CDC Is Considering Recommending a High-Dose Flu Shot for Adults Over 65

Older woman getting her flu shot

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Key Takeaways

  • The high-dose flu vaccine is one of the options available to adults over 65 right now.
  • The CDC is discussing whether the high-dose flu vaccine is better for people in this age group than other vaccines.
  • No decision has been made at this point.

The Centers for Disease Control and Prevention (CDC) is considering recommending a high-dose flu shot for adults over 65 over other options that are currently available. CDC officials discussed making the change at a meeting for the Advisory Committee on Immunization Practices (ACIP) earlier this week. However, no decision has been made yet.

The ACIP currently recommends that all adults get the flu vaccine but does not state a preference for a high-dose flu vaccine over others.

“The ACIP is undertaking a very thorough review of the world’s literature on the topic,” William Schaffner, MD, an infectious disease specialist and professor at the Vanderbilt University School of Medicine, told Verywell. “Should one or more of these vaccines be preferentially recommended for people age 65 and older? That’s still being investigated.”

The committee has a few options, Schaffner said: continue to encourage the same flu vaccines for this age group or pick one because they think it’s the best.

“They just started that discussion and it will carry over into the June ACIP meeting,” Schaffner said.

Why the Flu Vaccine Matters for Older People

The CDC currently recommends that everyone who is 6 months and older receive an annual flu vaccine, but the agency particularly stresses the importance of people aged 65 and up getting vaccinated.

People in this age group are at higher risk of developing serious complications of the flu, including pneumonia and multi-organ failure, compared to those who are younger and healthy, due to changes in the immune system with age.

An estimated 70- to 80% of flu-related deaths have happened in people who are 65 and up, and 50- to 70% of hospitalizations due to the flu happen in this age group.

Current Flu Vaccine Recommendations for People 65 and Up

There are regular flu shots that are approved for people 65 and older and two that are specially designed for this group. One is the high-dose flu vaccine.

This vaccine, which is also known as Fluzone High-Dose, contains four times the amount of antigen—the inactivated virus that creates an immune response—than a regular flu shot. It’s linked to higher antibody production after the vaccine. Research has actually shown that older adults who receive this flu shot have 24% fewer cases of the flu than those who get the regular flu shot.

The other flu vaccine that’s specially designed for the 65-and-up group is the adjuvanted flu vaccine, also known as Fluad Quadrivalent. It’s formulated with an adjuvant, which is a special ingredient that creates a stronger immune response. The adjuvanted flu vaccine also creates a higher immune response than in people who get a standard flu shot.

When given a choice, “most seniors opt for the high-dose, perhaps, because it has been on the market longer and more people are aware of it,” Amesh A. Adalja, MD, a senior scholar at the Johns Hopkins Center for Health Security, told Verywell.

The adjuvanted vaccine first became available in the U.S. during the 2016-2017 flu season.

What This Means For You

The CDC is considering recommending the high-dose flu vaccine over others for people aged 65 and up. But right now recommendations encourage everyone to get an annual flu shot—no matter what type you receive.

Why a High Dose Flu Vaccine Might Be Better

The high-dose flu vaccine “usually generates a stronger immune response,” Richard Watkins, MD, an infectious disease physician and professor of medicine at the Northeast Ohio Medical University, told Verywell. As a result, he said, the idea of recommending this vaccine over the adjuvanted vaccine for seniors “seems like a reasonable course of action.”

“Seniors are at high risk for severe influenza and respond poorly to standard vaccines,” Adalja said. “High dose vaccines improve the immunogenicity of the vaccine.”

But Schaffner stressed that no decision has been made just yet. “We will have to wait and see,” he added.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Centers for Disease Control and Prevention. Meeting of the Advisory Committee on Immunization Practices.

  2. Centers for Disease Control and Prevention. Flu & people 65 years and older.

  3. Centers for Disease Control and Prevention. Past seasons estimated influenza disease burden.

By Korin Miller
Korin Miller is a health and lifestyle journalist who has been published in The Washington Post, Prevention, SELF, Women's Health, The Bump, and Yahoo, among other outlets.