Home Health News Senior flu shots: Why a high-dose vaccine is more effective – Insider – INSIDER

Senior flu shots: Why a high-dose vaccine is more effective – Insider – INSIDER

9 min read


  • Seniors can get the standard flu shot, but it may not be as effective, since people over the age of 65 have a weaker immune system.
  • A high dose flu vaccine that has four times as many antigens than a regular flu shot is a better option for seniors. 
  • Seniors can also get an adjuvanted flu vaccine, which contains a substance that increases the efficacy of the shot for seniors.
  • This article was reviewed by Jason R. McKnight, MD, MS, a family medicine physician and clinical assistant professor at Texas A&M College of Medicine
  • Visit Insider’s Health Reference library for more advice.

Each year, 63% of adults in the US get a flu vaccine to prevent influenza, a respiratory virus that causes fever, cough, and runny nose. 

The flu vaccine works well for younger people but seniors may need specialized vaccines to get the same protection since they are at greater risk of developing serious complications from the flu-like pneumonia.

Here’s what you need to know about which vaccines work best to protect seniors from the flu.

Can seniors get the normal flu shot?

Getting a standard flu shot is helpful for people over 65 because it reduces the risk of developing a severe infection that could lead to hospitalization. 

Therefore, if a normal flu shot is all that’s available, it’s better than no flu shot at all. However, a normal flu shot may not be as effective for seniors, says Laura Haynes, PhD, a professor of immunology at the University of Connecticut Center on Aging. 

This is because the flu vaccine introduces antigens in the form of a small, inactive dose of the influenza virus. These antigens enter your bloodstream and trigger an immune response that ramps up your body’s production of disease-fighting cells called antibodies specifically designed to fight off the flu.

But as you age, your immune system weakens, making it harder for your body to produce enough antibodies to effectively fend off infection. That’s why there are other flu shots designed specifically for people over 65. 

Types of flu shots for seniors

There are two types of vaccines that the CDC recommends for people over 65: the high dose flu vaccine, also called Fluzone, and the adjuvanted flu vaccine, known as Fluad. You can get both the high-dose and adjuvanted flu vaccines at your doctor’s office, but you can also find the high dose vaccine at pharmacy clinics like CVS

There haven’t been any studies comparing the high-dose and adjuvanted flu vaccines, and the CDC doesn’t state any preference about which vaccine to use. However, some doctors may prefer the high-dose vaccine because it has been in use since 2009, while the adjuvanted vaccine came out more recently in 2015.

High dose flu vaccine

The high dose flu vaccine has 4 times as many antigens as a regular flu shot, and is available specifically for people over 65

The higher antigen load means that even if your immune system has a weaker reaction, having more virus particles present helps your body create more antibodies — ideally enough to protect you from infection, Haynes says.

A study published in 2014 in the New England Journal of Medicine found that the high dose flu vaccine was 24% more effective in preventing flu in people over 65, compared with the standard vaccine. Moreover, seniors who get the high dose vaccine are also less likely to be hospitalized for the flu.

Adjuvanted flu vaccine

Another vaccine specifically designed for seniors is the adjuvanted flu vaccine. An adjuvant is a substance that increases your body’s reaction to virus proteins. 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 study published in 2020 in the Journal of Infectious Diseases 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.

The bottom line

Getting any flu shot is helpful for seniors, but the high dose and adjuvanted flu shots are the best option to guard against illness and hospitalization. 

There is also little risk involved with getting the flu vaccine. “You cannot get the flu from a flu vaccine,” Haynes says, though you may not feel well for a day or two after getting it because your immune system is gearing up to fight off the virus, which can cause mild symptoms like headache or low-grade fever.

The CDC recommends that any adult can get the flu vaccine unless you have a severe allergy to one of the ingredients, like gelatin or certain antibiotics. If you aren’t sure which flu vaccine is right for you, talk to your doctor to figure out the best option.

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