Flu Shot High Dose Vs Low Dose

What Is The Correct Dosage Of Vaccine

The amount of inactivated vaccine that should be administered intramuscularly is based on the patients age and the vaccine product you are using.

• For children 635 months of age, the correct dosage is:
• 0.25 mL for Afluria Quadrivalent
• 0.5 mL for Fluarix Quadrivalent
• 0.25 mL or 0.5 mL for Fluzone Quadrivalent
• 0.5 mL for FluLaval Quadrivalent

Flu Season Is Starting In Case You Didn’t Know

Whatever you do, it’s crucial to get the flu shot. “There was almost no flu last year and people’s immune systems may have forgotten about influenza,” Timothy Murphy, MD, senior associate dean for clinical and translational research at the University at Buffalo Jacobs School of Medicine and Biomedical Sciences, tells Health. “This could be a particularly severe flu season, and it may come earlier.”

As for the high-dose flu vaccineit’s not available to everyone. Here’s what infectious disease experts say.

What Other Flu Vaccines Are Available For People 65 Years And Older

In addition to Fluzone High-Dose Quadrivalent, one other influenza vaccine is licensed specifically for people 65 years and older. The adjuvanted flu vaccine,FLUAD Quadrivalent, contains an adjuvant, an ingredient intended to help improve immune response.

One recombinant influenza vaccine, Flublok Quadrivalent , is available during the 20202021 influenza season. Flublok Quadrivalent was first licensed by the FDA in the United States for use in adults 18 years and older in 2017. An earlier trivalent version was licensed in 2013 but was later replaced by the quadrivalent version. A new CDC study showed that flu shots made using recombinant technology produced a better antibody response among health care personnel compared with both cell-based and traditional flu shots.

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The Centers For Disease Controls 2021

Annual flu vaccination is recommended for everyone six months and older. Different flu shots are approved for people of different ages. In general, if you are pregnant or have an underlying health condition, you should still get a flu shot, but you can talk to your healthcare provider first if you are concerned.

The regular quadrivalent flu vaccine and high dose flu vaccine can be made using several different methods. Below we explain the three ways that flu vaccines are made:

Below is a table of the available flu vaccines, the way they are made, and the age range appropriate for each type of vaccination.

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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Better Protection Against The Flu

As noted earlier, better HI antibody responses are known to correlate with protection against influenza infection and reduced clinical disease risk. Yet while it is very encouraging that Fluzone HD induces higher serum antibody titers without significant safety concerns, the jury is still out on whether this actually translates into fewer confirmed cases and serious complications from the flu.

As a condition of licensure under FDAs accelerated approval process, the agency instructed Sanofi Pasteur to conduct a head-to-head study to compare Fluzone HD and Fluzone in 27,000 to 30,000 adult subjects 65 years of age and older. That study will be conducted over three flu seasons to try to account for typical fluctuation in vaccine efficacy, which is related to differences between the flu virus that arrives and the strains picked in advance to make the vaccine. The first season is already enrolled, with the 2010-2011 and 2011-2012 seasons to follow. Until that study is finished and the results are known, Fluzone HDs labeling informs providers and recipients that there have been no controlled studies demonstrating a decrease in influenza disease after vaccination with Fluzone High-Dose.

Where Can I Get An Influenza Vaccine

Influenza vaccines are provided at a wide variety of locations across the province, including:

• Pharmacies .
• Doctors’ offices
• Travel clinics

Services vary by location. You can use our influenza clinic locator to find an influenza vaccine clinic near you.

To find a pharmacy offering the influenza vaccine near you, please visit this link. You may be able to book your influenza vaccine online or by phone, and some pharmacies are accepting walk-ins.

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Time For Your Flu Vaccine: Do You Need A Higher Dose

The pros and cons of the high-dose vaccine, and tips to protect yourself from infection this season.

The flu is far more than a fever and sniffles that sideline you for a few days. In older adults, it can lead to serious complications like bronchitis and pneumonia, and it can worsen existing medical conditions such as heart disease, asthma, and diabetes. In fact, most flu-related hospitalizations and nearly all deaths from the disease occur in people 65 and older.

“The strength of the immune response tends to decrease with age. So as people get older, they are more likely to become significantly ill from diseases like the flu,” explains Dr. Elisa Choi, an internal medicine and infectious disease specialist at Harvard Vanguard Medical Center. The best way to protect yourself against the flu is by getting vaccinated, but because of the natural decline in your immune system, you may produce fewer flu-fighting antibodies in response to the vaccine than you once did, and be less protected as a result.

The Flu Shot Is Your Best Defence

This years flu season is taking place at the same time as COVID-19. Dont take any unnecessary risks with your health. Get the flu shot as early in the season as possible.

The flu shot is recommended for everyone 6 months old and older. It is:

• available from your doctor or nurse practitioner, and at participating pharmacies and local public health units across the province
• proven to reduce the number of doctor visits, hospitalizations and deaths related to the flu
• different each year because the virus changes frequently so you need to get it every fall

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So It Offers More Protection From The Flu

Exactly. A 2014 study published in The New England Journal of Clinical Medicine, which involved more than 30,000 adults aged 65 and older, found that participants who received the high-dose flu vaccine had 24% fewer flu illnesses compared to those who got the standard flu vaccine.

Another study, carried out during the 2013-2014 flu season and published in The Lancet Respiratory Medicine in 2017, found that the high-dose flu shot was associated with a lower risk of hospital admissions compared with the regular flu shot in people age 65 and over. This was particularly true for those living in long-term care facilities.

Are There Benefits Of Fluzone High

Data from clinical trials comparing Fluzone to Fluzone High-Dose among people 65 years and older indicated that a stronger immune response occured after vaccination with Fluzone High-Dose. A study published in the New England Journal of Medicine indicated that the high-dose vaccine was 24% more effective in preventing flu in adults 65 years and older relative to a standard-dose vaccine. Another study published in The Lancet Respiratory Medicine reported that people 65 years and older who got Fluzone High-dose had a lower risk of hospital admission compared with people in that age group who got the standard-dose Fluzone, especially those living in long-term care facilities. This study was conducted during the 2013-14 flu season among more than 38,000 resident of 823 nursing homes in 38 states.

For the 2021-22 season, all Fluzone High-Dose vaccine will be quadrivalent. Data comparing the effectiveness of Fluzone High-Dose Quadrivalent with standard-dose inactivated quadrivalent vaccines are not yet available.

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Other Ways To Protect Yourself

Keep in mind that the flu vaccine isn’t necessarily 100% effective. It is possible to come down with the flu, even after you’ve been vaccinated. Yet it’s still worth getting the shot. “Even if you get the flu despite having received a flu shot,” says Dr. Choi, “the vaccine can lessen the severity of symptoms and help you avoid serious complications from the flu.”

Should you ask your doctor to prescribe anti-influenza drugsoseltamivir and zanamivir in advance, in case you do catch the flu? Not necessarily, according to Dr. Choi. The flu shares many symptoms in common with other upper respiratory infections, and you might mistakenly treat a bacterial illness with an antiviral drug.

Plus, a research review published in April 2014 in The Cochrane Collaboration raises concerns about these drugs’ effectiveness at preventing flu complications, and highlights potential side effects such as nausea, vomiting, and headaches.

“The safest course of action, particularly during the height of flu season, is to call the physician as soon as your symptoms appear,” says Dr. Choi.

Getting Tiv Getting The Flu

With more than a doubling of the vaccination rate since 1990, one would expect a healthy drop in flu-related hospitalizations and deaths. But those numbers havent dropped. In fact, overall hospital admission and death rates in the U.S. have actually increased over the last two decades, even after accounting for changing age demographics and ups and downs in this customized vaccines effectiveness against each seasons new flu strain.

The actual life- and health-sparing value of flu vaccine in the elderly has been a subject of some controversy. Nearly all the evidence for protective benefit in this population comes from non-randomized observational studies. Typical of these was a large 2003 medical record review of 286,000 community-dwelling Americans at least 65 years old. In this review, those who got a flu vaccine experienced nearly a 20 percent reduction in risk of hospitalization for cardiac disease, about a 30 percent lower risk of hospitalization for pneumonia or influenza, and an impressive 49 percent average reduction in risk of death from all causes over the span of two flu seasons.

This obvious bias is built into any study that simply tallies deaths or hospitalizations of people who decided on their own whether to get a flu shot. People who choose on their own to get the vaccine clearly tend to be much healthier than those who dont, and they appear to take better care of themselves when they do get sick.

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How Does A High

Fluzone High-Dose Quadrivalent contains four times the amount of antigen as the regular dose flu vaccine. As we get older, our immune systems have a harder time fighting off infections and learning from vaccines. The higher amount of antigen in the high-dose flu vaccine helps an older adults immune system better recognize and react to the vaccine.

The influenza strains and inactive ingredients in Fluzone High-Dose are the same as Fluzone Quadrivalent one of the available regular dose flu vaccines. However, a few other regular dose flu vaccines are available which vary more from the high-dose vaccine than Fluzone Quadrivalent.

The following are other FDA-approved flu vaccines for the 2021/2022 flu season and how they differ from the high-dose flu vaccine:

Can Inactivated Influenza Vaccine Be Given At The Same Time As Other Vaccines Such As Pneumococcal Polysaccharide Or Zoster Vaccines

Yes if other vaccines are indicated, they can be administered during the same clinical encounter as inactivated influenza vaccine. When giving several injections at a single visit, administer each vaccine at a separate injection site. The injection sites should be separated by 1 inch or more, if possible, so that any local reactions can be differentiated.

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Cdc Advisory Committee Recommends Use Of High

In a June 22 meeting, the Advisory Committee on Immunization Practices voted to recommend the use of high-dose vaccines or adjuvated flu vaccine over standard-dose vaccines for seniors. An adjuvant is an ingredient added to a vaccine that helps create a stronger immune response.

Previously, the CDC had said that seniors could get the high dose, but that any dose would do, says Auwaerter.

The CDC director must approve the ACIPs recommendation in order for it to become policy, which is likely to happen, Auwaerter says.

If You’re Ages 50 To 64

The choices include the regular flu shot, the new quadrivalent flu shot, the tiny-needle shot and the egg-free Flucelvax.

Should I get the quadrivalent vaccine?

For somewhat younger adults, the quadrivalent shot may be ideal in terms of protection against flu. But here as well, studies have yet to prove superior performance over regular vaccine. And because it’s brand new this year, supplies are limited. Zimmerman says that if all the alternatives were offered at the same price, for people 50 to 64 he’d choose the quadrivalent vaccine. “However, I would not travel an extra 20 minutes for it,” he adds.

Is the tiny-needle shot a good option?

Those wary of needles can also opt for the tiny-needle or “intradermal” shot, which deposits the medicine under the skin rather than in the muscle, as a standard shot does. It’s been approved for people ages 18 to 64 and protects against three viral strains, same as the standard flu shot. It also can be harder to find than the standard flu shot.

What about the egg-free vaccine?

Anyone 18 or older who is hypersensitive to eggs a problem that’s actually far more common in young children can choose a vaccine whose virus is grown in mammalian cells rather than chicken eggs.

Katharine Greider is a freelance writer.

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Who Is Most At Risk

Complications from the flu can include serious conditions, like pneumonia or heart attacks and, in some cases, death. Flu causes about 12,200 hospitalizations and 3,500 deaths in Canada each year.

Some people are more vulnerable to complications and hospitalization from the flu:

• babies under 6 months old are too young to get the flu shot, but they’ll get some protection if their parent got the flu shot while they were pregnant
• children under 5 years of age, because their immune systems are developing, and their airways are small and more easily blocked
• people 65 years old and older, because their immune systems are weaker and they are more likely to have an underlying condition that increases their risk
• pregnant people, because their immune system, heart and lungs change especially later in pregnancy making them more likely to get seriously ill from the flu
• people with underlying health conditions, such as asthma, heart disease or diabetes

What To Do If Your Older Parent Or Relative Is Unwilling Or Unable To Get Vaccinated

Now, what if your older parent wont, or cant, get a flu shot?

Some older adults just dont want to get it. Here are some things you can try:

• Ask them to clarify what their concerns are. Its important to start by listening, in order to understand what an older person believes about the flu and the flu shot.
• Provide information to dispel myths and misunderstandings. Sometimes all people need is a little of the right kind of information.
• Point out that it can benefit an older persons family members and neighbors. Getting a flu shot can reduce the risk that we pass the flu on to another person. People are sometimes more willing to take action to protect others than to protect their own health.
• Make sure they know they wont have to pay for the flu shot. If you get the shot from a provider who takes Medicare, it shouldnt cost anything.
• Offer to go together to get your flu shots. Sometimes it helps to make it a family outing.

There are also some older adults for whom its hard to get a flu shot, such as people who are homebound or have very limited transportation options.

If this is your situation, the main thing to do is encourage flu shots for family and others coming to the house. For older adults who dont get out much, their main source of exposure to influenza and other dangerous viruses will be from those who come to them.

Above all, dont panic if your older loved one cant or wont get a flu shot.

This article was reviewed and updated in October 2021.

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