Which Flu Shot to Choose If You Are Over 65 Years Old

To prevent winter illnesses, now is the time for all of us, especially older adults, to get updated on our flu and COVID vaccinations . If you are over 65 years old, you may want to consider a high-dose or adjuvanted flu shot. These formulations are recommended for older people because they may be more effective. (However, the Centers for Disease Control and Prevention says a regular flu shot is fine if you can’t easily access the medications preferred for your age group.)

Which flu shots are best for older adults?

Here are three vaccinations the CDC recommends getting if you can if you are 65 or older:

• High dose flu shot.

• A recombinant flu shot that is also egg-free.

• Adjuvant influenza vaccine.

I’ll tell you what these terms mean and why these vaccines are considered the best for older adults. But you don’t need a deep understanding of the differences to make an appointment at your local pharmacy. Just ask if they have any of the above vaccines, and if so, get one of them over the other, “regular” flu shot.

What does “high dose” mean and why is it good?

The vaccine works by exposing your immune system to a small amount of antigen. An antigen is something that the immune system can recognize and later respond to; In many flu vaccines, the antigen is a killed and torn apart influenza virus. (This is why the flu shot can’t give you the flu .)

As we age, our immune systems sometimes don’t respond as strongly as they did when we were younger, so the regular flu vaccine may not stimulate as strong an immune response as is needed for the vaccine to be effective. One way to get around this problem is to simply give more antigen. That’s the idea behind the high-dose shot: it just contains more virus particles. More precisely, four times more.

Side effects are slightly more common with high doses of the flu vaccine than with the regular vaccine, but these are the same types of side effects that anyone can get from the flu shot, and like the regular flu shot, they are usually not serious . The Centers for Disease Control and Prevention reports, “The most common side effects occurring during clinical studies were mild and temporary and included pain, redness at the injection site, headache, muscle aches and malaise.”

What does “adjuvant” mean?

Instead of high-dose flu vaccine, another particularly strong option for older adults is an adjuvanted vaccine . Instead of a higher dose of antigen, it contains an adjuvant, which is an ingredient that causes your immune system to react more strongly . (The adjuvant in this case is squalene oil, also called MF59.)

As with the high-dose vaccine, side effects with this vaccine are slightly more common than with the standard flu vaccine, but they are not serious. The Centers for Disease Control and Prevention (CDC) reports: “The most common side effects observed during clinical trials were mild to moderate and temporary and included pain, redness at the injection site, headache, muscle aches, and malaise. “

What is a “recombinant” flu shot?

The term “recombinant” refers to the method of producing virus particles for a vaccine. Traditionally, flu vaccines were made using chicken eggs. There is also a new cell culture vaccine that does not use eggs. And there is a third type: recombinant vaccine.

As the CDC explains , the recombinant vaccine does not use influenza viruses at all. Instead, part of the flu virus genome is added to a different type of virus (“recombinant” means different parts of the genetic material are joined together), and that virus is grown in cells, and then the part containing the flu virus protein is processed. purified and used to make a vaccine.

The recombinant vaccine is available for all age groups, not just older people. It is one of the preferred vaccines for older adults because it contains more antigen than other regular flu vaccines and has been shown to work well in older adults.

If I am over 65 years old, do I need a special flu shot?

The Centers for Disease Control and Prevention (CDC) says any flu shot is fine as long as it is approved for people in your age group. But there are three flu vaccines that are designed specifically for adults 65 and older.

According to the CDC, there have been no randomized studies comparing the three vaccines to each other, but there is data showing that each vaccine works better for people over 65 (preventing flu cases and reducing hospitalizations) than the standard vaccine.

Flu complications are especially likely in older adults, with people over 65 accounting for more than half of hospitalizations and more than 70% of deaths, according to a 2013 study . That’s why flu shots are especially important at this age.

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