August 15, 2014
News Review From Harvard Medical School -- Best Flu Vaccines for Seniors, Kids
The nasal flu vaccine is more effective for young children, and the high-dose flu shot may be better for older adults, two new reports say. The advice on flu vaccines for children comes from a committee that advises the U.S. government. The Flu-Mist vaccine is preferred for healthy children ages 2 through 8, the committee said. This vaccine is given as a nasal mist. It contains live flu virus that has been altered so it cannot cause flu. Children can also receive standard flu shots. The new information about the high-dose vaccine comes from a study published August 15. Nearly 32,000 adults, ages 65 or older, were randomly divided into 2 groups. One group received standard flu shots. The other group got high-dose flu shots. Those who got the high-dose shots were 24% less likely to develop flu than those who got the standard shots. The new advice on flu vaccines for children was published online August 15 by the journal Morbidity and Mortality Weekly Report. The study results on the high-dose vaccine appear in the New England Journal of Medicine. HealthDay News wrote about the study.
By Howard LeWine, M.D.
Harvard Medical School
What Is the Doctor's Reaction?
Protection against influenza keeps getting better.
The U.S. Advisory Committee on Immunization Practices just released updated advice for this coming flu season. The big change is that there is now a preferred vaccine for many younger children. And new research shows that older adults have better flu immunity if they receive a high-dose flu shot. The New England Journal of Medicine published the study results yesterday.
Here are some key points in this year's flu vaccine advice:
- The flu strains covered by the 2014-2015 vaccines will be similar to what was covered last season.
- A child, ages 6 months to 8 years, who received at least one dose of flu vaccine last season will need only a single dose of this season's vaccine. Two doses are required if no vaccine was given last season.
- Live attenuated influenza vaccine (FluMist) squirted into the nose is the preferred vaccine for children ages 2 to 8 years. It provides better protection than the flu shot in this particular age group. The flu shot contains no live virus.
The advisory committee did not say anything new about the high-dose flu vaccine (Fluzone) for adults 65 years and older. However, the results of the study published yesterday show that it is better than standard-dose vaccine for this group.
The standard vaccine protects about 60% of adults from getting the flu. Protection is lower in adults 65 and older, about 50% effective.
Fluzone High-Dose contains inactivated particles of virus. It is given as a shot. It has four times as many of these particles as the standard vaccine.
This translated into:
- A more potent immune response, as measured by antibody levels in the blood
- A 24% lower risk of getting sick with the flu for older adults in the study
The researchers estimate that the high-dose flu shot provides seniors with the same level of protection that younger adults receive from the standard flu shot.
The high-dose vaccine can cause more side effects. These may include short-term, low-grade fever, discomfort at the injection site and general achiness. But it appears to be just as safe the standard vaccine. In this study, fewer people who received the high-dose vaccine reported serious side effects than those who got the standard dose.
What Changes Can I Make Now?
With some rare exceptions, everyone 6 months and older should get a yearly flu vaccine.
Depending on your age and medical conditions, some types of vaccine may be better for you than others. But it is more important to get vaccinated with the standard flu shot if that is the only one available. The high-dose flu shot and FluMist also might be more costly for some people.
What Can I Expect Looking to the Future?
Scientists will continue to get better at predicting which strains to include in the yearly flu vaccine. And they will discover new ways to make the shots more effective.