivalent Influenza Vaccine. All flu vaccines offer protection against flu and reduce the impact of flu if you were to catch it.

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    When Should Seniors Get The Influenza Vaccine

    It is important for seniors to get the influenza vaccine before the influenza season starts.

    In B.C., the influenza vaccines are usually available in October. For best protection, you should try to get the vaccine as soon as possible. This gives your body enough time, about 2 weeks, to build immunity before the influenza season starts. This immunity typically lasts through the influenza season which usually ends in April.

    In addition to the influenza vaccine, seniors should be immunized against pneumococcal disease. The pneumococcal vaccine protects against infections of the brain, bloodstream, lungs and ear. It is safe to get the influenza and pneumococcal vaccines at the same time. Most people only need 1 dose of pneumococcal vaccine and will not need a booster dose.

    For information about pneumococcal infection and the vaccine, see HealthLinkBC File #62b Pneumococcal Polysaccharide Vaccine.

    Are You 65 Or Older Get Two Vaccinations Against Pneumonia

    • By Gregory Curfman, MD, Assistant Professor of Medicine, Former Editor-in-Chief, Harvard Health Publishing

    ARCHIVED CONTENT: As a service to our readers, Harvard Health Publishing provides access to our library of archived content. Please note the date each article was posted or last reviewed. No content on this site, regardless of date, should ever be used as a substitute for direct medical advice from your doctor or other qualified clinician.

    If you or a loved one is age 65 or older, getting vaccinated against pneumonia is a good idea so good that the Centers for Disease Control now recommends that everyone in this age group get vaccinated against pneumonia twice.

    This new recommendation is based on findings from a large clinical trial called CAPiTA, which were published today in The New England Journal of Medicine.

    Streptococcus pneumoniae, sometimes just called pneumococcus, is a common bacterium that can cause serious lung infections like pneumonia. It can also cause invasive infections of the bloodstream, the tissues covering the brain and spinal cord , and other organs and tissues. Older individuals are especially prone to being infected by Pneumococcus, and these infections are often deadly.

    The dark spots are pneumonia-causing Streptococcus pneumoniae bacteria isolated from the blood of an infected person.

    One caveat is that while PCV13 is effective in preventing pneumonia caused by S. pneumoniae, it does not prevent pneumonia caused by viruses or other bacteria.

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    Older Adults Still Need Their Shots For The Flu Shingles And More

    As we age, the immune system slows down, chronic conditions become more common, and the body may be less able to fight off infection and more vulnerable to its complications.

    Thats where vaccines come in. These immunity boosters help prevent serious diseases at any age.

    Vaccines are not only for kids or teens, says David Kim, M.D., director of the division of vaccines and immunization at the Department of Health and Human Services. If youre older, youre at a higher risk for certain vaccine-preventable diseases.

    Here are the shots you may need, when to get them, and why theyre critical for keeping you and your loved ones healthy.

    Should Everyone 65 Years

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    The immune system weakens as humans age. This places older individuals at greater risk of severe illness. Aging also affects the immune systems ability to respond to threats. A higher dose flu shot gives older people a better immune response and better protection.

    Check with a healthcare professional if this vaccine is right for your medical situation.

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    Who Should Not Get The Influenza Vaccine

    Speak with a health care provider if you:

    • Have had a life-threatening reaction to a previous dose of influenza vaccine, or any part of the vaccine. People with egg allergies can be safely immunized with the influenza vaccine
    • Have had severe oculo-respiratory syndrome after getting an influenza vaccine
    • Are receiving a checkpoint inhibitor to treat cancer. This may affect when you should get the vaccine
    • Developed Guillain-Barré Syndrome within 8 weeks of getting an influenza vaccine without another cause being identified

    GBS is a rare condition that can result in weakness and paralysis of the body’s muscles. It most commonly occurs after infections. In rare cases GBS can also occur after some vaccines. GBS may be associated with influenza vaccine in about 1 per million recipients.

    Immunization Strategies Around The World

    Influenza is a vaccine-preventable disease. The first influenza vaccines have been developed, tested and used in the 1930s and 1940s, and in Europe since 1960s.,,, Vaccines are registered and licensed for use in the elderly as trivalent or quadrivalent, with and without adjuvant. Trivalent influenza vaccines contain an A-like influenza virus, an A-like influenza virus and a B-like influenza virus. The MF59 adjuvanted trivalent inactivated influenza vaccine is licensed for persons aged 65 y of age. Quadrivalent vaccines include an additional vaccine virus strain, a B-like virus. The World Health Organization provides recommendations in February and September each year regarding which viruses will be included in influenza vaccines for the forthcoming northern and southern hemisphere influenza seasons, respectively. No preferential recommendation is made for one influenza vaccine product over another for persons for whom more than one licensed. For persons aged 65 y and older any registered influenza vaccine, standard-dose or high-dose, trivalent or quadrivalent, unadjuvanted or adjuvanted could be used for immunization. Practically speaking, however, not all registered influenza vaccines are available every year fluctuations in production and distribution often limit the options. The list of approved influenza vaccines is shown in .

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    Can You Prevent The Flu

    Yes. The best way to prevent it is to get an annual flu vaccine.Getting the shot is a smart idea. It makes a big difference in hospitalization and death rates among older adults who live at home and those in nursing homes.

    A high-dose flu vaccine is made just for seniors. It has four times as much active ingredient as a regular flu shot to provide a better immune response in older people. Itâs recommended for people ages 65 and older, if it’s available.

    Keep in mind that the seasonal flu viruses change each year, so older adults need to get a new flu shot each fall.

    Also, there are two vaccines to prevent pneumonia. If youâre a healthy adult over age 65, the CDC suggests you get both vaccines. The timing and sequence will vary depending on what vaccine youâve had before.

    The Seasonal Flu Vaccine Is Needed Every Year

    CDC Says Flu Shots May Be Less Effective This Year

    Receiving an annual flu vaccination provides the best protection against flu throughout the flu season. Adults 65 years and older may want to consider getting one of the flu vaccines designed specifically for their age groupbut getting any flu shot is better than not getting vaccinated at all. If you have questions about which flu vaccine is best for you, talk to your health care provider.

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    What Are Fluzone High

    Dr. William Schaffner, an infectious diseases specialist at Vanderbilt University Medical Center, said that although the two vaccines have the same outcome, they work a little differently.

    Fluzone High-Dose contains four times the antigen that’s in a standard dose, effectively making it a stronger version of the regular flu shot. FLUAD pairs the regular vaccine with an adjuvant, an immune stimulant, to cause the immune system to have a higher response to the vaccine.

    The data indicates that no matter what flu strain is out there, it provides more protection for older people, Schaffner said.

    Cochrane Review And Its Limitations

    While most doctors in the US and globally agree with the CDC recommendation to vaccinate people at the population level, a Cochrane review casts doubt as to whether the vaccine has any efficacy against influenza.

    Opponents of vaccination against influenza have recently used arguments based on a Cochrane’s meta-analysis of immunization trials which concluded that flu vaccines offer no benefit. Presentation of these results in the media serve to mobilize the anti-vaccine constituency and invigorate resolve to refuse other vaccinations. The European Scientific Working Group on Influenza refutes the Cochrane findings, stating that any doubt regarding the benefits of influenza vaccination is dangerous from both a scientific and ethical point of view. Specifically, the ESWI points out that the Cochrane Review failed to distinguish between seasons with high, mild or no circulation of an influenza virus, a factor which would dramatically influence any final effectiveness estimate.

    The current media discussion is based on a dramatic misinterpretation of 2 scientific notions: efficacy and effectiveness of influenza vaccines. Effectiveness studies measure the level of protection offered by the influenza vaccine against influenza-like-illnesses. However, it is common scientific knowledge that influenza vaccines offer no protection against viruses other than the circulating influenza viruses.

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    Immunizations Are Even More Important As We Age

    As we age, the immune system declines in its ability to fight off infections, which makes people ages 65 and older more vulnerable to diseases like influenza, COVID-19, pneumonia, and shingles.

    People of this age group are also at a higher risk for serious complications related to these diseases compared to younger populations. The flu in a 40-year-old is very different than in an 80-year-old.

    According to our experts, while a 40-year-old might be in bed for a few days nursing the flu with rest, an 80-year-old is more likely to experience more serious symptoms that could lead to hospitalization, and in the most serious and unfortunate circumstances, can even be a cause of death.

    These are five important vaccines to consider if you are age 65 or older:

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