ACIP Recommends High-Dose Influenza Vaccine for Patients 65 Years or Older


This recommendation comes at an critical time as this flu season is feared to be a rebound after the low numbers the last few years due to COVID-19 precautions.

Older woman with influenza (Adobe Stock)

Older woman with influenza (Adobe Stock)

As the United States prepares for the next influenza season, the Center for Disease Control’s Advisory Committee on Immunization Practices (ACIP) has granted preferential recommendation for the use of differentiated flu vaccines for adults 65 years and older. Prior to this recommendation, there has never been a preferred flu vaccine for older adults, and no updated ACIP recommendations for influenza vaccines for this population have been made since 2010.

Because people over 65 years old are especially vulnerable to influenza, which can lead to life-threatening complications, this recommendation comes at an auspicious time as the US prepares for the next influenza season. With precautions for COVID-19 in place, flu cases have been low, and now with those precautions minimized, flu cases are expected to rebound, and the older population is at higher risk again. With this mind, the recommendation by the ACIP supports that not all flu vaccines are created equal, and that this susceptible population requires better protection than what a standard dose vaccine may provide.

Seasonal influenza is a serious illness that disproportionally affects people 65 years or older and can lead to pneumonia, serious heart conditions, hospitalizations, and death. Other people who are especially susceptible to complications are people of color, and people with co-morbidities such as diabetes, asthma, chronic obstructive pulmonary disease, and heart disease.

“We are encouraged that the ACIP has recommended tailored influenza vaccines for adults 65+, and believe this is the first step in creating clearer guidance on protection against the flu for this high-risk population,” Christopher Rizzo, MD, U.S. Senior Medical Director at Sanofi, the manufacturer of the recommended vaccine, said in the company's press release. “We are hopeful this recommendation will mean more adults 65+ will be immunized with a flu vaccine that is best suited for their needs. Available clinical data and real-world evidence clearly support differentiated flu vaccines as being more effective than a standard dose vaccine at preventing influenza infection, helping to lower the burden of disease and minimize health disparities in the U.S. population. We look forward to a final decision from CDC.”

The recommended influenza vaccine, Fluzone® High-Dose Quadrivalent is touted as the first and only influenza vaccine with superior flu protection and 10 years of evidence [from 2009-2019] in preventing flu-related hospitalizations in adults over 65 years.

A prior press release by Sanofi urged the ACIP to recommend their 65 years and older vaccine has this description of the Sanofi Fluzone High-Dose vaccine: “With protection against 4 flu strains, Fluzone High-Dose is the only influenza vaccine licensed for use in adults 65 years of age and older to have demonstrated superior efficacy in a randomized controlled trial versus a standard dose influenza vaccine for the prevention of laboratory-confirmed influenza illness and the only influenza vaccine with 10 years of data demonstrating protection from flu and its related complications. In a real-world analysis of approximately 34 million people, those who received Fluzone High-Dose experienced an 18% reduction in cardio-respiratory hospitalizations and over a 27% decrease in pneumonia hospitalizations, both of which are reductions above what the standard dose vaccines provided.”

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