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Nurse’s Guide to the Flu Vaccine for Seniors
- Learn about the specific flu vaccine for seniors, designed to protect against the flu and influenza vaccines in people ages 65 and older.
- Understand the side effects of the senior flu vaccine, including fatigue, headaches, and muscle aches.
- Review why senior patients need a specific flu vaccine and what kinds of flu vaccines nurses should recommend they avoid.
Katy Luggar-Schmit
LPN
Did you know there is a flu vaccine for seniors? Senior flu shots are stronger influenza vaccines designed for people ages 65 and over. Elderly adults are at a greater risk of flu-related complications and death, and older immune systems are less responsive to the standard flu shot.
The CDC now recommends that all elderly adults receive either a higher dose vaccine or an adjuvanted vaccine, which contains compounds that increase vaccine effectiveness. These extra-strength vaccines address issues specific to aging immune systems and prompt a stronger immune response than standard flu shots. This will result in fewer hospitalizations and deaths from influenza.
This article discusses the flu vaccine for seniors. It explains the options available, the best time to get a flu shot, and why it is important for elderly adults to get an annual influenza vaccine. It also covers side effects from the senior flu shot and how long they last. I will also cover how flu season is managed in long-term care facilities.
What is a senior flu shot?
The CDC recommends that everyone over the age of six months should get an annual flu vaccine, with a few exceptions. However, the standard flu vaccine is not as effective in people aged 65 and older. Elderly adults are also at higher risk for complications and death from the flu period.
To fight this, more powerful vaccines were developed with elderly adults in mind. As mentioned, senior flu shots prompt a stronger immune response, which offers greater protection against influenza.
Types of Flu Shots for Elderly Adults
Senior flu shots come in two forms: high-dose or adjuvanted influenza vaccine. Three of these vaccines are available for the 2023 to 2024 flu season:
Fluad Quadrivalent Adjuvanted Flu Vaccine
This vaccine contains the same level of antigens as the standard flu but has an extra ingredient called an adjuvant to create a greater immune response. This is the only adjuvanted vaccine available this coming flu season.
It contains four influenza strains and is currently approved for elderly adults 65 and older. Research in elderly adults shows that adjuvanted flu vaccines are more effective than the standard flu shot, help prevent complications and hospitalizations, and appear to provide longer protection.
Flublok Quadrivalent Recombinant Flu Vaccine
Contains antigen levels three times greater than regular flu shots. It is a recombinant vaccine manufactured without eggs. Flublok Is approved for people aged 18 and older and is not limited to elderly adults.
Fluzone High-Dose Quadrivalent Vaccine
Contains antigen levels four times greater than the standard dose vaccines. Available since 2009 flu zone is only approved for people 65 years and older.
High-Dose Flu Vaccine
The high-dose flu vaccines contain increased amounts of antigens. Antigens are the vaccine components that prompt the immune system to produce antibodies against influenza strains.
Antigens in the annual flu vaccine match the predicted influenza strains for the coming flu season. The antibodies the individual developed from the flu shot help their immune system quickly mount a defense when exposed to it again.
High-dose vaccines promote a stronger immune response. Studies show that the high-dose flu vaccine offers elderly adults 24% more protection against the flu than the standard flu vaccine.
Which Flu Shot is Best for Elderly Adults?
According to the CDC, the best flu shots for people over age 65 are Fluzone, Flublok, and Fluad. Known as senior flu shots, the CDC gives no preference to one over another.
Why Patients 65 and Older Should Get the Flu Shot?
This group of patients is 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. Getting an annual senior flu shot is critical to prevent complications.
An individual’s protection wanes over time, and each year, the vaccine is developed for the most rampant flu strains. However, research shows that people over age 65 often have weaker immune responses to the vaccine than younger people.
Two factors can hinder an elderly adult’s response to the flu vaccine:
- Pre-existing antibodies from prior flu seasons
- Chronic inflammation from arthritis, diabetes, heart disease, or other underlying health conditions
Both high-dose and adjuvanted flu shots provide elderly adults with better protection against complications from the flu. Compared to standard vaccines, senior flu shots reduce flu-related hospitalizations and deaths.
The flu can cause serious complications that require immediate medical care, including:
- 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
- worsening chronic medical conditions
What Flu vaccines Should Elderly Adults Avoid?
Elderly adults should not be given the nasal spray vaccine. The live intranasal influenza vaccine is not approved for use in adults over 50. Elderly adults should also avoid getting the standard flu shot unless higher doses or adjuvanted influenza vaccines are not available.
When Should Elderly Adults Get a Flu Shot?
The best time to administer the flu vaccine for seniors is late Fall. This helps to ensure their body has enough time to build immunity before the holidays when flu activity starts to ramp up.
This age group should also be advised against getting the flu shot too early in the season. The vaccine’s protection fades faster in elderly adults, so an August vaccination could lose effectiveness before the end of the flu season.
The flu vaccine for seniors is available from August through December.
What Are the Side Effects of the Senior Flu Shot?
The extra protection offered by the senior flu shots is also more likely to cause side effects than standard flu shots. Side effects of the senior flu shot are mild to moderate and only last a few days.
Senior flu shot side effects can include:
- fatigue
- headaches
- injection site pain and redness
- malaise
- muscle aches
How is the Flu Managed Among Long-Term Care Facilities?
If possible, all long-term care facility residents should receive the flu vaccine before flu season. Vaccines are usually available to long-term care facilities beginning in September. For facilities participating in Medicare and Medicaid programs, all residents are expected to be vaccinated unless contraindicated medically, resident, or legal representative refuses, or the vaccine is not available.
Flu Testing in Long-Term Care
Even when it is not flu season, flu testing should occur when any resident has signs or symptoms of acute respiratory illness or flu-like illness. When there are two instances of the flu identified within 72 hours of each other in residents in the same unit, outbreak control measures should be started as soon as possible.
The Bottom Line
In conclusion, The CDC recommends stronger influenza vaccines for people over 65. Also called senior flu shots, these vaccines are specifically formulated for aging immune systems that have a higher risk of complications and death from the flu.
As a nurse, it is important to provide proper and thorough patient education to patients in this age group so they can make the best personal healthcare decisions for flu season.
Ensuring all patients who would like a flu vaccine get one is also important and will result in positive health outcomes.
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