Advanced Flu Shots: Vaccination Guidelines for Ages 65 and Over

The advanced flu vaccine is designed to help people 65 and older avoid getting the flu (flu) infection. The Centers for Disease Control and Prevention (CDC) recommends that all people 6 months and older get an annual flu shot (with very few exceptions).

The flu vaccine is especially important because people 65 and older are at higher risk for complications and death from the flu. There are two flu vaccines designed for older adults that may provide additional protection.

This article will discuss flu vaccines for older adults. It will outline two types of vaccines designed for people 65 and older and one vaccine they should not get. It will cover the side effects of the advanced flu vaccine, when to get the flu shot and how often you should get the flu shot.

What is the advanced flu vaccine?

People 65 and older are at the highest risk for complications from the flu. About half of flu-related hospitalizations and up to 85% of flu-related deaths occur in this age group. Therefore, getting the flu vaccine is crucial.

This age group, like everyone else, needs an annual flu shot. A person’s protection wanes over time, and vaccines are tailored each year to the most prominent strains of the flu. September and October are the best times to get an advanced flu shot, but you can also get it later in the season.

Anyone 65 and older can get any available flu vaccine approved for that age group. However, they should not get the nasal spray vaccine. Additionally, they may benefit from a vaccine designed for people 65 and older.

Types of flu vaccines for older adults

It is normal for your body to respond less to vaccines as you age. Older adults who get the flu vaccine often have a weaker immune response than younger people who get the flu shot. But the vaccine was still effective in reducing flu visits and hospitalizations.

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Some flu vaccines are designed to elicit a stronger immune response. These flu shots provide greater protection for people 65 and older. There are two types of advanced flu shots that are only available to people 65 and older.

high-dose flu vaccine

High-dose flu vaccine contains four times the amount antigen, the part of the vaccine that the immune system produces antibodies (proteins that recognize and bind to specific antigens) against a specific antigen. People who get this vaccine usually have a stronger immune response.

One study found that people 65 and older who received a high-dose flu vaccine were 24 percent more protected from the flu than people in this age group who received a regular flu shot.

The high-dose flu vaccine is sold under the brand name Fluzone High-Dose. It has been available since 2009. It’s only for people 65 and older.

adjuvant influenza vaccine

Adjuvanted flu vaccines use an added ingredient called an adjuvant to trigger a stronger immune response. It contains the same number of antigens as the standard flu vaccine.

Adjuvanted influenza vaccine (trade name Fluad) was approved in the United States in 2015. Fluad Quadrivalent is used to prevent four strains of influenza virus and is only licensed in the United States for people 65 years of age and older.

There are fewer studies of adjuvanted influenza vaccines than high-dose influenza vaccines. Some insurance information suggests that people 65 and older who receive the supplemental flu vaccine are less likely to be hospitalized than those who receive the standard flu vaccine.

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Which advanced flu vaccine is best?

The CDC says people 65 and older should get any flu vaccine available to them. No one type is better than another. Discuss with your doctor or pharmacist whether a high-dose flu shot or an adjuvanted flu shot is better for you.


People 65 and older who get the flu vaccine are less likely to get the flu, be hospitalized, or die. High-dose or adjuvanted influenza vaccines may provide additional protection.

side effect

People who got the high-dose flu vaccine were more likely to experience side effects than those who got the standard flu shot. They include:

  • pain and redness at the injection site
  • feeling tired
  • headache and muscle aches

Most people who received the high-dose parainfluenza vaccine had no or moderate side effects. People who received the adjuvanted flu vaccine were more likely to experience mild to moderate side effects.

emergency flu symptoms

The flu can be serious, especially in people 65 and older. You should seek immediate medical attention if you experience any of the following symptoms:

  • Difficulty breathing
  • chest or abdominal pain or pressure
  • dizziness or confusion
  • Seizures
  • severe pain, weakness, or instability
  • Not urinating or other signs of dehydration
  • Symptoms get better, then get worse again
  • chronic illnesses that worsen during your illness


The annual flu shot is especially important for people 65 and older because they are at the highest risk of becoming seriously ill from the flu. Half of flu hospitalizations and at least 70% of flu-related deaths occur in people 65 and older.

While they can get any flu shot, some studies have shown additional benefits of advanced flu shots, namely high-dose flu shots and adjuvanted flu shots.

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VigorTip words

If you are over 65, it is important to protect yourself from the flu. The CDC doesn’t say one vaccine is better than another — getting vaccinated is important. However, some studies suggest that advanced flu vaccines (high-dose and adjuvanted vaccines) may provide additional protection. Talk to your doctor about whether the flu vaccine for older adults is right for you.

Frequently Asked Questions

  • How often should I get the flu shot?

    You should get the flu vaccine every year. There are two reasons. The protection provided by the flu vaccine becomes less effective over time, so you will need another dose. In addition, the vaccine is adjusted each year to protect against the flu strains that are expected to be the most common that year.

  • When is the best time to get the flu vaccine?

    If you live in the Northern Hemisphere and are 65 years or older, September and October are the best times to get the flu shot. But if you didn’t shoot earlier in the season, it’s still worth it to shoot late in winter or even in spring.

  • What is the difference between the regular flu shot and the advanced flu shot?

    Advanced flu vaccines are designed to elicit a stronger immune response. This can be done by using higher doses of the antigen (the part of the vaccine that triggers an immune response) or by using an adjuvant (an additive that stimulates a stronger response).

  • How long is the advanced flu vaccine valid for?

    A person’s immune response to vaccines decreases over time, which can happen more quickly in older adults. The advanced flu vaccine should be given in September or October each year to ensure a good response during flu season.