Over 65 You Have A Choice Of Flu Vaccines
- Health Tips
When it comes to influenza shots, older adults have an extra option
In addition to the regular-dose influenza vaccine, people 65 and older have the option of being vaccinated with a high-dose vaccine made to bring about a stronger immune response. This stronger formulation was developed because peoples immune systems weaken as they age, making older adults more likely to catch the flu. Aging also lowers the bodys ability to have a strong immune response after getting the flu vaccine.
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.
Whats New And Resources For The 2021
The CDC maintains a page dedicated to the current flu season. There is a section for the public and also a section for providers. This is a good place to get up-to-date information on influenza and influenza vaccination. You can find it here:
Note that the CDCs Flu FAQ page currently includes lots of information about influenza and COVID-19, such as how to tell them apart, why its safe to be vaccinated for both at the same time, and more.
The CDC also provides information specific to older adults here:
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Myth #: You Get The Flu From The Flu Shot
“It’s a myth that you can get flu from the flu vaccine,” Schaffner said.
The viruses in the flu shot are killed, so people cannot get the flu from a flu vaccine. However, because it takes about two weeks for people to build up immunity after they get the flu vaccine, some people may catch the flu shortly after they’re vaccinated, if they are exposed to the flu during this time period.
Some people may also mistakenly attribute symptoms of a cold to the vaccine, Schaffner said.
The nasal spray vaccine contains a “live attenuated” flu virus, but the virus is weakened so that it cannot cause the flu. The viruses in the nasal spray can’t replicate in the warm temperatures of the lungs and other parts in the body. However, because temperatures in the nose are colder, the virus causes a small infection in the nose. This infection does not cause symptoms in most people, but in some people, it causes symptoms such as runny nose and sore throat, Schaffner said.
This local infection will prompt the body to make antibodies against the flu virus, Schaffner said. “That provides better protection against the real flu, which is of course, is a virus that can make you seriously ill,” Schaffner said.
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Given such prospects, what makes vaccinating more older adults such a challenge? Improvement appears possible. The C.D.C. has reported that last year when public health strategies emphasized flattening the hospitalization curve, protecting essential workers and preserving resources for Covid patients the proportion of older people who were vaccinated against flu rose 9.5 percent in selected jurisdictions.
Further, a new C.D.C. study has found that three-quarters of unvaccinated Medicare beneficiaries actually visit a health care provider during flu season, with even more such missed opportunities among Black and Hispanic beneficiaries.
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Who Can Receive Fluzone High
In the United States, Fluzone High-Dose Quadrivalent is licensed only for people 65 years and older. Fluzone High-Dose Quadrivalent is not recommended for people with a history of severe allergic reaction to the vaccine or to ingredients other than eggs. Information about vaccine ingredients is located in package inserts from each manufacturer.
Headache And Other Aches And Pains
After your shot, you might have headaches or some achiness and pain in the muscles throughout your body. This also usually happens on the first day and goes away within two days. Taking pain relievers can help ease your discomfort.
Its controversial whether its safe to take acetaminophen or ibuprofen to treat these vaccine side effects.
Some research suggests that these medications might change or decrease how your body responds to the vaccine. One study involving children found that taking acetaminophen or ibuprofen didnt reduce the bodys response to the flu vaccine.
Other research is mixed. Its still unclear whether these medications should be avoided.
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A Flu Vaccine Is The Best Protection Against Flu
Flu vaccination has many benefits. It has been shown to reduce flu illnesses and also to reduce the risk of more serious flu outcomes that can result in hospitalization or even death in older people. Flu vaccination has been shown in several studies to reduce severity of illness in people who get vaccinated but still get sick.
The best way to protect against flu and its potentially serious complications is with a flu vaccine. CDC recommends that almost everyone 6 months and older get a seasonal flu vaccine each year, ideally by the end of October. However, as long as flu viruses are circulating, vaccination should continue throughout flu season, even into January or later.
Flu vaccination is especially important for people 65 years and older because they are at higher risk of developing serious flu complications. Flu vaccines are updated each season to keep up with changing viruses. Also, immunity wanes over a year so annual vaccination is needed to ensure the best possible protection against flu. Because immunity may decrease more quickly in older people, it is especially important that this group is not vaccinated too early . September and October are generally good times to be vaccinated for people 65 years and older.
The Flu Shot Is Effective
The effectiveness of the vaccine varies from season to season. It depends on:
- how well the vaccine matches with the circulating flu viruses
- the health and age of the person getting the flu shot
The viruses circulating in the population can sometimes change during the time it takes to produce a vaccine. When this happens during the flu season, the flu shot may not work as well as expected.
It’s also important to remember that the flu shot protects against several different flu viruses each season. The seasonal flu shot can still provide protection against the remaining 2 or 3 viruses, even when theres:
- a less-than-ideal match
- lower effectiveness against one virus
If you do get the flu, the flu shot may reduce the severity of flu-related complications.
Getting your flu shot is still the most effective way to protect yourself against the flu and flu-related complications.
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What Type Of Vaccine Is Recommended For Seniors The High
For the 2021-2022 flu season, adults over age 65 should get either the Fluzone High-Dose vaccine or the flu vaccine with adjuvant .
Seniors need these special high-dose versions of the flu shot because their immune systems dont produce as strong an immune response after getting the regular-dose vaccine.
That reduces the regular dose vaccines effectiveness and puts them at higher risk for severe illness.
The higher dose vaccines help older bodies produce a better immune response and increases their protection against the flu.
Type Of Flu Vaccine For Older People
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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Groups Who Should Especially Get The Vaccine
The flu shot can protect you against the flu. Because of this, it can reduce your chances of being infected with COVID-19 and the flu at the same time. This can lead to serious complications. You should especially receive the flu vaccine this season if youre:
- at high risk of severe COVID-19 related illness
- capable of spreading the flu to those at high risk of severe illness related to COVID-19
The flu vaccine is especially important for the following groups.
People At High Risk Of Complications From The Flu

- people with health conditions, such as:
- cancer and other immune compromising conditions
- diabetes
- kidney disease
- neurological or neurodevelopmental conditions
- children up to 18 years of age undergoing treatment for long periods with acetylsalicylic acid
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Myth #: It Contains Thimerosal Which May Be Harmful
Thimerosal a preservative that contains mercury has never been shown to be harmful, Cunningham said. The type of mercury linked with nervous system damage is methyl mercury, he said. Concerns over levels of methyl have led to recommendations that pregnant women avoid eating large amounts of certain types of fish, such as swordfish.
In contrast, thimerosal is an ethyl mercury compound.
Still, because the preservative raised controversy, especially over a now-disproven link to autism, it was taken out of almost all U.S. vaccines starting in 2001, Cunningham said.
The injectable form of the flu vaccine is available to health care providers as large, multidose bottles and small vials carrying individual doses. A tiny amount of thimerosal is added to the multidose bottles to ensure that no bacteria will grow in the vaccine, Cunningham said. The individual-dose bottles contain no thimerosal.
The nasal spray form of the flu vaccine also contains no thimerosal, he noted.
Who Should Not Get The Vaccine
You should not get the flu vaccine if you:
- have had a severe allergic reaction to a previous flu vaccine or any part of the vaccine
- are taking medicines called combination checkpoint inhibitors, for example, ipilimumab plus nivolumab
- have severe neutropoenia, which is low levels of a type of white blood cell
- are ill with a temperature greater than 38 degrees Celsius – wait until you are well before getting the vaccine
If you have an egg allergy, talk to your GP before getting the vaccine. Most people with an egg allergy can get the flu vaccine.
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Persons New To Canada
Health care providers who see persons newly arrived in Canada should review the immunization status and update immunization for these individuals, as necessary. Review of pneumococcal vaccination status is particularly important for persons from areas of the world where sickle cell disease is present, as persons with sickle cell disease are at risk of serious pneumococcal infections. In many countries outside of Canada, pneumococcal conjugate vaccine is in limited use. Refer to Immunization of Persons New to Canada in Part 3 for additional information about vaccination of people who are new to Canada.
Who Should Have The Vaccine
In 2021/22 flu season, the following people are eligible to receive the flu vaccine for free:
- All children aged 2 to 15 on 31st Aug 2021
- Those aged 50 years or over
- Those in long-term residential care homes
- Carers
- Frontline health and social care workers
- Close contacts of immunocompromised individuals
- Those aged 6 months to 65 years in at-risk groups including people with the following health conditions:
- Respiratory diseases, including asthma
- Heart disease, kidney disease or liver disease
- Neurological conditions including learning disability
- Diabetes
- A severely weakened immune system , a missing spleen, sickle cell anaemia or coeliac disease
- Being seriously overweight
Babies under 6 months old are too young to receive a flu vaccine. This is because they have maternal antibodies passed on from their mother which prevent the vaccine from working so well. Flu vaccination is offered to all pregnant women in the UK . As well as protecting pregnant women themselves, this also helps to protect their newborn babies from flu.
Your doctor may recommend the flu vaccine in other circumstances as well.
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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.
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.
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Best Time To Get Your Flu Shot
The best time to get your flu shot is by the end of October. Once you get your shot, your body needs about two weeks to get ready to fight the flu.
Flu season usually runs from November through the end of April. If itâs past October and you didnât get your flu shot yet, get it. Itâll help keep you safe for the rest of the flu season.
What Is In This Years High

Fluzone High-Dose Quadrivalent the high-dose flu vaccine is an inactivated influenza vaccine. This means it contains a certain amount of dead flu viruses . Because the viruses in the shot are dead, you cannot get sick with influenza from the vaccine.
The high-dose flu vaccine is a quadrivalent vaccine, meaning it contains four different strains of the influenza virus. The vaccines exact composition changes every year in an effort to match the strains expected to circulate during flu season .
This years high-dose flu vaccine includes the following strains:
-
Two type A influenza viruses H1N1 and H3N2
-
Two type B influenza viruses Victoria and Yamagata lineages
Fluzone High-Dose Quadrivalent is an egg-based vaccine, meaning chicken eggs were used to create the vaccine. If you have an egg allergy, its best to discuss this with your healthcare provider before getting your flu vaccine.
Most people with egg allergies are still able to receive egg-based flu vaccines. But if you are advised to avoid egg-based vaccines, there are flu vaccine options available that are made without eggs .
The vaccine also includes the following inactive ingredients to help create and stabilize the shot:
-
Formaldehyde an ingredient that kills the virus during vaccine production
-
Sodium chloride the liquid that the virus is placed in to allow it to be injected
The syringe the vaccine comes in is not made with rubber latex, so its safe for people with latex allergies to receive it.
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