The Best Flu Vaccine For People Over 65
As we get older, our immune systems have a harder time responding to illnesses and vaccines. To help provide better protection, there are a few recommended options for older adults this year:
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Fluzone High-Dose Quadrivalent also known as the high-dose flu shot
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Fluad Quadrivalent
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Flublok Quadrivalent
If one of these three vaccines isnt available, you should still get vaccinated with another flu vaccine thats FDA-approved for your age range. All flu vaccines are effective against the flu. Its better to be vaccinated than to try to wait for a particular flu vaccine to become available.
/2022 Universal Influenza Immunization Program
The following provides information about the Ontario Ministry of Health Universal Influenza Immunization Program for the 2021/2022 influenza season. The UIIP offers influenza vaccine free of charge each year to all individuals six months of age and older who live, work or go to school in Ontario.
Vaccination against influenza will be important this fall given the potential for the co-circulation of COVID-19. Preventing the flu will be important not only to protect individual health and the health of families and communities, but also to protect and mitigate impacts on our health care system.
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:
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If You’re Age 65 And Older
The choices include the regular flu shot , the high-dose flu shot , the quadrivalent flu shot and the egg-free shot called Flucelvax.
Should you get the high-dose vaccine or standard one?
Talk to your doctor about whether you need a high-dose vaccine, but studies do show that people who receive the high-dose vaccine produce more antibodies infection-fighting proteins in the blood than those who get the regular dose. That’s important because vaccines work by provoking the immune system’s defenses against the target disease, and older people tend to mount a weaker response.
In fact, the high-dose vaccine was developed to address concerns that the standard-dose shot doesn’t work very well in people 65 and older, the very group most likely to be hospitalized or die from flu complications. Last year, for example, the CDC reported that season’s regular vaccine lowered an older person’s risk of flu by only 27 percent, an unexpectedly low level of effectiveness compared with a 63 percent reduction for people ages 50 to 64.
Whether the high-dose shot’s effect on blood antibodies will translate into substantially fewer people getting sick is not yet clear. But signs are good that it offers at least some advantage. In August the vaccine’s maker, Sanofi Pasteur, issued preliminary findings from an ongoing clinical trial showing the higher dose increased flu prevention by 24 percent over the standard dose.
What about the new quadrivalent vaccine?
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.
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What Is The Difference Between High
The high-dose flu vaccine has four times the amount of flu virus antigen and was created for people ages 65 and older. The purpose of an âenhancedâ vaccine is to help elicit a strong immune response even among people who have weaker immune systems. The standard-dose vaccines are effective for everyone under 65 years old.
This year, both the high-dose and standard-dose vaccines are quadrivalent, meaning they offer broader protection against four different flu viruses. Two of the viruses are influenza A viruses and two are influenza B viruses.
Below we outline the main differences between the standard and high dose influenza vaccines.
Standard Quadrivalent Flu Shot vs Fluzone High-Dose
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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.
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Who Shouldnt Get Quadrivalent Flu Vaccine
Different influenza vaccines are approved for use in people in different age groups. In addition, some vaccines are not recommended for certain groups of people. Factors that can determine a persons suitability for vaccination, or vaccination with a particular vaccine, include a persons age, health and any allergies to flu vaccine or its components. For more information, visit Who Should and Who Should NOT get a Flu Vaccine.
Mild Side Effects Of Fluzone High
Below we describe mild side effects* of both Fluzone High-Dose Quadrivalent and Fluzone Quadrivalent. Most of these side effects may go away within a few days or a couple of weeks. But if they become more severe or dont go away, talk with your doctor or pharmacist.
Mild side effects of both Fluzone High-Dose Quadrivalent and Fluzone Quadrivalent in adults can include:
- feeling tired or unwell
- muscle aches
- pain, redness, or swelling at the injection site
* The list above is a partial list of mild side effects from Fluzone High-Dose Quadrivalent and Fluzone Quadrivalent. To learn about other mild side effects, talk with your doctor or pharmacist, or visit the prescribing information for Fluzone High-Dose Quadrivalent influenza vaccine and Fluzone Quadrivalent influenza vaccine.
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Why Is There A Need For Flu Vaccines Designed Specifically For People 65 Years And Older
People 65 years and older are at increased risk of developing serious complications from flu compared with young, healthy adults. This is partly because human immune defenses become weaker with increasing age. During most seasons, people 65 years and older account for the majority of flu hospitalizations and deaths. In the United States, between about 70 percent and 85 percent of seasonal flu-related deaths and between 50 percent and 70 percent of seasonal flu-related hospitalizations have occurred among people 65 years and older. The weakened immune system can also mean that older people dont respond as well to flu vaccination. Given the higher risk of severe flu illness and lower protective immune response after vaccination among older adults, substantial research and development have led to the production of new flu vaccines intended to provide better immunity in this age group.
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What’s The Research Behind These Shots Do They Work
Research indicates that high-dose flu vaccines, such as Fluzone High-Dose and FLUAD, have improved a patient’s protection against the flu.
A peer-reviewed study published in The New England Journal of Medicineand sponsored by Sanofi, the company behind Fluzone High-Dose, found that the high-dose vaccine is about 24% more effective than the standard shot in preventing the flu.
An observational study in 2013 found that FLUAD is 51% effective in preventing flu-related hospitalizations for patients 65 and older.
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Kristin Englund, an infectious disease physician at the Cleveland Clinic, noted that some hospitals might carry only Fluzone High-Dose because there are more studies on it and it’s been on the market longer than FLUAD.
There are no studies that do a comparative analysis between the two vaccines. There also aren’t any studies that test the high-dose vaccine on younger patients, which is why the FDA licensed the vaccines only for people 65 and older.
Will these super-vaccines cost more money?
Schaffner said that because both vaccines are more elaborate than the normal dose, they cost more to make.
Both Fluzone High-Dose and FLUAD are covered by those who qualify for Medicare with no out-of-pocket cost.
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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:
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Two type A influenza viruses H1N1 and H3N2
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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:
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Formaldehyde an ingredient that kills the virus during vaccine production
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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.
Vaccine Wastage And Cold Chain Requirements
- Vaccine wastage due to spoilage or expiry is a concern for all immunization programs in Ontario, including the Universal Influenza Immunization Program. The Vaccine Storage and Handling Guidelines have been developed to facilitate proper storage and handling of publicly funded vaccines and minimize vaccine wastage as well as promote vaccine safety and effectiveness.
- When minimum cold chain requirements are not met by a health care provider or setting, the public health unit has the authority to withhold vaccines until compliance issues have been resolved or until completion of other follow-up deemed necessary to ensure appropriate vaccine storage and handling.
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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.
When Should I Get My Flu Vaccine
Flu vaccine effectiveness can have a lot to do with when you get it. Its recommended to get your flu vaccine about 2 weeks before flu season begins in your area preferably by the end of October. However, if you get the flu vaccine too early July or August, for instance you may not be protected for the entire flu season.
While September or October are the ideal times to get your flu vaccine, its still recommended to get it later than that if you were unable to do so earlier. If youre unsure when flu season begins in your area, talk to your local pharmacist or healthcare provider.
If youve recently received or will be receiving a COVID-19 vaccine including booster doses you dont have to wait a certain time to get the flu vaccine. You can even get them on the same day, if thats more convenient. These two vaccines arent known to interfere with each other.
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How Effective Is The Nhs Flu Immunisation Programme
The flu vaccine works better in some years than others . Across all age groups including children, the flu vaccine prevented 15-52% of flu cases between 2015 – 2020 .
Protection from the flu virus varies for different age groups. In children aged 2-17, the flu vaccine prevented 66% of flu cases in 2016-17, 27% of flu cases in 2017-18, and 49% of flu cases in 2018-19. However, in the over 65 age group the inactivated flu vaccine worked less well than it did in other adults and children. In 2016-17, the data suggest that the inactivated flu vaccine did not work at all in people aged over 65, whilst in 2017-2018 it resulted in slightly better results in that age group. Due to the lower effectiveness of the inactivated flu vaccine in older people, a vaccine containing an adjuvant was introduced for the 2018-19 season. This is a substance that strengthens and lengthens the immune response to the vaccine and resulted in better prevention of flu in people aged 65 or over in flu seasons since 2018-19. The adjuvanted vaccine is still recommended for this age group in the 2021-22 season.
It is not understood why flu vaccines do not work so well in older adults. However, this reinforces the importance of vaccinating children and healthcare workers, both of whom can help to stop the spread of flu to older adults.
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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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 Medicineexternal icon 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 Medicineexternal icon 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.
Financial And Insurance Assistance
If you need financial support to pay for Fluzone, or if you need help understanding your insurance coverage, help is available.
Sanofi Pasteur, Inc., the manufacturer of Fluzone, has an online tool that may help you estimate the cost of Fluzone High-Dose Quadrivalent. For more information about this, see the manufacturers website.
For additional cost assistance information about Fluzone, visit Medicine Assistance Tools site or talk with your doctor or pharmacist.
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Are Quadrivalent Flu Vaccines Safe
Yes. Flu vaccines that protect against four flu viruses have a safety profile similar to seasonal flu vaccines made to protect against three viruses, with similarmostly mildside effects. Like all seasonal flu vaccines, vaccines that protect against four flu viruses are monitored annually for their safety and effectiveness.
Quadrivalent vaccine cannot cause flu illness because they contain inactivated virus, attenuated virus, or are made using recombinant methods that dont use flu virus in the manufacturing process.
For information about flu vaccine side effects, see Can the flu vaccine give me the flu?