What You Should Know and Do this Flu Season If You Are 65 Years and Older

It has been recognized for many years that people 65 years and older are at greater risk of serious complications from the flu compared with young, healthy adults because human immune defenses become weaker with age. While flu seasons can vary in severity, during most seasons, people 65 years and older bear the greatest burden of severe flu disease. In recent years, for example, it’s estimated that between 71 percent and 85 percent of seasonal flu-related deaths have occurred in people 65 years and older and between 54 percent and 70 percent of seasonal flu-related hospitalizations have occurred among people in that age group. So influenza is often quite serious for people 65 and older.

Actions To Take This Flu Season:

1. Get Your Flu Shot
   The best way to prevent the flu is with a flu shot. CDC recommends that everyone 6 months of age and older get a seasonal flu vaccine each year by the end of October if possible. However, as long as flu viruses are circulating, vaccination should continue throughout flu season, even in January or later.Vaccination is especially important for people 65 years and older because they are at high risk for complications from flu. Flu vaccines are often updated each season to keep up with changing viruses and also immunity wanes over a year so annual vaccination is needed to ensure the best possible protection against influenza.A flu vaccine protects against the flu viruses that research indicates will be most common during the upcoming season. (See Vaccine Virus Selection for this season’s exact vaccine composition.) The 2016-2017 vaccine has been updated from last season’s vaccine to better match circulating viruses. Immunity from vaccination sets in after about two weeks.People 65 years and older can get any injectable vaccine (flu shot) that is approved for use in that age group. This includes cell-based, recombinant and flu shots made using traditional egg-based manufacturing processes.There are two vaccines designed specifically for people 65 and older:
   • The “high dose vaccine” is designed specifically for people 65 and older and contains 4 times the amount of antigen as the regular flu shot. It is associated with a stronger immune response following vaccination (higher antibody production). Results from a clinical trial of more than 30,000 participants showed that adults 65 years and older who received the high dose vaccine had 24% fewer influenza infections as compared to those who received the standard dose flu vaccine. The high dose vaccine has been approved for use in the United States since 2009.
   • The adjuvanted flu vaccine, Fluad, is made with MF59 adjuvant which is designed to help create a stronger immune response to vaccination. In a Canadian observational study of 282 persons aged 65 years and older conducted during the 2011-12 season, Fluad was 63% more effective than regular-dose unadjuvanted flu shots. There are no randomized studies comparing Fluad with Fluzone High-Dose. This vaccine will be available for the first time in the United States during the 2016-2017 season.

   The high dose and adjuvanted flu vaccines may result in more of the mild side effects that can occur with standard-dose seasonal shots. Mild side effects can include pain, redness or swelling at the injection site, headache, muscle ache and malaise.

   Note: People 65 years of age and older should not get the nasal spray flu vaccine (which is not recommended for use in any population for the 2016-17 season), the intradermal flu shot, or jet injector flu vaccine.

2. Practice good health habits including covering coughs, washing hands often, and avoiding people who are sick.
3. Seek medical advice quickly if you develop flu symptoms to see whether you might need medical evaluation or treatment with antiviral drugs. CDC recommends that antiviral drugs be used as early as possible to treat flu in people who are very sick with flu (for example, people who are in the hospital), and people who are sick with flu and have a greater chance of getting serious flu complications, like people 65 and older. Benefit is greatest if treatment is started within the first 2 days of illness. A full list of high risk factors is available at “People at High Risk of Developing Flu-Related Complications”.
4. Get pneumococcal vaccines.
   • People who are 65 years of age and older should also be up to date with pneumococcal vaccination to protect against pneumococcal disease, such as pneumonia, meningitis, and bloodstream infections. Talk to your doctor to find out which pneumococcal vaccines are recommended for you.
   • Pneumococcal pneumonia is an example of a serious flu-related complication that can cause death. You can get the pneumococcal vaccine your provider recommends when you get the flu vaccine.

• Flu symptoms include fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills and fatigue. Some people may also have vomiting and diarrhea. People may be infected with the flu and have respiratory symptoms without a fever.