Senior Flu Shots: A Guide to Getting Vaccinated Age 65 and Over

The senior flu shot is designed to help people 65 and older avoid influenza (the flu) infection. The Centers for Disease Control and Prevention (CDC) recommends that all people age 6 months and older get an annual flu vaccine (with very rare exceptions).

Since people aged 65 and over are at higher risk for complications and death from the flu, the flu vaccine is particularly important. There are three vaccines that the CDC recommends specifically for seniors because they offer additional protection. 

This article will discuss the flu shot for seniors. It will outline the types of shots recommended for people aged 65 and over and the vaccines they should not get. It will cover senior flu shot side effects, when to get a flu shot, and how often you should get a flu shot. 

What Is a Senior Flu Shot?

People 65 and older are at the highest risk for complications from influenza. About half of flu-related hospitalizations and up to 85% of flu-related deaths are in this age group. Because of that, it’s critical that they get their flu shot. 

This age group, like everyone else, will need a flu shot each year. A person's protection wanes over time, and each year the vaccine is tailored to the most prominent flu strains. September and October are the best times to get the senior flu shot, but you can get it later in the season too. 

A person 65 and older shouldn’t get the nasal spray vaccine. In addition, it's also recommended that seniors not receive standard-dose flu vaccines. Instead, they should get one of the vaccines specifically recommended for people 65 and older.

Types of Flu Shots for Seniors

As you age, it’s normal for your body to respond less to vaccines. Older people who get the flu shot generally have a weaker immune response than younger people who get the vaccine. But the vaccine is still effective in reducing medical visits and hospitalizations for the flu.

Some flu shots are designed to cause a stronger immune response. These flu vaccines can offer greater protection for people 65 and older. There are two types of senior flu shots that are recommended for people 65 and older. 

High-Dose Flu Vaccine

The high-dose flu vaccines contain increased amounts of antigen, the part of the vaccine that the immune system produces antibodies (proteins that recognize and bind to specific antigens) against. People who get these vaccine often have a stronger immune response.

One study found that people 65 and older who get the high-dose flu vaccine have 24% more protection against the flu than those in this age group who get the regular flu vaccine.

There are two high-dose flu vaccines:

• Fluzone High-Dose Quadrivalent has been available since 2009. it contains four times the amount of antigen compared to standard-dose flu vaccines. It is licensed only for people 65 years and older.
• Flublok Quadrivalent is a recombinant vaccine manufactured using a different process. It contains three times the amount of antigen in regular flu vaccines. It is approved for use in all people age 18 and over.

Adjuvanted Flu Vaccine

The adjuvanted flu vaccine uses an added ingredient, known as an adjuvant, to trigger a stronger immune response. It contains the same amount of antigen as the standard flu vaccine.

The adjuvanted flu vaccine (brand name Fluad Quadrivalent) was approved in the U.S. in 2015. Fluad Quadrivalent is formulated to protect against four strains of influenza, It is licensed in the U.S. only for people 65 and older.

There’s less research on the adjuvanted flu vaccine than there is on the high-dose flu vaccine. Some insurance information indicates that people age 65 and older who get the adjuvanted flu vaccine are less likely to be hospitalized than those who get the standard flu vaccine.

Which Senior Flu Vaccine Is Best?

The CDC has said that people 65 and older should preferentially receive one of the three vaccines discussed above. There is no preference for one of these over another. Talk with your doctor or pharmacist about whether a high-dose flu vaccine or the adjuvanted flu vaccine might be preferable for you.

Benefits

People 65 and older who get the flu vaccine are less likely to contract the flu, be hospitalized, or die. The high-dose flu vaccine or the adjuvanted flu vaccine might provide additional protection. 

Side Effects

People who get the high-dose flu vaccine are more likely to have side effects than people who get the standard flu vaccine. They include:

• Pain and redness at the injection site
• Feeling tired
• Headache and muscle ache

Most people who got the high-dose side flu vaccine had no or moderate side effects. People who got the adjuvanted flu vaccine were more likely to have mild to moderate side effects.

Emergency Flu Symptoms

Flu can be serious, especially in people 65 and older. If you experience any of the following symptoms you should seek immediate medical care:

• Difficulty breathing
• Chest or abdominal pain or pressure
• Dizziness or confusion
• Seizures
• Severe pain, weakness, or unsteadiness
• Not urinating or other signs of dehydration
• Symptoms that get better, then worse again
• Chronic medical conditions that get worse during your illness 

Summary

The annual flu vaccine is particularly important for people 65 and older as they are at the highest risk of becoming seriously ill with the flu. Half of all flu hospitalizations and at least 70% of flu-related deaths occur in people 65 and older.

Three flu vaccine options are preferentially recommended for seniors, including the high-dose flu vaccines and the adjuvanted flu vaccine. People over 65 can receive any of these vaccines. The nasal spray vaccine and standard-dose flu vaccines are not recommended for this age group.

A Word From Verywell

If you’re over the age of 65, it’s important to protect yourself against influenza. The CDC does not say that one vaccine is better than another—it’s just important to get vaccinated. However, some research shows additional protection from the senior flu shots—the high dose and adjuvanted vaccines. Talk to your doctor about whether the flu shot for seniors is right for you.