High-Dose flu vaccine for 65 and over

Resaved Dr TLast year my husband and I were given the extra-strength flu shots intended for senior citizens. Are they available again this year?  Did any studies show they were better than regular flu shots? We haven’t heard anything about them this year.

(edited from the FDA website) The extra strength “Fluzone High-Dose” flu vaccine is again available and we have an ample supply in our office.  This is the fourth flu season that it has been available.  The vaccine is preservative free and is covered by Medicare.  It is not a live vaccine and can be given to those with compromised immune systems.

The High-Dose vaccine has four times the amount of “antigen” in the hopes that it will be more effective in stimulating the immune systems of those 65 years and older who do not always get the full protection from standard flu shots due to our immune systems not being quite as robust as we get older.

The vaccine was initially tested in in 3,837 subjects 65 years of age and older. The initial study showed the vaccine to be safe without serious side effects.  Those who received the higher dose produced more antibodies against the flu particularly the A strains and lesser so the B strain. As might be expected the greater amount of antigen caused more non serious side effects such as sore arm, headache and fever.  The study was not designed to see if it actually prevented more flu cases.  Based on the initial study the FDA approved the vaccine as an option for those over 65.  The manufacturer agreed to collect data on 30,000 patients over 3 years to see if the vaccine was actually more effective than the standard flu shot in preventing the flu.  An ongoing study designed to determine the effectiveness of the High-Dose vaccine in preventing illness from influenza compared to the regular strength is expected to be completed in 2014-2015.
The Bottom Line:  The High-Dose flu vaccine is a reasonable option for those over 65.  So far it appears promising and probably will be more effective in preventing the flu in those 65 and over though it may be another year or two before we can be more definitive.

Dr T


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