Flu Shots for Adults Age 65 and Older: What to Know
by Jake Newby
| 3 min read

The best way to protect against the flu and its potentially serious complications is the flu vaccine. The flu vaccine is especially important for adults who are 65 years and older as they are at a higher risk of developing serious flu complications compared to young, healthy adults, partly due to a weakened immune system associated with increasing age. On average, getting the flu vaccine reduces the chance of getting the flu by 40% to 60% among the overall population. Because flu viruses are constantly evolving, flu vaccines are updated each season. New for the 2022-2023 flu season, the Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices recommend the use of high-dose or adjuvanted flu vaccines is recommended for adults 65 and older over standard dose unadjuvanted flu vaccines. Adults age 65 and older should not get a nasal spray vaccine.
Why do older adults need high-dose or adjuvanted flu vaccines?
High-dose or adjuvanted flu vaccines are recommended for adults over the age of 65 because they don’t respond as well to regular flu shots as younger adults. In response to a regular flu shot, older people produce 50% to 75% fewer antibodies than younger people, according to Mayo Clinic.
What high-dose or adjuvanted flu vaccines are available?
The following three vaccines are approved and preferentially recommended for adults 65 years and older:
- Fluzone High-Dose Quadrivalent vaccine
- Flublok Quadrivalent vaccine
- Fluad Quadrivalent adjuvanted flu vaccine
An adjuvant is an ingredient that helps create a stronger immune response.
What time of year should older adults get the high-dose or adjuvanted flu vaccine?
Most everyone should be vaccinated by the end of October each year. Adults 65 and older should not get vaccinated early – in July or August – because protection provided by the vaccine may wane over time. Early vaccination should only be considered for any person who is unable to return in September or October to be vaccinated.
High-dose and adjuvanted flu vaccine side effects
The high-dose and adjuvanted flu vaccines may result in more of the temporary, milder side effects that can occur with standard-dose seasonal flu shots, including:
- Headache
- Muscle ache and malaise
- Pain
- Redness or swelling at the injection site
These side effects typically subside in one to three days. Other considerations Adults 65 and older should be up to date with their pneumococcal vaccination to protect against pneumonia, meningitis, and bloodstream infections. Pneumococcal pneumonia is an example of a serious flu-related complication that can cause death. Talk to your health care provider to find out which pneumococcal vaccine(s) are best for you. You can get the pneumococcal vaccine your provider recommends when you get a flu vaccine. Additionally, older adults should engage in the same everyday preventative actions the CDC recommends to everyone to avoid getting sick, including covering their mouths while coughing and frequently washing their hands. Related:
- Flu Season 2022-2023: What You Need to Know
- The COVID Mental Health Crisis
- What to Do When You’ve Lost Your COVID Vaccine Card
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