Senior in mask receiving bandage after vaccination

Federal vaccine advisers now recommend that adults aged 65 and older preferentially receive strengthened influenza vaccines for the best protection against severe illness.

In a Wednesday meeting, independent experts with the Advisory Committee on Immunization Practices agreed that older adults should be offered one of three adjuvanted or high-dose vaccines over standard vaccines when available. 

Older adults have been a target population for yearly flu vaccination since the 1960s due to their increased risk of severe illness and death from flu, a factor the ACIP panel considered in its decision. In addition, standard influenza vaccines are often less effective in seniors when compared with younger populations due to their naturally declining immunity.

Currently available high-dose and adjuvanted vaccines recommended for seniors include Fluzone High-Dose, Fluad and Flublok. No preference for these vaccines over standard vaccine options had been previously stated before the Wednesday decision, but older adults are already receiving these vaccines in high numbers, according to data from the Centers for Disease Control and Prevention. 

Already widely accepted

An analyses of vaccine effectiveness suggested that most Medicare beneficiaries aged 65 years and older have received a higher-dose or adjuvanted vaccine in recent seasons, according to the ACIP panel.

The panel did not recommend any one of the high-dose vaccines over the others. Protective benefits are moderate and “clearly outweigh” any known side effects or harms in most settings, which are minimal, they noted.

“It is critical that we do everything we can to protect vulnerable populations like older adults against influenza,” Gregg Sylvester, M.D., chief health officer at Seqirus, which makes Fluad, said in a statement following the ACIP’s decision. “Today’s recommendation is evidence of the ACIP’s commitment to providing clear, evidence-backed guidance to protect public health.”

The timing of the panel’s endorsement was likely influenced by increased attention to the vulnerability of older adults during the pandemic, long-term care experts told McKnight’s Clinical Daily in the lead-up to Wednesday’s meeting.

ACIP advises the CDC, which often endorses its recommendations.

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