Which Influenza Vaccination Is Best For Older Adults
Looking at the list of available flu shots can be overwhelming. In looking at this years CDC table of available influenza vaccines, I counted eight options that are available for people aged 65 or older:
- 4 standard-dose quadrivalent inactivated vaccines
- 1 standard-dose quadrivalent inactivated vaccine manufactured with a newer cell culture-based technology
- 1 high-dose quadrivalent inactivated vaccine
- 1 standard-dose quadrivalent adjuvanted inactivated vaccine
- 1 quadrivalent recombinant vaccine
Only Fluzone High-Dose Quadrivalent and Fluad Quadrivalent carry an age indication specific to 65 years or older.
However, the CDC does not recommend any influenza vaccine over another, for adults aged 65 or older.
So if you are an older adult, or if youre trying to arrange a flu shot for an aging relative, which flu vaccine should you try to get?
My take is this: if you have a choice, go for one of the vaccines designed for older adults.
Why? Because we know that as people get older, their immune systems tend to respond less vigorously to immunization. And because research suggests that the high-dose flu shot generates higher antibody titers and has been associated with better influenza outcomes.
We do have more research and experience for Fluzone High-Dose than for Fluad, so unless you are enrolling in a clinical trial of Fluad, I would suggest going with the Fluzone High-Dose.
New Flu Vaccine Available This Winter For Those Aged 65 And Over
A more effective flu vaccine is available this winter for those aged 65 and over, which could prevent deaths and reduce the burden on the NHS.
- 12 September 2018
Delegates at the Public Health England conference heard that a more effective flu vaccine for those aged 65 and over this winter has the potential to prevent deaths and significantly reduce the burden on the NHS.
The vaccine, available for the first time this year in the UK for those aged 65 and over, could reduce GP consultations by 30,000, hospitalisations by over 2,000 and prevent over 700 hospital deaths from flu in England, alleviating some of the health burden that seasonal flu places on the population, workplaces and the NHS.
The newly available adjuvanted vaccine is expected to significantly boost effectiveness by improving the bodys immune response to the vaccine. This is important because typically, older adults bodies do not respond as well to the flu vaccine due to their naturally weaker immune systems. Older adults are also more likely to suffer complications from flu.
The broader flu vaccination programme will also be improved by offering all eligible adults under 65, including pregnant women and those with long-term health conditions, the quadrivalent vaccine in injected form.
This protects against a total of four strains of flu two strains of flu A and two strains of flu B.
Professor Paul Cosford, Medical Director at PHE, said:
Chief Medical Officer, Professor Dame Sally Davies said:
Can The Flu Shot Give Me The Flu
No. All flu vaccines used in Australia are inactivated, which means they do not contain the live flu virus so you can’t catch the flu from the vaccine.
Less than 1 in 6 people experience side effects from the flu shot that are similar to the early signs of the flu. These may include fever, tiredness and muscle aches. These side effects can start within a few hours of vaccination and sometimes last for 1 to 2 days. They usually go away on their own, once your body has developed an immune response to the vaccine, which will protect you from the flu virus.
Its important to remember that the side effects show the vaccine is triggering an immune response, which is what its designed to do.
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Who Needs To Get A High
Fluzone High-Dose Quadrivalent is only FDA-approved for people over 65, so if youre younger than that, you should stick to the regular dose vaccine. Speak with your healthcare provider to decide which available flu vaccine is the best option for you.
If youre over 65 and questioning your flu vaccines options, contact your healthcare provider. Theyll let you know which of the three CDC-recommended flu vaccines for people over 65 is the best for you.
If your pharmacy or healthcare providers office doesnt have high-dose flu vaccines in stock, its recommended to get vaccinated with a regular dose vaccine instead of waiting for Fluzone High-Dose Quadrivalent to be restocked. A regular dose vaccine will still offer you protection against the flu.
Which Flu Vaccine Is The Most Effective
When flu vaccines are being produced, the strains included are standardized by the FDA. Each 2021-2022 vaccine includes:
Two type B viruses
This means that no matter what vaccine you choose, youre being protected against the same strains. Flu vaccines are typically between 40% and 60% effective from year to year. But when it comes to picking the right flu vaccine for you, you have to take other factors into account.
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Who Should Have The Flu Shot
The Australian Government recommends that everyone over the age of 6 months has a flu vaccination every year.
Its difficult to predict who will catch influenza , or who will become seriously ill from it. The flu can require hospitalisation and can even be fatal.
Getting vaccinated against the flu helps protect both you and the people around you. Its particularly important to protect vulnerable people in the community who cant be vaccinated, such as babies who are younger than 6 months and adults with low immunity.
How Are Benefits Of Vaccination Measured
Public health researchers measure how well flu vaccines work through different kinds of studies. In randomized studies, flu vaccination is randomly assigned, and the number of people who get flu in the vaccinated group is compared to the number who get flu in the unvaccinated or placebo group. Randomized studies are the gold standard for determining how well a vaccine works. The effects of vaccination measured in these studies is called vaccine efficacy. Randomized, placebo-controlled studies are expensive and are not conducted after a recommendation for vaccination has been issued, as withholding vaccine from people recommended for vaccination would place them at risk for infection, illness and possibly serious complications. For that reason, most U.S. studies of vaccine benefits conducted after a vaccine is licensed and recommended are observational studies. Observational studies look at a group of people in a real world setting and compare the occurrence of flu illness in vaccinated people to unvaccinated people. This means that vaccination of study subjects is not randomized. The measurement of vaccine effects in an observational study is referred to as vaccine effectiveness.
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Is The Flu Vaccine Safe In Pregnancy
Yes. Studies have shown that it’s safe to have the flu vaccine during any stage of pregnancy, from the first few weeks up to your expected due date.
Women who have had the flu vaccine while pregnant also pass some protection on to their babies, which lasts for the first few months of their lives.
It’s safe for women who are breastfeeding to have the vaccine.
Flu Vaccine And Coronavirus
Flu vaccination is important because:
- more people are likely to get flu this winter as fewer people will have built up natural immunity to it during the COVID-19 pandemic
- if you get flu and COVID-19 at the same time, research shows you’re more likely to be seriously ill
- getting vaccinated against flu and COVID-19 will provide protection for you and those around you for both these serious illnesses
If you’ve had COVID-19, it’s safe to have the flu vaccine. It will still be effective at helping to prevent flu.
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Live Attenuated Influenza Vaccine
Children 2-17 years of age who are eligible for an influenza vaccine can receive FluMist® Quadrivalent by nasal spray.
The nasal spray vaccine will be available at health units, some pharmacies and some doctors’ offices. Pharmacists will be able to give the nasal spray flu vaccine to children 2 years of age and older. The Influenza Clinic locator will list if a nasal spray vaccine is available at that clinic. Call ahead to confirm. The nasal spray vaccine is not approved for use in those younger than 2 years of age and they should receive their influenza vaccine by needle.
Flu Vaccine For Frontline Health And Social Care Workers
If you’re a frontline health and social care worker, your employer should offer you a flu vaccine. They may give the vaccine at your workplace.
You can also have an NHS flu vaccine at a GP surgery or a pharmacy if:
- you’re a health or social care worker employed by a registered residential care or nursing home, registered homecare organisation or a hospice
- you work in NHS primary care and have direct contact with patients this includes contractors, non-clinical staff and locums
- you provide health or social care through direct payments or personal health budgets, or both
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Why Do We Need New Vaccines For Flu
Australia’s National Immunisation Program provides free influenza vaccine for the elderly, as well as other high-risk groups including pregnant women, those with chronic diseases and Indigenous Australians.
Older people’s immune systems don’t respond to flu vaccines as well as younger people’s.
Recent studies have also shown flu vaccines don’t appear to be as effective in the elderly at protecting against flu and its complications.
Compounding this problem is that the flu subtype that tends to affect older people is different to that which affects younger people .
Although the seasonal flu vaccine now contains four strains to cover all the relevant subtypes present, the protection against H3N2 infection appears to be poorer than against other strains.
Two strategies are attempting to improve the effectiveness of flu vaccines.
One is to increase the dose of the flu strains in the vaccine. This is the basis for Sanofi’s High Dose FluZone vaccine, which contains four times the amount of flu antigen than the standard dose.
Another way is to add a substance that improves the immune response, known as an adjuvant, in combination with the flu strains.
This is the basis for Seqirus’ Fluad vaccine, which contains the adjuvant MF59.
This vaccine has been used overseas for many years, but has only been become available in Australia this year.
Influenza Immunisation Program Advice 2022
View a summary of the Queensland government’s 2022 influenza immunisation program advice which provides important information specific to Queensland including:
- which vaccines to give for specific age groups
- information regarding people with medical conditions who are eligible for funded influenza vaccine
- vaccine ordering and supply details.
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Who Is Most At Risk
Flu can affect you at any age, but some people are more at risk thanothers.
You are strongly advised to get the flu vaccine if you are:
- 50 years or older
- Aged from 2 to 17
- Living with a long-term health condition
- Living in a nursing home or other long-term care facility
- A carer
- In regular contact with pigs or poultry
Can Seniors Get A Covid
COVID-19 vaccines and booster shots may cause side effects similar to senior flu shots. It is still unknown whether coadministration of these vaccines leads to more reactivity to ingredients, sensitivity, or side effects, according to the CDC.
If youve received or are planning to receive a COVID-19 vaccine or booster along with a senior flu shot, heres what you need to know:
- After at least six months of receiving the second dose of the Pfizer-BioNTech vaccine, you are eligible for a booster shot.
- If you received Moderna or Johnson & Johnson vaccines, you are currently not eligible for a booster shot.
- The Pfizer-BioNTech booster shot has been authorized for people 65 and older and for high-risk individuals.
- Getting the senior flu shot will not offer protection against COVID-19 and vice versa.
- COVID-19 vaccines may be administered with flu vaccines, although it is still unknown whether vaccine side effects increase with coadministration, according to the CDC.
You should first consult your loved ones doctor to figure out what could work best for them.
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Besides Vaccination How Can People Protect Themselves Against The Flu
Getting a flu vaccine each year is the best way to prevent the flu. In addition to getting the flu shot, people should take the same everyday preventive actions to prevent the spread of flu, including covering coughs, washing hands often, and avoiding people who are sick. Antiviral drugs are an important second line of defense to treat the flu. These drugs are not a substitute for vaccination and must be prescribed by a health care provider.
What Should Seniors Know About The Inactivated Influenza Vaccine
Influenza vaccines are a safe and effective way to help people stay healthy, prevent illness and even save lives. As people age, they may be at higher risk of complications from influenza. For this reason, seniors age 65 years and older are advised to get an inactivated influenza vaccine or flu shot each year.
The inactivated influenza vaccine is provided free to seniors age 65 years and older. Contact your health care provider to get your influenza vaccine.
The inactivated influenza vaccine is safe. It contains killed influenza viruses that cannot cause influenza. Common reactions to the vaccine include redness, soreness or swelling where the vaccine was given.
Mild symptoms may occur in some people after being immunized, especially those receiving the vaccine for the first time. Symptoms can include fever, headache, aching muscles and fatigue that may last 1 to 2 days. These symptoms are less severe and last a shorter time compared to influenza infection.
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What You Need To Know About The 2021
While no one knows for sure just how bad the upcoming flu season will be, heres some flu information we know so far:
The 2020-2021 flu season wasunusually mildcompared to whats been seen in past years. This could be due to multiple factors, including higher flu vaccination rates during 2020 and the effect the COVID-19 pandemic has had on social distancing and hand washing. Experts are not sure if this will be the case again for the 2021-2022 flu season.
Flu transmission rates in other countries are lower than usual so far this year. The World Health Organization meets twice a year in February and September to review flu activity around the world and recommend which strains to include in the flu vaccine. Flu transmission in the Southern Hemisphere countries like Australia can help predict what the U.S. flu season might be like. Australia had a record low number of cases of the flu during 2021. Hopefully, that means we will too.
Even though the flu vaccine doesnt protect against all strains of the flu, its still recommended for everyone over the age of 6 months. The flu vaccine is typically about 40% to 60% effective, and its hard to predict if the current flu vaccines will be a good match for the strains going around. But its still one of the best ways to help prevent getting sick with the flu.
How Much Better Are These Vaccines
Compared to the standard flu vaccine, the high-dose version has been shown to better stimulate the immune system of older users to make protective antibodies.
It has been shown to better reduce rates of flu infection in over-65s than the standard vaccine.
And, interestingly, it also seems to protect against pneumonia.
One common criticism of clinical trials is that they don’t include the types of people who are found in the “real world”.
But population-based observational studies suggest the high-dose vaccine is more protective than the standard-dose vaccine where H3N2 is the predominant circulating strain as it was last year.
What about the Fluad vaccine?
Compared to the standard vaccine, adjuvanted flu vaccine has been shown to better stimulate the immune system of older users to make protective antibodies.
Unlike the high-dose vaccine, there have not been clinical trials that show a difference in infection rates compared with the standard vaccine.
But observational data suggests the adjuvanted vaccine is more protective against hospitalisation with influenza or pneumonia to a similar degree as the high-dose vaccine.
One problem with both these vaccines is that they only contain three strains, rather than the four strains in the current vaccine.
The strain missing from the new vaccines is an influenza B type.
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Why Are Confidence Intervals Important For Understanding Flu Vaccine Effectiveness
Confidence intervals are important because they provide context for understanding the precision or exactness of a VE point estimate. The wider the confidence interval, the less exact the point value estimate of vaccine effectiveness becomes. Take, for example, a VE point estimate of 60%. If the confidence interval of this point estimate is 50%-70%, then we can have greater certainty that the true protective effect of the flu vaccine is near 60% than if the confidence interval were between 10% and 90%. Furthermore, if a confidence interval crosses zero, for example, , then the point value estimate of VE provided is considered not statistically significant. People should be cautious when interpreting VE estimates that are not statistically significant because such results cannot rule out the possibility of zero VE . The width of a confidence interval is related in part to the number of participants in the study, and so studies that provide more precise estimates of VE typically include a larger number of participants.