Tuesday, March 21, 2023

What Age Is High Dose Flu Vaccine

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Cdc Is Considering Recommending A High

High Dose Influenza Vaccine Under Age 65: Dr. David Liew

Heather Mercer is native to Northwest Ohio and graduated from Loma Linda University with two doctorate degrees . She is currently a professor at Owens Community College, as well as a fact-checker for Verywell Health. She has gained experience in a variety of settings, ranging from corporate wellness and preventive medicine, to mental health, chronic disease, and end-of-life care.

What Is The Cost Of The Flu Shot

You may have concerns about the cost of getting an annual flu vaccination. The cost varies depending on where you go and whether you have insurance. In some cases, you may be able to get the flu shot free of charge or at a low cost.

Typical prices for the adult flu vaccine range between $0 and $40 , depending on the vaccine you receive and your insurance coverage.

Ask your doctor about getting the flu shot during an office visit. Some pharmacies and hospitals in your community may provide vaccinations. You can also research flu clinics at community centers or senior centers.

Note that some of the typical providers like schools and workplaces may not offer them this year due to closures during the COVID-19 pandemic.

Use websites like Vaccine Finder to find locations near you that offer the flu vaccine, and contact them to compare costs.

The sooner you get a vaccination, the better. On average, it can take up to 2 weeks for your body to produce antibodies to protect against the flu. The Centers for Disease Control and Prevention recommends getting a flu shot by the end of October.

What Is In The Influenza Vaccine

Information on specific ingredients included within individual influenza vaccines can be found on the label of the medicine, the Product Information and Consumer Medicine Information leaflets for each individual vaccine. You can ask your pharmacist for a copy or find it through our CMI database by searching the product’s name. The CMI provides the full list of ingredients for each product.

Additionally, information on medicines supplied in Australia, including ingredients, can be located by searching the Australian Register of Therapeutic Goods either by product name or ARTG number.

Influenza vaccines available for the 2022 influenza season within Australia do not contain any thiomersal/mercury.

Formaldehyde is used in the early stages of manufacture of some influenza vaccines as an inactivation agent. The formaldehyde is removed in the latter stages of manufacture and the product is tested to ensure formaldehyde levels are below detectable limits before the final product can be released.

All influenza vaccines available this year are latex free. However, the possibility that the product may have come into contact with instruments which contain latex cannot be excluded. Patients who are extremely sensitive to latex should consult their doctor for advice.

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Iv Vaccine Preparations Authorized For Use In Canada: Additional Information

The following sections describe information on the efficacy and effectiveness, immunogenicity, and safety of influenza vaccines that are authorized for use in Canada by type: IIV and LAIV. Refer to Appendix A for a summary of the characteristics of specific influenza vaccine products available in Canada for the 2020-2021 season.

NACI acknowledges that evidence related to influenza vaccine performance, particularly with respect to vaccine efficacy and effectiveness, is constantly evolving with advances in research methodology and accumulation of data over many influenza seasons. Therefore, the evidence summarized in this section may not include the latest studies. However, in accordance with usual practice, NACI continues to closely monitor the emerging evidence on the efficacy and effectiveness, immunogenicity, and safety of influenza vaccines to update and to make recommendations when warranted.

Why A High Dose Flu Vaccine Might Be Better


The high-dose flu vaccine usually generates a stronger immune response, Richard Watkins, MD, an infectious disease physician and professor of medicine at the Northeast Ohio Medical University, told Verywell. As a result, he said, the idea of recommending this vaccine over the adjuvanted vaccine for seniors seems like a reasonable course of action.

Seniors are at high risk for severe influenza and respond poorly to standard vaccines, Adalja said. High dose vaccines improve the immunogenicity of the vaccine.

But Schaffner stressed that no decision has been made just yet. We will have to wait and see, he added.

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Iv5 Additional Vaccine Safety Considerations

Influenza vaccine is safe and well tolerated. Contraindications, precautions, and common AEs are described in Section II. Additional information regarding egg-allergic individuals and GBS is provided below.

Egg-allergic individuals

After careful review of clinical and post-licensure safety data, NACI has concluded that egg-allergic individuals may be vaccinated against influenza using any appropriate product, including LAIV, without prior influenza vaccine skin test and with the full dose, irrespective of a past severe reaction to egg and without any particular consideration, including vaccination setting. The amount of trace ovalbumin allowed in influenza vaccines that are authorized for use in Canada is associated with a low risk of AE. The observation period post-vaccination is as recommended in Vaccine Safety in Part 2 of the CIG. As with all vaccine administration, vaccine providers should be prepared with the necessary equipment, knowledge, and skills to respond to a vaccine emergency at all times.

Refer to the Statement on Seasonal Influenza Vaccine for 2018-2019 for safety data supporting this recommendation for IIV and LAIV.

Guillain-Barré syndrome

Simultaneous Administration With Other Vaccines

It is safe to administer a COVID-19 vaccine at the same time as other vaccines, such as the influenza vaccine.

For people 12 years of age and older, seasonal influenza vaccines may be given:

  • at the same time as a COVID-19 vaccine
  • at any time before a COVID-19 vaccine
  • at any time after a COVID-19 vaccine

For children aged 5 to 11, NACI recommends that a 14-day interval between a COVID-19 vaccine and other vaccines, such as the flu vaccine, be considered. This is a precaution to assist with the monitoring of possible side effects from a COVID-19 vaccine. Provinces and territories will decide on an interval for this age group as part of their vaccination programs.

NACI will continue to:

  • monitor the evidence base, including ongoing and anticipated trials investigating influenza vaccines administered at the same time as, or any time before or after, COVID-19 vaccines
  • update its recommendations as needed

Consult the NACI guidance concerning the use of COVID-19 vaccines for further information on the simultaneous administration of COVID-19 vaccines with other vaccines.

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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.

Evidence Behind The High

Manufacturing delay causes shortage of high-dose flu shot for seniors

A study published in The Lancet Infectious Diseases Journal found the high-dose vaccine to be 22 percent more effective than the standard dose vaccine for flu prevention among people 65 and older. Additionally, the study showed a significant reduction in flu-related hospital admissions among those who were administered the high-dose vaccine.

Fishbein adds, âHigh-dose vaccines are recommended for people 65 and older because their immune systems are weaker and they are more likely to die from flu. High-dose vaccines contain more flu proteins called antigens. This means that there are more of the vaccine ingredients in order for the body to create a stronger antibody response. A higher dose is necessary for people 65 and older because they comprise the majority of flu hospitalizations.â

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Possible Side Effects Of Influenza Vaccination

You may experience minor side effects following vaccination. Most reactions are mild and last no more than a couple of days and you will recover without any problems.

Common side effects of influenza vaccines include:

  • pain, redness, swelling or hardness where the needle went in
  • fever, tiredness, body aches.

Talk to your immunisation provider about possible side effects of the influenza vaccines, or if you or your child have side effects that worry you.

The Consumer Medicine Information available on the Therapeutic Goods Administration website lists the ingredients and side effects of each vaccine.

Learn more about the possible side effects of vaccination

If An Inactivated Influenza Vaccine Approved For Adult Use Is Inadvertently Administered To A Child Is This Considered A Valid Dose

If an inactivated influenza formulation approved for adults is inadvertently administered to a child, this should be counted as a single valid dose for the child. However, this is considered a vaccine administration error. Healthcare personnel should take steps to determine how the error occurred and put strategies in place to prevent it from happening in the future. In addition, we encourage providers to report all vaccine administration errorseven those not associated with an adverse eventto the Vaccine Adverse Event Reporting System external icon. A discussion of strategies to prevent errors can be found in the Vaccine Administration chapter of Epidemiology and Prevention of Vaccine-Preventable Diseases . Additional resources can be found on CDCs vaccine administration web page.

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High Dose Vaccine For Flu

Known as Fluzone High-Dose Quadrivalent, the high-dose flu vaccine is the only approved vaccine that consists of an inactivated influenza . Note that the high-dose flu vaccine is a quadrivalent, which means it includes four distinct influenza virus strains that help in killing bacteria in a persons body. Every year, the vaccines specific composition varies in order to match the strains that are likely to circulate throughout flu season.

Below are the strains included for this year:

  • Two type A influenza viruses H1N1 and H3N2
  • Two type B influenza viruses Victoria and Yamagata lineages

How To Get Vaccinated Against Influenza

A special high

Influenza vaccines are given as an injection, usually in the upper arm. It is important to get the right vaccine for your age. Your immunisation provider can tell you which vaccine they will use for you or your child’s influenza immunisation.

Influenza vaccines available under the NIP for the 2022 season include:

  • VaxiGrip Tetra

The Therapeutic Goods Administration website provides product information and consumer medicine information for each vaccine available.

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A Staff Member Inadvertently Administered The Wrong Dosage Of Influenza Vaccine How Do We Correct This

If a smaller than recommended dose of any inactivated influenza product is inadvertently administered, additional vaccine should be given so that the patient receives a full dose. The amount of vaccine that should be administered is based on when the patient is available to be revaccinated. For example:

  • If a partial dose of an inactivated influenza vaccine product is administered and revaccination can occur on the same clinic day, the patient should receive a remaining volume to total the correct dosage. For example, if the correct dosage for the patient is 0.5 mL and they received only 0.25 mL, an additional 0.25 mL should be given if revaccination can occur on the same day.
  • If the patient cannot be revaccinated until the next day or later, a full dose of inactivated influenza vaccine should be administered as soon as the patient can return.
  • If a larger dose of influenza vaccine is inadvertently administered, count the dose as valid. Revaccination with additional vaccine is not needed.

Giving an incorrect dose is considered a vaccine administration error. Healthcare personnel should take steps to determine how the error occurred and put strategies in place to prevent it from happening in the future.

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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V Choice Of Seasonal Influenza Vaccine: Additional Information

With the recent availability of a number of new influenza vaccines, some of which are designed to enhance immunogenicity in specific age groups, the choice of product is now more complex. Section II.5 summarizes NACI’s recommendations on the choice of currently authorized influenza vaccines. This section provides more details for these recommendations.

Naci Influenza Working Group

High dose flu vaccine for elderly

Members: I Gemmill , L Cochrane, N Dayneka, R Harrison, K Klein, D Kumar, J Langley, J McElhaney, A McGeer, D Moore, S Smith, and B Warshawsky.

Former member: M Lavoie.

Liaison representatives: L Grohskopf .

Ex-officio representatives: C Bancej , P Wolfe-Roberge , and J Xiong .

Former ex-officio representative: K Watkins .

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What Are The Benefits Of The Flu Vaccine

The flu vaccine may keep you from getting the seasonal flu. This can save you time and money . The flu vaccine can also help prevent the spread of the flu to others. And the flu vaccine can help protect the babies of women who got the vaccine while they were pregnant.

If you do get the flu, your symptoms may be milder and you may be less likely to have other health problems from the flu.

The flu shot may cause mild problems, such as soreness, redness, and swelling on the arm where you got the shot. You might also have a fever and muscle aches for a day or two after you get the vaccine.

The flu vaccine can’t cause the flu.

The risk of a serious problem from the flu vaccine is very small.

Should I Repeat A Dose Of Injectable Influenza Vaccine Administered By An Incorrect Route

Yes if a formulation labeled for intramuscular injection is given by the subcutaneous or intradermal route, it should be repeated. The dose may be administered as soon as possible. There is no minimum interval required between the invalid dose and the repeat dose.

Administering vaccine by the wrong route is considered a vaccine administration error. Healthcare personnel should take steps to determine how the error occurred and put strategies in place to prevent it from happening in the future.

In addition, we encourage providers to report all vaccine administration errorseven those not associated with an adverse eventto the Vaccine Adverse Event Reporting System external icon. A discussion of strategies to prevent errors can be found in the Vaccine Administration chapter of Epidemiology and Prevention of Vaccine-Preventable Diseases . Additional resources can be found on CDCs vaccine administration web page.

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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?

Who Should Get Vaccinated Against Influenza


Yearly influenza vaccination is recommended for people aged 6 months and over. Anyone who wants to protect themselves against influenza can talk to their immunisation provider about getting vaccinated.

The Australian Immunisation Handbook includes more information about specific groups who should get vaccinated against influenza.

The following people are more at risk of complications from influenza and are eligible for annual influenza vaccination free under the National Immunisation Program:

  • Aboriginal and Torres Strait Islander people aged 6 months and over
  • Children aged 6 months to under 5 years
  • Pregnant women at any stage of pregnancy
  • People aged 65 years or over.
  • People aged 6 months or over who have medical conditions that mean they have a higher risk of getting serious disease:
  • cardiac disease
  • haematological disorders
  • children aged six months to 10 years on long term aspirin therapy.

Children under nine years receiving their influenza vaccination for the first time require two doses of vaccine, spaced by a minimum of one month.

In some states and territories, influenza vaccines may also be provided for free to other people not listed above. Speak to your immunisation provider or contact your state or territory Department of Health to find out.

People who are not eligible for a free vaccine can purchase the vaccine from their immunisation provider.

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