What Kind of Flu Shot Should I Get?

Greeves & Roethler, PLC

If you were one of the 80 percent of people age 65 and older who lined up for a flu shot last year, public health experts want you to keep up the good work this fall.

Should you get a high-dose or an adjuvanted flu vaccine? AARP’s article entitled “Which Flu Shot is Best For You?” says that the first option, the Fluzone High-Dose is an injectable flu vaccine that has been approved by the FDA for those over the age of 65 for more than a decade. It contains four times the antigens (the flu proteins our immune system recognizes and attacks) of a regular flu vaccine. The shot is also quadrivalent. That means it offers even more protection because it protects against four strains of the virus, not just three.

Getting this high-dose vaccine “is very important for older adults, who are more susceptible to flu complications, both because of the decreased immunity that comes with age and also because they are more likely to have other coexisting health conditions, such as heart disease or type 2 diabetes, that leave them more vulnerable to the flu’s ill effects,” explains William Schaffner, M.D., an infectious disease specialist at the Vanderbilt University School of Medicine.

In any given year, 50 to 70% of flu-related hospitalizations occur among people ages 65 and older, according to the Centers for Disease Control and Prevention (CDC). “More protection from a high-dose shot could be really important for older people in particular right now, to keep them out of overfilled hospitals,” says Schaffner, referring to the possibility that hospitals will face a daunting season of combined flu and COVID-19 cases.

The second type of flu shot approved for people over age 65 is the adjuvanted flu vaccine (Fluad Quadrivalent). It’s made with something called the MF59 adjuvant. This is an additive that creates a more robust immune response. “It wakes up your immune system, so that it responds better to the vaccine,” says Dr. Schaffner.

A 2020 study published in The Journal of Infectious Disease showed that both Fluzone (high dose) and Fluad (adjuvanted) are both very effective in preventing the flu and flu-related hospitalizations among seniors.

The best time to get your shot is from mid-September through October. You want to hit the sweet spot between being early enough to ensure your body has time to build up immunity and late enough in the season to make sure immunity doesn’t wear off by March or April. Ask your doctor about timing because peak flu season may vary from one part of the country to another. In addition, try to schedule the shot in the morning when possible. Research shows that adults over 65 who were given vaccines between 9 and 11 a.m. had higher levels of protective antibodies than those given the shot in the afternoon.

You may notice more side effects — like a sore arm — after your flu vaccination. “It tends to be a little sorer after a high-dose shot because you’ve put in four times as much flu vaccine,” points out Schaffner. The doctor says to avoid the over-the-counter pain relievers because they may dilute the shot’s effectiveness.

Finally, you can get the high-dose shot at the same time as you get your COVID-19 but be aware that you may end up with two sore arms.

Reference: AARP (Sep. 10, 2021) “Which Flu Shot is Best For You?”

Suggested Key Terms: COVID-19 (coronavirus), Senior Health, Influenza (Flu)

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