Flu Shots for Adults Age 65 and Older: What to Know 

Jake Newby

| 3 min read

Flu viruses are constantly evolving, so vaccines are updated each season. Older adults are urged to get high-dose or adjuvanted flu vaccines.
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 2023-2024 flu season, the Centers for Disease Control and Prevention (CDC) and the Advisory Committee on Immunization Practices (ACIP) recommend adults over 65 receive any of the following three higher dose or adjuvanted influenza vaccines:
  • Quadrivalent high-dose inactivated influenza vaccine (HD-IIV4)
  • Quadrivalent recombinant influenza vaccine (RIV4)
  • Quadrivalent adjuvanted inactivated influenza vaccine (aIIV4).
An adjuvant is an ingredient that helps create a stronger immune response. If none of these three vaccines is available at an opportunity for vaccine administration, then any other age-appropriate influenza vaccine should be used.

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 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.
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