High-dose and adjuvanted flu vaccines found to provide better protection for seniors

High-dose and adjuvanted influenza (flu) vaccines boosted protection against flu symptoms and hospitalization for people 65 years and older during the 2022–2023 flu season compared to the standard flu vaccine.

The study “Comparative effectiveness of licensed influenza vaccines in preventing influenza-related medical encounters and hospitalizations in the 2022-2023 influenza season among adults ≥65 years of age” was published on Aug. 21, 2024, in Clinical Infectious Diseases.

“Our research showed that there were advantages for older people to receive high-dose or adjuvanted flu vaccines over the standard vaccine,” said Jennifer Ku, Ph.D., MPH, an infectious disease epidemiologist with the Kaiser Permanente Southern California Department of Research & Evaluation.

“While seasonal variation exists, it is expected that seniors will continue to benefit from flu vaccines that are stronger than the traditional standard-dose vaccines.”

Vaccination is the best way to prevent flu and reduce the severity of flu symptoms. Typically, flu vaccines are made by incubating the viruses in chicken eggs.

To improve flu vaccine performance and its production, high-dose, adjuvanted, and recombinant vaccines became available. The high-dose vaccine is four times higher-dose than regular flu vaccines, while adjuvanted vaccines have an additional ingredient to boost the immune system. Recombinant vaccines are produced using recombinant technology that does not rely on eggs in the manufacturing process; they were not widely administered within Kaiser Permanente in Southern California and so were not included in this study.

In 2022, the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) made a recommendation to use high-dose, adjuvanted, or recombinant vaccines over standard dose vaccines for adults aged 65 years and older. Individuals in this age group are at increased risk for severe illness, hospitalization, and death due to flu.

The study included nearly a half-million people aged 65 years and older who received one or more doses of flu vaccine during the 2022–2023 flu season. As compared to standard dose flu vaccine, the vaccine effectiveness of high-dose and adjuvanted flu vaccine against hospitalization for flu was estimated as 25% and 62%, respectively. As compared to standard dose flu vaccine, the vaccine effectiveness of high-dose and adjuvanted flu vaccine against health care visits for flu was estimated at 9% and 17%, respectively.

“This was the first real-world study to compare high-dose and adjuvanted flu vaccines to the more traditional standard-dose egg-based vaccines after the preferential recommendation was made by ACIP,” said the senior author on the paper, Hung Fu Tseng, Ph.D., MPH, a senior scientist with the Department of Research & Evaluation.

“Our study findings support ACIP’s recommendation to vaccinate seniors with high-dose and adjuvanted flu vaccines.”