Everything you ever wanted to know about flu vaccines

Created date

September 16th, 2016
For seniors, a higher-dose flu vaccine is more effective than the standard dose but may produce more side effects.

For seniors, a higher-dose flu vaccine is more effective than the standard dose but may produce more side effects.

You’ve probably had the flu at some point in your life. And since you successfully fought it off, you may think you could do it again. So why get a flu shot?

“The flu can be very dangerous after age 65,” says Andrew Kundrat, M.D., medical director at Riderwood, an Erickson Living community in Silver Spring, Md. “Your immune system is not as robust and that makes you vulnerable to complications. Some medications can further weaken your immunity.”

Having chronic medical conditions can make you vulnerable as well. Chronic lung disease, heart disease, neurological conditions, kidney and liver disorders, and cancer are some examples. 

According to the Centers for Disease Control and Prevention (CDC), recent research shows between 80% and 90% of seasonal flu-related deaths have occurred in people 65 years and older. In addition, between 50% and 70% of seasonal flu-related hospitalizations have occurred among seniors. 

Washing your hands thoroughly and frequently can reduce your chances of contracting the flu, but the best prevention measure is getting vaccinated.

A more effective vaccine

The regular flu vaccine is made up of inactivated virus components (antigen) from flu strains that scientists estimate are most likely to emerge in the upcoming season. Research shows, however, that older adults may not respond to the standard vaccine, primarily because of the decreased immune response that accompanies the aging process. Thus, a higher-dose vaccine with four times the amount of antigen as the regular vaccine was made available for use in 2014. A study published in the New England Journal of Medicine showed that it’s about 24% more effective in preventing flu than the standard vaccine.

The higher-dose vaccine may produce more side effects than the standard dose. “You may get redness and soreness in your arm at the injection site, or get a mild flu-like illness for a few days,” Kundrat says. “These side effects are a sign that your immune system is responding properly.”

Why people hesitate 

According to the CDC, people don’t get vaccinated mainly because they don’t understand the importance of the vaccine, or it is not easily available to them. Some people have other reasons.

For example, today’s seniors remember when in 1976, swine flu vaccines were suspended because more than 500 cases of Guillain-Barré syndrome (GBS)—a rare neurological disease that causes muscle weakness and sometimes paralysis—were reported, including 25 deaths. In 2004, the Institute of Medicine issued a report concluding that the 1976 swine flu vaccine may in fact have caused GBS in some cases. 

Since then, however, there has been no evidence of an association between flu vaccines and adverse effects, including GBS. Both the Food and Drug Administration and the CDC continually monitor the safety of all vaccines. “The message for people is that the risk of adverse events is miniscule,” Kundrat says. 

If it’s late in the season, some people think it is pointless to be vaccinated. But the flu virus lurks around until about April. “Even if it is February, get vaccinated anyway,” Kundrat advises.

A persistent myth is that the vaccine causes the flu. But studies of millions of people have shown conclusively that this does not occur. The nasal spray form of the vaccine can, however, cause flu-like side effects, including runny nose, cough, fatigue, sore throat, or headache. 

Nasal spray warning

Seniors are not candidates for the nasal spray. Your children or grandchildren may have received the nasal vaccine in the past, but in June, the CDC’s Advisory Committee on Immunization Practices (ACIP) issued a warning that it should not be used for the upcoming flu season. They based their recommendation on recent studies that showed the nasal spray was only 3% effective in preventing the flu in children age 2 through 17. The flu shot, however, was shown to be 63% effective. Final recommendations about the nasal spray for adults have not been published as of this writing.

If you get sick

Call your doctor as soon as you have a sore throat, fever, and body aches. You may be a candidate for an antiviral drug that can lessen symptoms and shorten the duration of the illness. “Antivirals are most effective if they are started within two days of getting sick,” Kundrat says. “They can be started later for people who are at an especially high risk of flu-related complications.”

According to the CDC, antivirals are an excellent option for seniors who have a high-risk health condition or may be hospitalized as a result. Antiviral drugs will not completely alleviate symptoms, so be sure to rest and drink plenty of fluids. Cover your cough and stay at home until at least 24 hours after you no longer have a fever (100°F or 37.8°C).

Finally, even if you are not doing it for yourself, get vaccinated to protect other people including your family and friends, and other susceptible people in your community such as pregnant women, babies, and children.