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Published on November 02, 2015

You should get a flu shot. But which one?

You should get a flu shot. But which one?

First things first: If you’re 65 and older, you should get a flu shot. Period.

At that age, you’re at a much higher risk of flu complications, including bronchitis, sinus infections, ear infections and even pneumonia, all of which can lead to hospitalization or even death.

But when you go for your shot, which one should you get?

Do you opt for the same regular dose you got when you were younger? Or, is it time for a higher-dose vaccine that contains four times the amount of antigen—the part of the vaccine that stimulates the immune system— as the standard shot?

In addition, should you get vaccinated to resist some forms of pneumonia?

“Aging decreases the body’s ability to have a good immune response after getting an influenza vaccine,” reports the national Centers for Disease Control and Prevention. “A higher dose of antigen in the vaccine is supposed to give older people a better immune response, and therefore, better protection against flu.”

The key words there are “supposed to,” said Mary Devlin, R.N., B.S.N., public health & wellness manager of the Visiting Nurse Association of Cape Cod.

A 2014 study published in the New England Journal of Medicine found that the high-dose vaccine was 24.2 percent more effective in preventing flu in adults 65 and older compared with the standard dose.

But those who get the higher-dose shot are more likely to develop side effects, such as fever and soreness at the injection site, during the week after vaccination, according to a Mayo Clinic study comparing the two vaccines.

The CDC has accelerated its approval of the Fluzone High-Dose vaccination, but its own advisory committee has not yet expressed a preference for either vaccine for those 65 and older. More studies are required to evaluate the stronger vaccine’s effect on seasonal flu outcomes, the CDC reports.

“If over the next few years, Fluzone High-Dose turns out to be superior to regular flu vaccine by these measures, high-dose vaccine may become the vaccine of choice for older people,” the CDC said.

Until then, Devlin recommends that you discuss which does you should take with your physician and pharmacist.  “Even if you don’t get the high-dose vaccine, make sure you get vaccinated—and do it as early in the flu season as possible,” she said.

Flu outbreaks can start in October, and it takes two weeks after you get the shot for your body to produce antibodies against the virus, she said. Some people hold off on vaccination out of concern that the protection wanes over time, but the shot should protect you for the entire flu season.

“The flu can be a very dangerous disease that can lead to hospitalization and death.  This can even negatively affect healthy individuals,” emphasized Angela Medeiros, director of Cape Cod Healthcare’s pharmacy at the Stoneman Outpatient Center in Sandwich.

And what about the pneumonia shot to complement the flu vaccine?

The CDC now recommends a pneumonia shot for everyone 65 and older. The risk of invasive pneumococcal disease in older adults is nearly 10 times that of young adults.

If you’ve never been vaccinated or if your previous vaccination history is unknown, you should get a pneumonia vaccine at age 65, according to the CDC. If you had your last pneumonia vaccine before age 65 and it’s been five years since your last dose, the CDC recommends getting a second vaccination.

The agency recommends seniors get both the Prevnar 13 and the Pneumovax 23 vaccines. As their names imply, Prevnar 13 protects against 13 types of pneumococcal bacteria, and the Pneumovax 23 protects against 23 types of pneumococcal bacteria.

Why not just get the vaccine that covers more strains? Because the two work in different ways, which appears to offer broader protection.

Devlin recommends discussing the pneumonia vaccine with your primary doctor to choose the best time to get the shots. “These two types of vaccines require the proper spacing and sequencing,” she said.

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