How Are Flu Vaccines For Seniors Different
Flu vaccines for seniors are made one of two ways:
- High-Dose flu vaccines are manufactured with four times more antigens than standard quadrivalent vaccines.
- Adjuvanted flu vaccines contain an additive to fortify a standard, quadrivalent vaccine.
The CDC has not made a specific recommendation for which high-dose flu vaccine is best for seniors. A healthcare professional will be able to help you determine which is best for your needs.
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.
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.
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Influenza And Preinfluenza Seasons
To improve the specificity of our outcomes, we defined a regional influenza season for each VAMC, based on Centers for Disease Control and Prevention multistate reporting regions . For each VAMC, we assigned season start and end dates based on influenza activity reported for that region. Using weekly reports of the percentage of positive influenza tests among all influenza tests performed in each region, we defined the regional influenza season as the weeks when the percentage of positive tests was 10% . We also defined a preinfluenza season as the period between 1 June 2010 and 31 August 2010, when the percentage of positive influenza tests was < 10% nationally .
What Is The High
This year’s high-dose flu shot is called the Fluzone High-Dose Quadrivalent, and it’s the only licensed high-dose inactivated flu vaccine, according to the Centers for Disease Control and Prevention . This vaccine has four components to help boost your immunity to the flu.
For adults 65 and older, the high-dose flu vaccine is recommended. “This type of vaccine contains a lot more viral protein, which is used to stimulate immunity, than the regular flu vaccine,”infectious disease expert Amesh A. Adalja, MD, senior scholar at the Johns Hopkins Center for Health Security in Maryland, tells Health. Basically, the high-dose flu shot works in the same way as the regular flu shotdelivering inactivated virus to prompt the body to make antibodies. But it’s associated with a stronger immune response.
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Why should seniors get the high-dose vaccine? Because older adults are at a higher risk of flu complications. CDC studies estimate that this age group accounts for 70% to 85% of flu-related deaths and 50% to 70% of flu-related hospitalizations each flu season.
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Iv2 Types Of Vaccines Compared
There are no studies, at present, to compare the efficacy or effectiveness of 60g HA/strain inactivated intramuscular influenza vaccine to 1) 15g HA/strain inactivated intramuscular influenza vaccine containing an adjuvant, or 2) 15g HA/strain inactivated intradermal vaccine. Since these vaccines are manufactured specifically for use in older adults, a head-to-head comparison would be informative for decision-makers. Only one study compared the immune responses of older adults vaccinated with 60g HA/strain to those vaccinated with 15g HA/strain intradermal vaccine and none have compared the immunogenicity of the 60g HA/strain product to 15g HA/strain intramuscular influenza vaccine containing an adjuvant.
There are also no studies that compare any of these vaccines with the quadrivalent influenza vaccines. Although a previous review found similar immune responses and safety profiles for inactivated quadrivalent compared with inactivated trivalent influenza vaccines in older adults, no studies have assessed the efficacy or effectiveness of the quadrivalent vaccines in seniors.
Flu & People 65 Years And Older
People 65 years and older are at higher risk of developing serious flu complications compared with young, healthy adults. This increased risk is due in part to changes in immune defenses with increasing age. While flu seasons vary in severity, during most seasons, people 65 years and older bear the greatest burden of severe flu disease. In recent years, for example, its estimated that between 70 percent and 85 percent of seasonal flu-related deaths have occurred in people 65 years and older, and between 50 percent and 70 percent of seasonal flu-related hospitalizations have occurred among people in this age group.
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Time For Your Flu Vaccine: Do You Need A Higher Dose
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Images: Thinkstock To avoid a miserable case of the flu and the complications it can cause, get a flu shot before the start of the season, ideally in early fall. |
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.
What Is The Difference Between Fluzone High
Fluzone High-Dose Quadrivalent contains four times the antigen, the part of the vaccine that helps your body build up protection against flu viruses, than Fluzone Quadrivalent and other standard-dose inactivated flu vaccines. The higher dose of antigen in the vaccine is intended to give people 65 years and older a better immune response to vaccination, and therefore, better protection against flu. Both Fluzone High-Dose and Fluzone Quadrivalent are produced by the same manufacturer and are quadrivalent vaccines. There are a number of other flu vaccines produced by other manufacturers.
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Increased Interest In Vaccinations
Chager identified, through her own professional experience during the COVID-19 pandemic, there has been increased interest in vaccines more broadly.
I’ve actually seen it with other vaccinations as well, not just influenza, she said. I’d say that maybe there is just a little bit more acceptance of the value of vaccinations.
Pharmasave conducted a survey 7,000 consumers across Ontario and Atlantic Canada, which found that 86 per cent of respondents said they plan to get a flu shot this year, up from 78 per cent last year.
I’m sure that the fall season and patients being really uneasy about getting sick during these months has a lot to do with the sentiment to get the influenza vaccination, Chager said.
In Ontario, its recommended that anyone six months and older receive the influenza vaccination but pharmacies are only able to inject in people over the age of five.
Design Overview And Data Sources
We conducted a retrospective cohort study to compare clinical outcomes of receiving HD vs SD influenza vaccination among community-dwelling elderly patients in the VHA during the 20102011 influenza season. We evaluated rates of hospitalization for influenza or pneumonia as the primary outcome, and examined hospitalization for all causes and mortality as secondary outcomes. The VHA Statistical Analysis System National Patient Care Database and VHA Decision Support System National Data Extracts were used to identify patients’ influenza vaccinations and to determine patient covariates and hospitalization status. These datasets consist of administrative records for all inpatient and outpatient encounters within the VA health system, and include patient age, sex, race/ethnicity, healthcare service locations and dates, diagnosis and procedure codes, and pharmacy records. Mortality was determined using the VHA Vital Status File, which combines multiple VA and non-VA data sources and contains dates of death for Veterans who since 2002 have received care, compensation, or pension benefits from the VHA, or are enrolled in the VHA .
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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.
Types Of Flu Shots For People 65 And Older
People 65 years and older should get a flu shot, not a nasal spray vaccine. They can get any flu vaccine approved for use in their age group with no preference for any one vaccine over another. There are regular flu shots that are approved for use in people 65 years and older and there also are two vaccines designed specifically for this age group:
High Dose and Adjuvanted Flu Vaccine Side Effects
The high dose and adjuvanted flu vaccines may result in more of the temporary, mild side effects that can occur with standard-dose seasonal flu shots. Side effects can include pain, redness or swelling at the injection site, headache, muscle ache and malaise, and typically resolve with 1 to 3 days.
Recombinant Vaccine
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What Are Flu Vaccines For Seniors
Often referred to as High-Dose , based on the brand name of one popular flu vaccine, flu vaccines for seniors are super-charged to help keep people 65+ healthy throughout the flu season. The two approved vaccines for people 65+ either contain four times the antigens of a regular flu shot or an additive known as an adjuvant.
Both offer greater, but about the same as one another, protection from illness than standard egg-based quadrivalent vaccines, studies have shown.
Achilles’ Heels Of The Current Influenza Vaccines
The success of current influenza vaccination campaigns depends heavily on extensive surveillance and manufacturing resources to ensure timely vaccine delivery. Given that each component of the vaccine is updated every 2 to 3 years on average, it is not too surprising that there are occasional problems. Some of the Achilles’ heels of the current influenza vaccine pipelines and the strategies needed to address them are summarized as follows.
Variable efficacy in specific populations. Influenza vaccines are relatively poorly immunogenic and do not induce long-lasting serum antibody titers. In the elderly, waning immunity also means poor responsiveness to vaccines. Therefore, strategies are required to improve the immune response to vaccine, especially in various at-risk target populations.
Variable virus. Antigenic matching between vaccine strains and circulating strains is critical. Current strategies to address this include improvement of global surveillance and the development of new-generation vaccines that target conserved regions of the virus.
Limited vaccine availability in resource-limited countries. Although not specific for influenza vaccines, there is great disparity in vaccine availability in countries throughout the world. More scalable platforms and cheaper vaccines that induce longer-lasting immunity are needed to address this need.
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Iii2 Efficacy And Effectiveness
Four studies comparing the relative efficacy of high dose vaccines were identified and described below.
The relative efficacy of Fluzone®High Dose compared with Fluzone® has been evaluated in two studies to date. The first study of 9158 ambulatory, medically-stable adults 65 years and older was conducted in 2009-2010 during the H1N1 pandemicFootnote 21. The relative efficacy was 12.5% in favour of Fluzone®High Dose against laboratory-confirmed influenza, but with exceedingly wide confidence bounds in this study 21 of the 22 symptomatic cases of influenza were caused by the Apdm09 strain, which was not in the seasonal vaccine.
The second study was conducted in 2011-2012 and 2012-2013 Footnote 22. In this study of almost 32,000 older adults, 18-24% fewer illnesses caused by influenza occurred in people who received Fluzone®High Dose compared with those who received Fluzone®. The relative efficacy against laboratory-confirmed influenza of the high dose vaccine compared to the standard dose vaccine was 18% in participants who provided swabs when they had an acute respiratory illness, with 2.0% and 2.4%, respectively, diagnosed with influenza. The relative efficacy against laboratory-confirmed influenza was 24% , with 1.4% and 1.9%, respectively, diagnosed with influenza, in those who provided swabs when they had an influenza-like illness ).
Vaccines For Adults 65+
Influenza can make older adults very sick. Two vaccines are approved just for seniors to give better protection against the flu. A high-dose flu vaccine is the preferred choice for adults 65 years and older. It protects against four strains of the influenza virus. If this vaccine is not available, then Fluad® is recommended. Both of these vaccines may cause more soreness, redness and swelling where the vaccine was given, lasting a few days longer than the standard vaccine. If neither of these vaccines are available, do not delay in getting vaccinated. All flu vaccines provide good protection.
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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.
Current Flu Vaccine Recommendations For People 65 And Up
There are regular flu shots that are approved for people 65 and older and two that are specially designed for this group. One is the high-dose flu vaccine.
This vaccine, which is also known as Fluzone High-Dose, contains four times the amount of antigenthe inactivated virus that creates an immune responsethan a regular flu shot. Its linked to higher antibody production after the vaccine. Research has actually shown that older adults who receive this flu shot have 24% fewer cases of the flu than those who get the regular flu shot.
The other flu vaccine thats specially designed for the 65-and-up group is the adjuvanted flu vaccine, also known as Fluad Quadrivalent. Its formulated with an adjuvant, which is a special ingredient that creates a stronger immune response. The adjuvanted flu vaccine also creates a higher immune response than in people who get a standard flu shot.
When given a choice, most seniors opt for the high-dose, perhaps, because it has been on the market longer and more people are aware of it, Amesh A. Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security, told Verywell.
The adjuvanted vaccine first became available in the U.S. during the 2016-2017 flu season.
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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, external icon 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.