Flu shot options for seniors (65 years and older)

By Amy Magill, Manager, Office of Clinical Integrity Aug 24, 2023 • 2 min


Millions of people get sick with the flu each year. Flu is typically a mild illness for many people, but for older adults, especially those who chronic health conditions, the flu can be very serious.

Older adults are particularly at risk for infection, hospitalization and even death due to flu-related complications, such as pneumonia. This is why flu vaccination is especially important for people 65 years and older. It's the best way to protect against the flu.

Types of flu vaccines for adults 65 years and older

People 65 years and older should get a flu shot, not a nasal spray vaccine. There are several different flu shots available to older adults. These include standard-dose flu shots and two flu vaccines designed specifically for people 65 years and older. Older adults can get any flu shot approved for use in their age group.

Older people have weaker immune systems that may not respond as well to standard-dose flu shots because they do not produce as high of an antibody response after the flu vaccination compared to younger people. People with low antibody levels may be at a higher risk of becoming infected with the flu. To help improve the antibody response, people 65 years and older have the option of getting either a high-dose or adjuvanted flu vaccine. These two vaccines are specifically formulated for older adults, and in studies have demonstrated better protection against flu for this age group than the standard-dose shot.

What is the high-dose flu vaccine?

The high-dose vaccine contains four times the amount of antigen (the component that stimulates the immune system) as a regular flu shot. The higher dose of antigen in the vaccine is intended to give older people a better immune response, and therefore, better protection against the flu.

What is the adjuvanted flu vaccine?

The adjuvanted flu shot contains an extra substance called an adjuvant that helps the vaccine create a stronger immune response.

What are the side effects of the high-dose and adjuvanted flu vaccine compared to the traditional flu vaccine?

The high dose and adjuvanted flu vaccines may result in more of the temporary, mild side effects that can occur with standard-dose seasonal shots. Mild side effects can include pain, redness or swelling in the area where the shot was given. Some people may develop body aches or a low-grade fever. These symptoms are usually mild and quickly go away on their own.

The seasonal flu vaccine is needed every year.

Receiving an annual flu vaccination (ideally before flu viruses begin spreading in your community) provides the best protection against flu throughout the flu season. Adults 65 years and older may want to consider getting one of the flu vaccines designed specifically for their age group—but getting any flu shot is better than not getting vaccinated at all. If you have questions about which flu vaccine is best for you, talk to your health care provider.

Updated August 2023.

Explore more

5 min
By Sanjay “Jay” Patel, DO, Allergy & Immunology
May 10
4 min
By Jenilee Matz, MPH
Aug 25