Flu Shot Options For Seniors
Millions of people get sick with each year.
Flu is typically a mild illness for many people, but for older adults, especially those who have chronic health conditions, the flu can be very serious.
Older adults are particularly at risk for infection, hospitalization and even death due to flu-related complications, such as pneumonia. This is why flu vaccine is especially important for people 65 years and older. It’s the best way to protect against the flu.
Are The New Vaccines Safe
Both vaccines are safe, but commonly cause mild side-effects, and very rarely can cause serious side-effects. However, these risks from the vaccine are less than from getting influenza infection.
The main side-effect of vaccines relates to their effect in stimulating the immune system.
In many people they cause a sore arm and, less commonly, a fever. The side-effects of these new flu vaccines are slightly more common than with standard vaccines.
Generally, these side-effects are mild and don’t last long.
None of the flu vaccines used in Australia contains live virus and therefore can’t cause flu infection. However, the vaccination season usually occurs around the same time as when another respiratory virus circulates, so this respiratory infection is commonly misattributed to vaccination.
Rare but serious side-effects, such as Guillain Barre Syndrome , have been described after flu vaccination.
Studies suggest the risk of these side-effects are less common after the flu vaccine than after flu infection.
People with allergies should discuss flu vaccines with their doctor. In the past, there has been concern the flu vaccines, which are manufactured in eggs, may elicit allergic reactions in people with egg allergy.
However, it is now thought people with egg allergies can receive flu vaccines safely under appropriate supervision.
In 2009, an adjuvanted vaccine was thought to be implicated in cases of narcolepsy in Europe.
Which Flu Vaccines Are Right For Seniors
Standard flu shot: The standard flu shot contains inactivated, or dead virus and is safe for ages 6 months and older who have not experienced contraindications to the vaccine.
Live Attenuated Influenza Vaccine nasal spray: The LAIV contains live but weakened influenza virus and is sprayed into the nose. This vaccine is NOT recommended for persons over 50 years of age.
Quadrivalent flu vaccine: The quadrivalent flu vaccine was created to protect recipients against four different flu viruses: two influenza A viruses and two influenza B viruses. For many years, flu vaccines only protected people against three strains of the flu virus, or were trivalent. When they were trivalent, the vaccines protected people against two A viruses but just one B virus. Adding protection against an additional B virus provides for even broader protection. Standard-dose quadrivalent shots are approved for people 3 years and older. However, as mentioned above, the quadrivalent nasal spray vaccine is NOT approved for people 50 and older.
High dose influenza vaccine: Seniors can choose a higher-dose vaccine that is designed specifically for people age 65 and older. Fluzone high-dose vaccines contain four times the amount of antigen found in regular flu shots. Because aging decreases the bodys ability to have a good immune response after vaccination, the additional antigen is intended to create a stronger immune response and thus better protection against the flu. Learn more here.
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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.
Safety And Side Effects

The inactivated flu vaccine does not contain the live virus and cannot cause flu. Flu vaccines have a very good safety record. The most commonly reported side effects of flu vaccines are:
- pain, swelling, bruising, hardness or redness at the injection site
- slightly raised temperature
- tiredness
- feeling generally unwell
A higher rate of these common side effects has been reported with Fluad, an adjuvanted trivalent vaccine which was recommended for people aged 65 and over in previous years. This year, Fluad Tetra is being offered to people aged over 65, which also uses an adjuvant. Side effects usually last 1-2 days.
There are several different makes of flu vaccine available each year. For more information on side effects, ask for the Patient Information Leaflet for the vaccine you are offered. Additional information about vaccine side effects, anaphylaxis and adverse reactions can be found here.
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Side Effects Of The Flu Vaccine
Similar to other types of vaccinations, theres a risk of side effects with the flu shot. Common side effects may include tenderness or redness at the injection site.
In addition, some people experience mild flu-like symptoms for 1 to 2 days after vaccination. This can include weakness, body aches, or a fever, but this isnt the flu.
You might have issues if youre severely allergic to eggs or another ingredient in the vaccine.
Signs of a serious reaction include:
- breathing difficulty
- dizziness
Life threatening allergic reactions are rare after getting the flu shot, though.
Symptoms of a reaction occur within a few hours of vaccination. If you do have symptoms of an allergic reaction, seek immediate medical attention.
The CDC recommends people with an egg allergy still get a flu shot. If you have a severe egg allergy, you may consider getting your flu shot in a medical setting that can treat allergic reactions. You can also request a vaccine that doesnt contain egg protein.
You may have to avoid vaccination if youre allergic to another ingredient in the vaccine.
In rare cases, Guillain-Barré syndrome may develop within days or weeks of a vaccination.
Guillain- Barré syndrome is a neurological disorder where the bodys immune system attacks the peripheral nervous system. This condition can cause muscle weakness and paralysis.
Among those who receive a vaccination, theres only
Adjuvanted Inactivated Flu Vaccine
Another vaccine specifically designed for seniors is the adjuvanted, inactivated flu vaccine. An adjuvant is a substance that increases your body’s reaction to virus proteins.
Medical term: Inactivated flu shots contain dead flu viruses. The antigens in the vaccine still provoke an immune response so you build up antibodies against the flu virus. Inactivated flu vaccines are typically recommended for people who are pregnant, are over the age of 65, or who have certain medical conditions.
The substance added to the adjuvanted flu vaccine is squalene oil, also called MF59, which is found naturally in plants and animals. “This gives an extra boost to the immune response to the vaccine which will then lead to greater protection from infection,” Haynes says.
Because the adjuvanted vaccine spikes your immune response, it may also have more side effects than the standard vaccine, including irritation at the injection site, muscle aches, and headache. However, the vaccine offers great protection for seniors a 2020 study found that people over 65 who got the adjuvanted vaccine were less likely to be hospitalized for the flu, compared with those who got the standard vaccine.
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Why Should Older Adults Get The Flu Shot
The flu shot is especially important for older adults because they tend to have weaker immune systems.
When the immune system isnt strong, it becomes harder for the body to fight off infections. Likewise, a weaker immune system can lead to flu-related complications.
Secondary infections that can develop with the flu include:
- ear infections
- bronchitis
- pneumonia
People ages 65 and older are at higher risk for serious complications. In fact, its estimated that as many as 85 percent of seasonal flu-related deaths occur in people ages 65 and older. Plus, up to 70 percent of seasonal flu-related hospitalizations occur in people ages 65 and older.
If you become ill after getting a vaccination, a flu shot may lessen the severity of symptoms of the illness.
Protecting yourself from the flu is increasingly important while COVID-19 is a factor.
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.
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Vaccines For Use In Over 65s
All eight vaccines in the above table of products are registered for use in those aged over 65 years.
The adjuvanted QIV, Fluad Quad and the non-adjuvanted Fluzone High-Dose Quadrivalent are specifically for use in elderly.
Fluad Quad can be used in individuals from 65 years of age and above.
Fluzone High-Dose Quadrivalent can be used in individuals from 60 years of age and above.
All people aged 65 years and over are eligible for free influenza vaccines under the NIP.
Adults Aged 18 Years And Older
In a clinical trial in subjects aged 18 years and older, FLULAVAL QUADRIVALENT exhibited immunogenicity noninferior to two trivalent inactivated influenza vaccine fomulations, each containing an influenza type B strain that corresponded to one of the two type B viruses in FLULAVAL QUADRIVALENT or a type B virus of the Yamagata lineage )1
- Noninferiority based on adjusted GMTs
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Best Timing For Vaccination
The timing of vaccination should aim to achieve the highest level of protection during the peak of the influenza season. Flu season in Queensland is typically from June to September, with the peak usually in August.
Vaccinating from April provides protection before the peak season takes place. While protection is generally expected to last for the whole season, the best protection against influenza occurs within the first 3 to 4 months following vaccination.
It is never too late to vaccinate since influenza can circulate in the community all year round. Vaccination should continue to be offered as long as influenza viruses are circulating and a valid vaccine is available.
It is also important to remind people that the vaccine is not immediately effective and it generally takes 10 to 14 days to be fully protected.
Revaccination late in the same year for individuals who have already received a vaccination is not routinely recommended, although not contraindicated. Revaccination may be considered for people travelling to the Northern Hemisphere in late 2020, who were vaccinated in early 2020. An individual’s risk factors, risk of disease and current circulating virus strains should be taken into consideration before recommending a second dose. A second dose is not funded under the National Immunisation Program and the individual will need to pay for the vaccine and consultation fee, if applicable.
The Best Flu Vaccine If You Have Egg Allergies

Many flu vaccines are made using chicken eggs called egg-based vaccines. While most people with egg allergies are still able to receive egg-based flu vaccines, there are rare instances where they can cause life-threatening allergic reactions. If this is the case for you or if youre concerned, Flucelvax Quadrivalent and Flublok Quadrivalent are two egg-free flu vaccine options.
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What Is In This Leaflet
This leaflet answers some common questions about Fluad® Quad.
It does not contain all the available information.
It does not take the place of talking to your doctor, nurse or pharmacist.
All medicines, including vaccines, have risks and benefits. Your doctor has weighed the risks of you having Fluad® Quad against the benefits they expect it will have for you.
If you have any concerns about Fluad® Quad, ask your doctor, nurse or pharmacist.
Keep this leaflet. You may need to read it again.
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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What Is The Senior Flu Shot
The senior flu shot is a vaccine developed specifically for adults age 65 and older to protect them against the flu virus. According to the CDC, seniors need stronger protection because immune systems tend to weaken with age, putting older adults at an increased risk of serious flu-related complications, such as pneumonia, other respiratory problems, hospitalizations, and even death. The flu can also worsen chronic conditions that are common in seniors like diabetes, asthma, and chronic obstructive pulmonary disease.
The senior flu shot creates a stronger immune response that helps older adults immune systems fight the flu virus more effectively than the regular flu shot. The vaccine works by stimulating the production of antibodies that protect seniors against the virus.
While older adults may get any flu vaccine approved for their age group, two flu vaccines were developed specifically for seniors: the high-dose flu vaccine and the adjuvanted flu vaccine.
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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Where Can Seniors Get A Flu Shot
Several locations offer senior flu shots, including doctors offices, local health departments, and pharmacies.
You may be worried about taking your senior relative to get a flu shot this year if COVID-19 is still spreading in your community. However, the CDC says its especially important for seniors and others who are at increased risk for flu complications to get vaccinated.
There are certain steps your loved one can take to stay safe when going to get the flu shot:
- Wear a mask to the vaccine appointment.
- If your loved one has a fever, hold off on vaccinating them until theyre feeling better.
- Wash hands frequently using soap and water for at least 20 seconds.
View CDC guidelines for more information on protecting yourself and senior relatives from the seasonal flu as well as COVID-19.
Flu Season Tips And Alerts
COVERAGE UNDER MAJOR HEALTH PLANS
FLUZONE® HIGH-DOSE QUADRIVALENT is free with Medicare Part B, and it may be covered with no co-payment or deductible under Medicare Advantage and private insurance plans.
FLUZONE® QUADRIVALENT INFLUENZA VACCINE
Helps protect people as young as 6 months of age against 4 different strains of the flu contained in the vaccine.
FLUBLOK® QUADRIVALENT INFLUENZA VACCINE
Proven flu protection in adults 50+, compared to a standard-dose influenza vaccine.
What are Fluzone® Quadrivalent, Flublok® Quadrivalent, and Fluzone® High-Dose Quadrivalent?
Fluzone Quadrivalent, Flublok Quadrivalent, and Fluzone High-Dose Quadrivalent are vaccines indicated for immunization against disease caused by influenza A and B strains contained in the vaccine. Fluzone Quadrivalent is given to people 6 months of age and older. Flublok Quadrivalent is given to people 18 years of age and older. Fluzone High-Dose Quadrivalent is given to people 65 years of age and older.
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