Flu info for people 65 Years and older

From the CDC
People 65 years and older are at higher risk of developing serious flu complications compared with young, healthy adults. This increased risk is due in part to changes in immune defenses with increasing age. While flu seasons vary in severity, during most seasons, people 65 years and older bear the greatest burden of severe flu disease.
In recent years, for example, it’s estimated that between 70 percent and 85 percent of seasonal flu-related deaths have occurred in people 65 years and older, and between 50 percent and 70 percent of seasonal flu-related hospitalizations have occurred among people in this age group.
A Flu Vaccine is the Best Protection
The best way to protect against flu and its potentially serious complications is with a flu vaccine. Flu vaccines are updated each season because flu viruses are constantly changing. Also, immunity wanes over time. Annual vaccination helps to ensure the best possible protection against flu. A flu vaccine protects against the flu viruses that research indicates will be most common during the upcoming season.
Flu vaccines for the 2022-2023 flu season have been updated from last season’s vaccine to better match circulating viruses. Immunity from vaccination fully sets in after about two weeks.
Flu vaccination is especially important for people 65 years and older because they are at higher risk of developing serious flu complications. Three specific flu vaccines are preferentially recommended for people 65 years and older over other flu vaccines.
People 65 and older should get a higher dose or adjuvanted flu vaccine, including: Fluzone High-Dose Quadrivalent, Flublok Quadrivalent, or Fluad Quadrivalent vaccine. These vaccines are preferred for people 65 years and older because a review of existing studies suggested that, in this age group, these vaccines are potentially more effective than standard dose unadjuvanted flu vaccines.
When should I get vaccinated?
For most people who need only one dose of flu vaccine for the season, September and October are generally good times to be vaccinated against flu. Ideally, everyone should be vaccinated by the end of October. Additional considerations concerning the timing of vaccination for certain groups of people include:
·         Most adults, especially those 65 years and older, and pregnant people in the first or second trimester should generally not get vaccinated early (in July or August) because protection may decrease over time. However, early vaccination can be considered for any person who is unable to return at a later time to be vaccinated.
·         Some children need two doses of flu vaccine. For those children it is recommended to get the first dose as soon as vaccine is available, because the second dose needs to be given at least four weeks after the first. Vaccination during July and August also can be considered for children who need only one dose.
·         Vaccination during July and August also can be considered for people who are in the third trimester of pregnancy during those months, because this can help protect their infants for the first few months after birth (when they are too young to be vaccinated).
Specific Flu Shots for People 65 and Older
For the 2022-2023 season, CDC and ACIP preferentially recommend the use of higher-dose flu vaccines (Fluzone High-Dose Quadrivalent inactivated influenza vaccine and Flublok Quadrivalent flu vaccine) or adjuvanted flu vaccine (Fluad Quadrivalent vaccine) over standard-dose unadjuvanted flu vaccines for people 65 years and older. This recommendation is based on a review of available studies which suggests that, in this age group, these vaccines are potentially more effective than standard dose unadjuvanted flu vaccines. 
If one of these vaccines is not available at the time of administration, people in this age group should get a standard-dose unadjuvanted inactivated flu vaccine instead. There are other flu vaccines approved for use in people 65 years and older. People 65 years and older should not get a nasal spray vaccine. More information about preferentially recommended flu vaccines is below:
High-Dose Flu Vaccine
Fluzone High-Dose Quadrivalent vaccine (manufactured by Sanofi Pasteur) contains four times the amount of antigen (the inactivated virus that promotes a protective immune response) as a regular flu shot. The higher dose of antigen is intended to give people 65 years and older a better immune response to vaccination, and therefore, better protection against flu. Fluzone High-Dose has been approved for use in people 65 years and older in the United States since 2009.
Flublok Quadrivalent (manufactured by Sanofi Pasteur) is a recombinant protein influenza vaccine approved for use in people 18 years and older. It is made using different production technology than inactivated influenza vaccines and contains three times the antigen dose compared with standard-dose inactivated flu vaccines. Recombinant flu vaccine became available for the first time in the United States during the 2013-2014 influenza season as a trivalent vaccine, Flublok. Flublok Quadrivalent became available during the 2017-2018 influenza season.
Adjuvanted Flu Vaccine
Fluad Quadrivalent flu vaccine (manufactured by Seqirus) is made with MF59 adjuvant, an additive that helps create a stronger immune response. Adjuvanted flu vaccine became available for the first time in the United States during the 2016-2017 flu season, when a trivalent version of Fluad was approved. Fluad Quadrivalent because available during the 2020-21 season.
The high dose and adjuvanted flu vaccines may result in more of the temporary, mild side effects that can occur with standard-dose seasonal flu shots. Side effects can include pain, redness or swelling at the injection site, headache, muscle ache and malaise, and typically resolve with 1 to 3 days.
Get pneumococcal vaccines
·         People who are 65 years and older also should be up to date with pneumococcal vaccination to protect against pneumococcal disease, such as pneumonia, meningitis, and bloodstream infections. Talk to your health care provider to find out which pneumococcal vaccines are recommended for you.
·         Pneumococcal pneumonia is an example of a serious flu-related complication that can cause death. You can get the pneumococcal vaccine your provider recommends when you get a flu vaccine.
Other Preventive Actions
In addition to getting a flu shot, people 65 years and older should take the same everyday preventive actions CDC recommends for everyone, including avoiding people who are sick, covering coughs, and washing hands often.
Because you are at higher risk of developing serious flu complications, if you get flu symptoms, call your health care provider right away. There are antiviral drugs that can treat flu illness and prevent serious flu complications. CDC recommends prompt treatment with a flu antiviral medication for people who have flu or suspected flu infection and who are at higher risk of serious flu complications.