A healthcare provider wearing gloves vaccinates an older woman

The Centers for Disease Control and Prevention on Thursday released its influenza vaccination guidance for the 2022-2023 flu season, with preferential advice on which drugs to prescribe for older adults.

Adults aged 65 years and older should receive a strengthened influenza vaccine for the best protection against severe illness, according to the CDC’s Advisory Committee on Immunization Practices, which develops and authors the guidance.

Older patients should be advised to take an adjuvanted or high-dose vaccines over standard vaccines when available, it stated. These include:

  • Quadrivalent high-dose inactivated influenza vaccine (HD-IIV4);
  • Quadrivalent recombinant influenza vaccine (RIV4); or 
  • Quadrivalent adjuvanted inactivated influenza vaccine (aIIV4). 

“If none of these three vaccines is available at an opportunity for vaccine administration, then any other age-appropriate influenza vaccine should be administered,” the committee stated.

Standard influenza vaccines are often less effective in seniors when compared with younger populations due to the former group’s naturally declining immunity. Quadrivalent formulations of high-dose (HD-IIV4) and adjuvanted (aIIV4) influenza vaccines were introduced in the 2020-2021 season, to further shield at-risk recipients from flu and severe flu outcomes. These options add strengthened protection by stimulating an immune response against four different antigens. Trivalent formulations of these vaccines are no longer available, the committee noted. 

Clinicians should begin offering flu vaccination during September or October for most people who require only one dose for the season. Vaccination during July and August for older adults “should be avoided unless there is concern that vaccination later in the season might not be possible,” they added.

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