Table of ContentsView AllTable of ContentsSenior Flu ShotsTypesBenefitsTimingSide Effects
Table of ContentsView All
View All
Table of Contents
Senior Flu Shots
Types
Benefits
Timing
Side Effects
Senior flu shots are more potent influenza vaccines designed for persons 65 years and older. Older adults are at greater risk of flu-related complications and death, and their immune systems are less responsive to the standard annualflu shot.
The Centers for Disease Control and Prevention (CDC) recommends all older adults (ages 65+) receive either a higher-dose vaccine or an adjuvanted vaccine, which contains compounds that boost the shot’s effectiveness.
These extra-strength flu vaccines address issues specific to the older population’s immune systems and prompt a stronger immune response than standard flu shots, resulting in fewer hospitalizations and deaths.
FatCamera / Getty Images
What Is a Senior Flu Shot?
The CDC recommends an annualflu vaccinefor everyone 6 months and older (with a few, rare exceptions).
However, the standard flu vaccine is not as effective in persons 65 years and older, and older adults are at higher risk for complications, and even death, from the flu.
The immune system gets progressively weaker with aging, a process called immunosenescence. This causes a slowing of immune cell generation in response to pathogens, leading to an increased susceptibility to disease in the older population.
In 2022, the CDC recommended that persons 65 years and older receive annual high-potency influenza vaccines instead of standard flu shots.These senior flu shots prompt a stronger immune response for greater protection against the influenza virus.
A Word From VerywellThe term “high-dose flu shot” can sometimes sound more intimidating than it really is. The intention behind these “higher-dose” vaccines is to ensure a full immune response and optimal immunity to the virus. Research shows that around and after age 65, the immune system begins to weaken. Administering a higher-dose vaccine compensates for a weaker immune system, resulting in a more typical immune response.—LINDSAY COOK, PHARMD, MEDICAL EXPERT BOARD
A Word From Verywell
The term “high-dose flu shot” can sometimes sound more intimidating than it really is. The intention behind these “higher-dose” vaccines is to ensure a full immune response and optimal immunity to the virus. Research shows that around and after age 65, the immune system begins to weaken. Administering a higher-dose vaccine compensates for a weaker immune system, resulting in a more typical immune response.—LINDSAY COOK, PHARMD, MEDICAL EXPERT BOARD
The term “high-dose flu shot” can sometimes sound more intimidating than it really is. The intention behind these “higher-dose” vaccines is to ensure a full immune response and optimal immunity to the virus. Research shows that around and after age 65, the immune system begins to weaken. Administering a higher-dose vaccine compensates for a weaker immune system, resulting in a more typical immune response.
—LINDSAY COOK, PHARMD, MEDICAL EXPERT BOARD
Types of Flu Shots for Seniors
Senior flu shots are available in two formulations: high-dose or adjuvanted. Three of these vaccines available for the 2024-2025 flu season include:
These senior flu vaccines are formulated to address specific immune system issues in people 65 years and older. They help boost immunity and prevent complications from influenza.
High-Dose Flu Vaccines
High-dose flu vaccines contain higher amounts of flu virus antigens.Antigensprompt the immune system to produceantibodiesagainst influenza strains. Antibodies are proteins that recognize and bind to specific antigens and neutralize pathogens.
The antibodies you develop from the flu shot help your immune system quickly mount a defense when exposed to the live flu virus.
High-dose vaccines promote a stronger immune response because they have more antigens than standard flu vaccines. Studies show high-dose vaccines offer older adults 24% more protection against the flu than the standard vaccine.
The following high-dose flu vaccines are available this season:
Both these vaccines can be given with other live or inactivated vaccines.
Adjuvanted Flu Vaccine
The adjuvanted flu vaccine contains the same level of antigens as the standard vaccine but has an extra ingredient (an adjuvant) to trigger a stronger immune response.
Fluad Quadrivalentis the only adjuvanted flu vaccine available for the current flu season and is only approved for people 65 years and older.
Research in older adults shows the adjuvanted flu vaccine is more effective than the standard flu shot, helps to prevent complications and hospitalizations, and also appears to provide longer protection.
Which Flu Shot Is Best for Seniors?According to the CDC, the best flu shots for people 65 years and older are Fluzone, Flublok, and Fluad. Known as senior flu shots, the CDC gives no preference to one over another.A 2023 study found high-dose vaccines offer slightly stronger immunity than adjuvanted ones, though the difference was not statistically significant.Consult your healthcare provider to determine which flu vaccine is best for you.
Which Flu Shot Is Best for Seniors?
According to the CDC, the best flu shots for people 65 years and older are Fluzone, Flublok, and Fluad. Known as senior flu shots, the CDC gives no preference to one over another.A 2023 study found high-dose vaccines offer slightly stronger immunity than adjuvanted ones, though the difference was not statistically significant.Consult your healthcare provider to determine which flu vaccine is best for you.
According to the CDC, the best flu shots for people 65 years and older are Fluzone, Flublok, and Fluad. Known as senior flu shots, the CDC gives no preference to one over another.
A 2023 study found high-dose vaccines offer slightly stronger immunity than adjuvanted ones, though the difference was not statistically significant.Consult your healthcare provider to determine which flu vaccine is best for you.
Why You Should Get the Senior Flu Shot
People 65 years and older are at the highest risk for influenza complications. About half of flu-related hospitalizations and up to 85% of flu-related deaths originate from this age group.
An annual senior flu shot is critical to prevent these complications because immunity wanes over time, and the vaccine is tailored annually to the current most prominent flu strains.
Research shows older adults often have weaker immune responses to the flu vaccine than younger people. The exact reason for this remains unclear, but investigators suspect two factors may contribute:
Senior flu shots address these issues to promote a stronger immune response and boost effectiveness.
Prevent Flu Complications
Both high-dose and adjuvanted flu shots provide older adults with better protection against potential complications from the flu. Compared to standard vaccines, senior flu shots reduce flu-related hospitalizations and deaths.
Some serious flu complications that require immediate medical care, include:
It’s important to know that the flu can develop intopneumonia, a serious and potentially fatal lung infection. Pneumonia and flu symptoms can overlap, Always inform your healthcare provider about any unusual or worsening symptoms.
What Flu Vaccines Should Seniors Avoid?Older adults should not be given Flumist, thenasal spray vaccine. This vaccine contains weakened, live influenza viruses and is not approved for use in adults over 50 years.The older population should also avoid getting the standard flu shot unless higher-dose or adjuvanted influenza vaccines aren’t available.
What Flu Vaccines Should Seniors Avoid?
Older adults should not be given Flumist, thenasal spray vaccine. This vaccine contains weakened, live influenza viruses and is not approved for use in adults over 50 years.The older population should also avoid getting the standard flu shot unless higher-dose or adjuvanted influenza vaccines aren’t available.
When Should Older Adults Get a Flu Shot?
The best time for older adults to get the flu shot is late September through the end of October. This helps to ensure you have enough time (about two weeks) to build immunity before the holidays when flu activity starts to ramp up.
People 65 years of age and older are advised against getting the flu shot too early in the season. The vaccine’s protection fades faster in this population. An August vaccination could lose effectiveness before the end of flu season, typically at the end of May.
What Are the Side Effects?
Senior flu shot side effects can include:
Rates of side effects vary among the different vaccines, as follows:
Summary
The CDC recommends more potent flu shots for people 65 years and older. This population has a higher risk of complications and death from the flu and tends to have a lower immune response to standard flu shots.
The three flu vaccines preferentially recommended for seniors are the high-dose Fluzone and Flublok and an adjuvanted flu vaccine Fluad. Studies show these more powerful vaccines enhance seniors' immunity and decrease flu-related hospitalizations and deaths, compared to standard flu shots.
Consult your healthcare provider to determine which flu vaccine is best for you.
19 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Frequently asked influenza (flu) questions: 2022-2023 season.DiazGranados CA, Dunning AJ, Kimmel M, et al.Efficacy of high-dose versus standard-dose influenza vaccine in older adults.N Engl J Med. 2014;371(7):635–45. doi:10.1056/NEJMoa1315727Centers for Disease Control and Prevention.Flu and people 65 years and older.National Institute on Aging.Vaccinations and older adults.Dugan HL, Henry, C, Wilson PC.Aging and influenza vaccine-induced immunity.Cellular Immunology. 2021;348:103998.https://doi.org/10.1016/j.cellimm.2019.103998Centers for Disease Control and Prevention.Advisory Committee on Immunization Practices (ACIP): GRADE: Higher dose and adjuvanted influenza vaccines for persons aged ≥65 years.Centers for Disease Control and Prevention.Fluzone high-dose seasonal influenza vaccine.Centers for Disease Control and Prevention.Recombinant influenza (flu) vaccine.Centers for Disease Control and Prevention.Adjuvanted flu vaccine.U.S. Food and Drug Administration.Highlights of prescribing information: Fluad Quadrivalent.Jacob J, Biering-Sørensen T, Holger Ehlers L, et al.Cost-effectiveness of vaccination of older adults with an MF59®-adjuvanted quadrivalent influenza vaccine compared to standard-dose and high-dose vaccines in Denmark, Norway, and Sweden.Vaccines(Basel). 2023;11(4):753. doi:10.3390/vaccines11040753Schmader KE, Liu CK, Flannery B, et al.Immunogenicity of adjuvanted versus high-dose inactivated influenza vaccines in older adults: a randomized clinical trial.Immun Ageing. 2023;20(1):30. doi:10.1186/s12979-023-00355-7Centers for Disease Control and Prevention.Flu and people 65 years and older.Kang M, Lin F, Jiang Z, et al.The impact of pre-existing influenza antibodies and inflammatory status on the influenza vaccine responses in older adults.Influenza Other Respir Viruses. 2023;17(7):e13172. doi:10.1111/irv.13172Domnich A, de Waure C.Comparative effectiveness of adjuvanted versus high-dose seasonal influenza vaccines for older adults: a systematic review and meta-analysis.Int J Infect Dis. 2022;122:855-863. doi:10.1016/j.ijid.2022.07.048Centers for Disease Control and Prevention.Vaccine Information Statement: Live, Intranasal Influenza VIS.Kaka AS, Filice GA, Myllenbeck S, Nichol KL.Comparison of side effects of the 2015-2016 high-dose, inactivated, trivalent influenza vaccine and standard dose, inactivated, trivalent influenza vaccine in adults ≥65 years.Open Forum Infect Dis. 2017;4(1):ofx001. doi:10.1093/ofid/ofx001U.S. Food and Drug Administration.Highlights of prescribing information: Flublok Quadrivalent.U.S. Food and Drug Administration.Highlights of prescribing information: Fluzone Quadrivalent.
19 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Centers for Disease Control and Prevention.Frequently asked influenza (flu) questions: 2022-2023 season.DiazGranados CA, Dunning AJ, Kimmel M, et al.Efficacy of high-dose versus standard-dose influenza vaccine in older adults.N Engl J Med. 2014;371(7):635–45. doi:10.1056/NEJMoa1315727Centers for Disease Control and Prevention.Flu and people 65 years and older.National Institute on Aging.Vaccinations and older adults.Dugan HL, Henry, C, Wilson PC.Aging and influenza vaccine-induced immunity.Cellular Immunology. 2021;348:103998.https://doi.org/10.1016/j.cellimm.2019.103998Centers for Disease Control and Prevention.Advisory Committee on Immunization Practices (ACIP): GRADE: Higher dose and adjuvanted influenza vaccines for persons aged ≥65 years.Centers for Disease Control and Prevention.Fluzone high-dose seasonal influenza vaccine.Centers for Disease Control and Prevention.Recombinant influenza (flu) vaccine.Centers for Disease Control and Prevention.Adjuvanted flu vaccine.U.S. Food and Drug Administration.Highlights of prescribing information: Fluad Quadrivalent.Jacob J, Biering-Sørensen T, Holger Ehlers L, et al.Cost-effectiveness of vaccination of older adults with an MF59®-adjuvanted quadrivalent influenza vaccine compared to standard-dose and high-dose vaccines in Denmark, Norway, and Sweden.Vaccines(Basel). 2023;11(4):753. doi:10.3390/vaccines11040753Schmader KE, Liu CK, Flannery B, et al.Immunogenicity of adjuvanted versus high-dose inactivated influenza vaccines in older adults: a randomized clinical trial.Immun Ageing. 2023;20(1):30. doi:10.1186/s12979-023-00355-7Centers for Disease Control and Prevention.Flu and people 65 years and older.Kang M, Lin F, Jiang Z, et al.The impact of pre-existing influenza antibodies and inflammatory status on the influenza vaccine responses in older adults.Influenza Other Respir Viruses. 2023;17(7):e13172. doi:10.1111/irv.13172Domnich A, de Waure C.Comparative effectiveness of adjuvanted versus high-dose seasonal influenza vaccines for older adults: a systematic review and meta-analysis.Int J Infect Dis. 2022;122:855-863. doi:10.1016/j.ijid.2022.07.048Centers for Disease Control and Prevention.Vaccine Information Statement: Live, Intranasal Influenza VIS.Kaka AS, Filice GA, Myllenbeck S, Nichol KL.Comparison of side effects of the 2015-2016 high-dose, inactivated, trivalent influenza vaccine and standard dose, inactivated, trivalent influenza vaccine in adults ≥65 years.Open Forum Infect Dis. 2017;4(1):ofx001. doi:10.1093/ofid/ofx001U.S. Food and Drug Administration.Highlights of prescribing information: Flublok Quadrivalent.U.S. Food and Drug Administration.Highlights of prescribing information: Fluzone Quadrivalent.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Centers for Disease Control and Prevention.Frequently asked influenza (flu) questions: 2022-2023 season.DiazGranados CA, Dunning AJ, Kimmel M, et al.Efficacy of high-dose versus standard-dose influenza vaccine in older adults.N Engl J Med. 2014;371(7):635–45. doi:10.1056/NEJMoa1315727Centers for Disease Control and Prevention.Flu and people 65 years and older.National Institute on Aging.Vaccinations and older adults.Dugan HL, Henry, C, Wilson PC.Aging and influenza vaccine-induced immunity.Cellular Immunology. 2021;348:103998.https://doi.org/10.1016/j.cellimm.2019.103998Centers for Disease Control and Prevention.Advisory Committee on Immunization Practices (ACIP): GRADE: Higher dose and adjuvanted influenza vaccines for persons aged ≥65 years.Centers for Disease Control and Prevention.Fluzone high-dose seasonal influenza vaccine.Centers for Disease Control and Prevention.Recombinant influenza (flu) vaccine.Centers for Disease Control and Prevention.Adjuvanted flu vaccine.U.S. Food and Drug Administration.Highlights of prescribing information: Fluad Quadrivalent.Jacob J, Biering-Sørensen T, Holger Ehlers L, et al.Cost-effectiveness of vaccination of older adults with an MF59®-adjuvanted quadrivalent influenza vaccine compared to standard-dose and high-dose vaccines in Denmark, Norway, and Sweden.Vaccines(Basel). 2023;11(4):753. doi:10.3390/vaccines11040753Schmader KE, Liu CK, Flannery B, et al.Immunogenicity of adjuvanted versus high-dose inactivated influenza vaccines in older adults: a randomized clinical trial.Immun Ageing. 2023;20(1):30. doi:10.1186/s12979-023-00355-7Centers for Disease Control and Prevention.Flu and people 65 years and older.Kang M, Lin F, Jiang Z, et al.The impact of pre-existing influenza antibodies and inflammatory status on the influenza vaccine responses in older adults.Influenza Other Respir Viruses. 2023;17(7):e13172. doi:10.1111/irv.13172Domnich A, de Waure C.Comparative effectiveness of adjuvanted versus high-dose seasonal influenza vaccines for older adults: a systematic review and meta-analysis.Int J Infect Dis. 2022;122:855-863. doi:10.1016/j.ijid.2022.07.048Centers for Disease Control and Prevention.Vaccine Information Statement: Live, Intranasal Influenza VIS.Kaka AS, Filice GA, Myllenbeck S, Nichol KL.Comparison of side effects of the 2015-2016 high-dose, inactivated, trivalent influenza vaccine and standard dose, inactivated, trivalent influenza vaccine in adults ≥65 years.Open Forum Infect Dis. 2017;4(1):ofx001. doi:10.1093/ofid/ofx001U.S. Food and Drug Administration.Highlights of prescribing information: Flublok Quadrivalent.U.S. Food and Drug Administration.Highlights of prescribing information: Fluzone Quadrivalent.
Centers for Disease Control and Prevention.Frequently asked influenza (flu) questions: 2022-2023 season.
DiazGranados CA, Dunning AJ, Kimmel M, et al.Efficacy of high-dose versus standard-dose influenza vaccine in older adults.N Engl J Med. 2014;371(7):635–45. doi:10.1056/NEJMoa1315727
Centers for Disease Control and Prevention.Flu and people 65 years and older.
National Institute on Aging.Vaccinations and older adults.
Dugan HL, Henry, C, Wilson PC.Aging and influenza vaccine-induced immunity.Cellular Immunology. 2021;348:103998.
https://doi.org/10.1016/j.cellimm.2019.103998
Centers for Disease Control and Prevention.Advisory Committee on Immunization Practices (ACIP): GRADE: Higher dose and adjuvanted influenza vaccines for persons aged ≥65 years.
Centers for Disease Control and Prevention.Fluzone high-dose seasonal influenza vaccine.
Centers for Disease Control and Prevention.Recombinant influenza (flu) vaccine.
Centers for Disease Control and Prevention.Adjuvanted flu vaccine.
U.S. Food and Drug Administration.Highlights of prescribing information: Fluad Quadrivalent.
Jacob J, Biering-Sørensen T, Holger Ehlers L, et al.Cost-effectiveness of vaccination of older adults with an MF59®-adjuvanted quadrivalent influenza vaccine compared to standard-dose and high-dose vaccines in Denmark, Norway, and Sweden.Vaccines(Basel). 2023;11(4):753. doi:10.3390/vaccines11040753
Schmader KE, Liu CK, Flannery B, et al.Immunogenicity of adjuvanted versus high-dose inactivated influenza vaccines in older adults: a randomized clinical trial.Immun Ageing. 2023;20(1):30. doi:10.1186/s12979-023-00355-7
Kang M, Lin F, Jiang Z, et al.The impact of pre-existing influenza antibodies and inflammatory status on the influenza vaccine responses in older adults.Influenza Other Respir Viruses. 2023;17(7):e13172. doi:10.1111/irv.13172
Domnich A, de Waure C.Comparative effectiveness of adjuvanted versus high-dose seasonal influenza vaccines for older adults: a systematic review and meta-analysis.Int J Infect Dis. 2022;122:855-863. doi:10.1016/j.ijid.2022.07.048
Centers for Disease Control and Prevention.Vaccine Information Statement: Live, Intranasal Influenza VIS.
Kaka AS, Filice GA, Myllenbeck S, Nichol KL.Comparison of side effects of the 2015-2016 high-dose, inactivated, trivalent influenza vaccine and standard dose, inactivated, trivalent influenza vaccine in adults ≥65 years.Open Forum Infect Dis. 2017;4(1):ofx001. doi:10.1093/ofid/ofx001
U.S. Food and Drug Administration.Highlights of prescribing information: Flublok Quadrivalent.
U.S. Food and Drug Administration.Highlights of prescribing information: Fluzone Quadrivalent.
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