People 65 Years and Older & Influenza

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

The best way to protect against flu and its potentially serious complications is with a flu vaccine. CDC recommends that everyone 6 months and older get a seasonal flu vaccine each year by the end of October. However, as long as flu viruses are circulating, vaccination should continue throughout flu season, even into January or later.

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. (See Vaccine Virus Selection for this season’s exact vaccine composition.) 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, studiesexternal icon 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.

More information about different types of flu vaccines can be found here.

Get pneumococcal vaccines

• People who are 65 years of age and older also should be up to date with pneumococcal vaccination to protect against pneumococcal disease, such as pneumonia, meningitis, and bloodstream infections. Talk to your doctor to find out which pneumococcal vaccines are recommended for you.
• Pneumococcal pneumonia is an example of a serious flu-related complication that can cause death. You can get the pneumococcal vaccine your provider recommends when you get a flu vaccine.

Other Preventive Actions

In addition to getting a flu shot, people 65 years and older should take the same everyday preventive actions CDC recommends for everyone, including covering coughs, washing hands often, and avoiding people who are sick.

Symptoms and Treatment

Because you are at high risk of developing serious flu complications, if you get sick with flu symptoms, call your doctor right away. There are antiviral drugs that can treat flu illness and prevent serious flu complications. CDC recommends prompt treatment for people who have influenza infection or suspected influenza infection and who are at high risk for serious flu complications, such as people 65 years and older.

Symptoms:
Flu symptoms include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people may also have vomiting and diarrhea. People may be infected with flu and have respiratory symptoms without a fever.
Treatment:

• Treatment should begin as soon as possible because antiviral drugs work best when started early (within 48 hours after symptoms start).
• For you to get an antiviral drug, a doctor needs to write a prescription. These medicines fight against flu by keeping flu viruses from making more viruses in your body.
• Antiviral drugs can make your flu illness milder and make you feel better faster. They may also prevent serious health problems that can result from flu illness.
• There are four FDA-approved influenza antiviral drugs recommended by CDC this season that can be used to treat the flu.