According to CDC.gov, it has been recognized for many years that people 65 years and older are at high risk of developing serious complications from flu compared with young, healthy adults. This is in part because human immune defenses become weaker with increasing age.
While flu seasons can vary in severity, during most seasons, people 65 years and older bear the greatest burden of severe flu disease. In recent years, for example, it’s estimated that between about 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. So, influenza is often quite serious for people 65 and older.
A Flu Vaccine is the Best Protection Against Flu
Flu vaccination has been shown to reduce flu illnesses and more serious flu outcomes that can result in hospitalization or even death in older people. In addition, if you get a flu vaccination but still get sick with the flu, the severity of your sickness may be reduced.
Flu vaccination is especially important for people 65 years and older because they are at high risk of developing serious complications from flu. Flu vaccines are updated each season as needed to keep up with changing viruses. Also, immunity wanes over a year so annual vaccination is needed to ensure the best possible protection against flu. A flu vaccine protects against the flu viruses that research indicates will be most common during the upcoming season. The 2019-2020 flu vaccine has been updated from last season’s vaccine to better match circulating viruses. Immunity from vaccination fully sets in after about two weeks.
Because of age-related changes in their immune systems, people 65 years and older may not respond as well to vaccination as younger people. Although immune responses may be lower in the elderly, studies have consistently found that flu vaccine has been effective in reducing the chance of medical visits and hospitalizations associated with flu.
Types of Flu Shots for People 65 and Older
People 65 years and older should get a flu shot and not a nasal spray vaccine. They can get any flu vaccine approved for use in that 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 people 65 years and older:
High Dose Flu Vaccine
The high dose vaccine (brand name Fluzone High-Dose) contains four times the amount of antigen (the inactivated virus that promotes a protective immune response) as a regular flu shot. It is associated with a stronger immune response following vaccination (higher antibody production). Results from a clinical trial of more than 30,000 participants showed that adults 65 years and older who received the high dose vaccine had 24% fewer influenza illnesses as compared to those who received the standard dose flu vaccine. The high dose vaccine has been approved for use in the United States since 2009. Learn more about high dose flu vaccine here.
Adjuvanted Flu Vaccine
The adjuvanted flu vaccine (brand name Fluad) is made with MF59 adjuvant, an additive that can create a stronger immune response to vaccination. In a recent review of multiple vaccine trials, older adults who received a MF59-adjuvated vaccine had a significantly higher immune response than those who received a standard flu vaccine, The adjuvanted vaccine was available for the first time in the United States during the 2016-2017 flu season. Learn more about adjuvanted flu vaccine here.
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 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.