Close up image of a caretaker helping older woman walk

Senior citizens have always been one of the groups most vulnerable to bad strains of the flu and outbreaks of pertussis, or whooping cough. Now they may be at risk for not receiving the appropriate vaccinations, the L.A. Times reported.

In California, where pertussis outbreaks have infected up to 6,000 residents this year, the state’s Department of Public Health and the U.S. Centers for Medicare & Medicaid Services have heard anecdotal reports that some physicians are erroneously refusing to inoculate seniors due to safety concerns. Doctors’ information to patients is outdated, state officials claimed, the L.A. Times reported.

In other states, such as Florida, seniors must contend with disagreements between physicians as to the safety, effectiveness and higher price tag for a new, strengthened flu vaccine, according to the Orlando Sentinel. That new high-dose flu vaccine is now available for seniors.

Last spring, the FDA approved a new flu vaccine manufactured by Sanofi-Pasteur that contains four times the number of antigens found in previous flu vaccines. The strengthened vaccine can also run $10 to $20 more than the standard flu shot. Some doctors argue that the higher dose does a better job of jump starting seniors’ immune systems; others argue that the severity of vaccine-related side effects aren’t worth it.