New and Improved Flu Vaccines

Believe it or not, the world’s best public health intervention ever is now even better. Full details about flu vaccine recommendations for those aged 65 and older are on the Centers for Disease Control and Prevention website at www.cdc.gov/flu/about/disease/65over.htm. This article will highlight the key points from the update.

For those aged 65 and older, the following two vaccine types are recommended this year:

• The high-dose vaccine, also known as quadrivalent, provides a stronger immune response following vaccination (higher protective antibody production).
• The adjuvanted flu vaccine, Fluad, is designed to help create a stronger immune response to vaccination. This vaccine will be available for the first time in the United States during the 2016–2017 season.

No longer recommended for seniors are the nasal spray flu vaccine (it is not recommended for use in any population at this time), the intradermal flu shot, or jet injector flu vaccine.

Side Effects

Let your patients know that 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.

When to Get Vaccinated

Keep in mind that the goal is to have as many patients vaccinated as possible. Recently, an immunologist at the University of Connecticut has advised those over the age of 65 to wait until October to be vaccinated to ensure adequate protection throughout the entire season, which can last into March.1

Most experts believe the ideal time for vaccination is between Halloween and Thanksgiving. But take note, if waiting might mean a vaccination doesn’t happen at all, advise your patients to get the vaccine anytime.

Remember the Pneumonia Vaccine

With all the hype about influenza, pneumonia, a highly preventable infectious disease, is all but forgotten. One of the deadliest complications of influenza infection is pneumococcal pneumonia. Be sure your patients are up to date with vaccination, and if they aren’t, urge patients to get the pneumococcal vaccine at the same time as the flu vaccine.

Create a Practicewide Flu Response Protocol

Plan a specific protocol to handle calls from patients during flu season. Your patients aged 65 and older fall into a high-risk pool and are at risk for a complicated course. It’s critical for these patients to get antiviral treatment early, so consider educational programs for patients and caregivers as well as your clinical and office reception staff.

So, here’s to improved vaccination rates and lowered infection rates in our patients. While our patients may or may not fully appreciate the value of this outstanding preventive care, you know you are doing exactly what you should do to protect them from this deadly and highly preventable illness.

— Rosemary Laird, MD, MHSA, AGSF, is a geriatrician, executive medical director of senior services for Florida Hospital at Winter Park, and past president of the Florida Geriatrics Society. She is a coauthor of Take Your Oxygen First: Protecting Your Health and Happiness While Caring for a Loved One With Memory Loss.

Reference
1. Patients over 65 may consider delaying flu shot, expert says. Fox News website. http://www.foxnews.com/health/2016/09/21/patients-over-65-may-consider-delaying-flu-shot-expert-says.html. Published September 21, 2016.