Which flu vaccines are recommended for older adults?

Dear Savvy Senior: I just turned 65 and would like to learn more about the stronger flu shots I see advertised for older adults. What can you tell me about them and how are they covered by Medicare? — Senior Novice

Dear Novice: There are actually three different types of senior-specific flu shots (you only need one) that the CDC is now recommending to people 65 and older. These FDA-approved annual vaccines are designed to offer extra protection beyond what a standard flu shot provides, which is important for older adults who have weaker immune defenses and have a greater risk of developing dangerous flu complications. Here’s more information on these three vaccines.

Fluzone High-Dose Quadrivalent: Approved for U.S. use in 2009, the Fluzone High-Dose is a high-potency vaccine that contains four times the amount of antigen as a regular flu shot does, which creates a stronger immune response for better protection. According to a study published in the New England Journal of Medicine, this vaccine was proven 24 percent more effective than the regular dose shot at preventing flu in seniors.

Fluad Quadrivalent: First available in the U.S. in 2016, this adjuvanted vaccine contains an added ingredient called adjuvant MF59 that also helps create a stronger immune response. In a 2013 observational study, Fluad was found 51 percent more effective in preventing flu-related hospitalizations for older patients than a standard flu shot.

You also need to be aware that both the Fluzone High-Dose and Fluad vaccines can cause more of the mild side effects that can occur with a standard-dose flu shot, like pain or tenderness where you got the shot, muscle aches, headache or fatigue. And neither vaccine is recommended for seniors who are allergic to chicken eggs, or those who have had a severe reaction to a flu vaccine in the past.

Also note that the CDC does not recommend one vaccination over the other.

FluBlok Quadrivalent: For older adults that are allergic to eggs, FluBlok, which is a recombinant vaccine that does not use chicken eggs in their manufacturing process is your best option. This vaccine is proven to be 30 percent more effective than a standard-dose influenza vaccine in preventing flu in people age 50 and older.

All of these vaccines are covered 100 percent by Medicare Part B as long as your doctor, health clinic or pharmacy agrees not to charge you more than Medicare pays.

Pneumonia vaccines

Another important vaccination the CDC recommends to seniors, especially this time of year, are the pneumococcal vaccines for pneumonia. Around 1.5 million Americans visit medical emergency departments each year because of pneumonia, and about 50,000 people die from it.

The CDC recently updated their recommendations for the pneumococcal vaccine and now recommend that everyone 65 and older who has not previously received any pneumococcal vaccine should get either PCV20 (Prevnar 20) or PCV15 (Vaxneuvance). If PCV15 is used, this should be followed by a dose of PPSV23 (Pneumovax23) at least one year later.

Or, if you’ve previously received a PPSV23 shot, you should get one dose of PCV15 or PCV20 at least one year later.

Medicare Part B also covers two different pneumococcal shots — the first shot at any time and a different, second shot if it’s given at least one year after the first shot.

COVID booster

If you haven’t already done so, you should also get a COVID-19 booster shot this fall. Both Moderna and Pfizer have developed new bivalent booster vaccines that adds an Omicron BA 4/5 component to the old formula, which provides better protection.

Send your senior questions to: Savvy Senior, P.O. Box 5443, Norman, OK 73070, or visit SavvySenior.org.