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Flu Shots for all – but what if you’re over 65?
As Rhode Island kicked off its annual Flu Vaccination Campaign, there was a deeper and more serious tone to it due to the coronavirus pandemic.
Many symptoms of the flu mirror symptoms of COVID-19. Both viruses can cause fever, cough, shortness of breath, nasal congestion, muscle aches, and fatigue. Flu vaccine will lessen the chances that someone will have to deal with the serious health consequences of the flu, and it will lessen the chances that Rhode Island’s healthcare system will be overburdened with both flu and COVID-19 patients in the coming months.
The goal of the RI Department of Health is to see 90% of Rhode Island vaccinated against the flu. Rhode Island usually has one of the highest compliance rates in the country.
During the 2018-2019 flu season, 60% of Rhode Islanders were vaccinated against the flu: 78% of children and 56% of adults. The flu resulted in 1,032 hospitalizations and there were 39 flu-associated deaths.
During the 2019-2020 flu season, when strict community mitigation measures were in place to prevent the spread of COVID-19 and when patterns of healthcare utilization were atypical, Rhode Island saw 950 hospitalizations and 20 flu-associated deaths. Vaccination records for this time period are not yet available.
“While a flu vaccination rate of 90% is an ambitious goal, flu vaccination will be more important than ever this year. The simple choice to get a flu shot and make sure that your loved ones get their flu shots is a powerful step to help keep all of Rhode Island healthy and safe,” said RI Director of Health Nicole Alexander-Scott, MD, MPH.
Rhode Island has brought 150,000 more doses of flu vaccine into the state than during years past and is prepared to purchase additional vaccine. This year’s vaccine protects against two influenza A strains (including the H1N1 strain) and two influenza B strains, based on what strains experts expect to be circulating in the community. Two enhanced flu vaccines will be available for seniors, both of which help create a higher immune response.
While flu shots are important for everyone older than six months of age, they are especially important for certain people, including older adults, younger children, healthcare workers, pregnant women, and people with chronic medical conditions. Examples of chronic medical conditions include diabetes, cancer, heart disease, and asthma.
After getting a flu shot, some people experience a slight ache or a low-grade fever. This means that the body is developing an immune response to the flu virus. These mild side effects are much less significant than the actual flu, which causes most people to stay in bed for a week. You cannot get the flu from the flu shot.
Flu shots will become available at hundreds of community clinics, schools, COVID-19 testing sites (for asymptomatic people), pharmacies, nursing homes, doctors’ offices, and other sites throughout the state. Be prepared to wear a face mask when going to get your flu shot, and observe other COVID-related precautions, like getting a temperature check and waiting 6 feet away from other patients.
RI resources:
- List of vaccination clinics and general information about the flu: www.health.ri.gov/flu. (Evening school clinics are open to the entire community.)
- Information about the flu in Spanish: health.ri.gov/gripe
- People with additional questions can call RIDOH’s Health Information Line at 401-222-5960 / RI Relay 711.
Which flu shot is right for you?
In 2017, more than 170,000 people, or 16% of the Rhode Island population, were over 65.
According to the AARP, adults 65 and older should ask their health care provider for either the high-dose or adjuvanted flu vaccine, both of which produce a stronger immune response (and therefore more protection against the flu) in older adults.
This year, the high-dose vaccine is quadrivalent instead of trivalent — meaning it protects against four strains of flu instead of three — and a quadrivalent version of the adjuvanted vaccine will also be available.
There are two vaccines that are specifically for people 65 and older this year (Flu Zone High Dose and Flu Ad). They are enhanced vaccines, meaning that they generate a stronger immune response. This year they are quadrivalent, meaning that they protect against 4 strains. (In past years they only protected against 3.)
While supplies are expected to be adequate, you may want to call your pharmacy if you are going to need a higher-dose flu shot.
Where can I get the high-dose, over 65, flu shot?
Pharmacies (including national chains like CVS and Walgreens), doctors’ offices, health department clinics are offering these vaccines, typically free with insurance. (Find a location near you with the CDC’s VaccineFinder tool.)
How the Flu Shot Is Made
Flu season begins for the public each fall. For flu experts in the United States, however, it begins in February. That’s when scientists and researchers from around the world gather for a meeting hosted by the World Health Organization (WHO), where they spend days reviewing which strains of the flu virus have been making people sick and decide which strains the next season’s vaccine should cover.
But when experts touched down in Beijing this year, their goal — to recommend a vaccine formula for the Northern Hemisphere’s 2019-2020 flu season — hit a roadblock.
A new variety of the flu virus known as H3N2 had begun to spread rapidly in several countries. In the United States, it caused a second wave of illnesses late in a flu season that had already seen the rise and fall of another strain entirely.
“That was something that we were concerned about and wanted to incorporate into the Northern Hemisphere vaccine … so we delayed the H3N2 decision by a month,” says virologist and physician Kanta Subbarao, director of the WHO Collaborating Centre for Influenza in Melbourne, Australia, one of six WHO centers that help track flu worldwide.
The extra month gave experts more time to analyze the newly circulating virus. By March, they had updated their recommendation to include a suitable H3N2 strain for this season’s flu shot, which is now available.
More importantly, the delay proved an old truth about an ancient virus: The flu is a moving target, and for the network of laboratories, agencies and manufacturers who help make the flu vaccine each year, tracking it is only the start.
A needle in a haystack
The challenge starts with the virus itself.
An expert shape-shifter, the flu is constantly changing — mutating as it replicates itself — in ways that allow its strains to get past our body’s immune defenses even if we’ve had the flu before, or if we roll up our sleeves for the shot each fall.
The result? “It’s a bit of a war between us and the virus,” says David Wentworth, director of the WHO Collaborating Centre for Influenza in the U.S., which is run out of the Centers for Disease Control and Prevention (CDC) in Atlanta.
This battle plays out not only within the bodies of people who come down with the flu’s signature fever, chills and muscle aches, but also in laboratories around the world, where researchers must work quickly to analyze how the flu virus is changing in order to predict what it might do next.
The worldwide system of surveillance starts when specimens from sick patients are sent to the lab for testing. Of those, about 7,000 end up at the laboratory run by microbiologist John Barnes, who leads the CDC’s influenza genomics team.
“We’re always busy, and we’re always getting new viruses to work on,” Barnes says. He and his team perform year-round genetic sequencing to determine how flu viruses are behaving, both in terms of which strains are infecting people and other characteristics, like whether a specimen shows signs of resistance to the antiviral drugs that can treat the flu.
From there, about one-third of the CDC specimens will undergo further assessment as part of a labor-intensive process known as antigenic testing.
“Almost every season’s a little different, and the viruses that circulate have nuance,” Wentworth says. “We’re looking for a needle in a haystack.”
The Pneumonia Shot & Older Adults
Older adults should also make sure they are up-to-date on pneumococcal vaccination. (These are one-time, not yearly). Pneumococcal vaccination helps reduce the risk of certain types of bacterial pneumonia and other potential complications of influenza. The pneumococcal vaccine recommended for all adults aged 65+ is the pneumococcal polysaccharide vaccine (“PPSV23”), brand name Pneumovax. It can be administered at the same time as the annual influenza vaccination, but it can also be administered separately.
Is their any place giving free flu shot (Quad) for seniors? I’m talking about no insurance.
As I understand it, CVS, Walgreens, etc. – all shots are no cost.
https://health.ri.gov/flu/ – more good info here – including searchable database by city
Good afternoon, Nancy,
I’m back and thanks for pushing the flu shots. I received my quadrivalent shot on Friday. Walgreen’s on Park Ave. has it in stock. It takes about 15 minutes to fill out the paperwork and get the shot. It’s my go-to place to get immunized.
I would add that anyone of any age goes to the CDC Website and look up the chart for any immunization and the age you should be getting them. I did it a few years ago and was surprised to see how many boosters we seniors should be getting.
While there, I spotted a sign about pneumonia vaccines. I questioned the pharmacist because it said we should have 2 pneumonia shots. She was showing I had had one. Walgreen’s holds your record for 2 yrs. then sends it to Corporate. Walgreen’s can retrieve your record and they get back to you. I told her that I have a medical portal and would check – I didn’t recall getting 2.
Lo and behold, I had the 2 shots – they were 3 yrs. apart. I called her and let her know.
For the 50 yr. olds, they need 3 shingles shots. There’s the original and the newer version that is 2 series – 1 shot and then another 3 months later.
I would encourage parents/grandparents of infants to get their TdaP (Tetanus, Diptheria, Pertussis {whooping cough} boosters. I had it done because my neighbor had an infant that I knew I would be around.
I would encourage everyone to stay on top of vaccines. Our young parents who refuse to vaccinate their kids don’t understand that, at their age, they probably had all the shots available when they were infants. I’d rather stay up all night with an infant crying and a mild fever than have them go through the agonies of measles and what some disease like measles can do. I know I was out of school for weeks, kept in a separate, dark room and only Dad was allowed in. I was thrilled to go back to school but then sent home when the principal (back in the old days) discovered a scab on my head. I was sent home until that fell off. Over-cautious? Maybe – I’m 71 but we’ve seen outbreaks of old diseases in college kids and they hit them harder than they would have as a child.
COVID – I’ve discussed this with my doctor. There is no vaccine and until there is one with proven efficacy, I’m taking a pass. I’ve been tested and negative. I’ll keep wearing my mask, washing my hands (and face). Scientists still don’t know the cause which is why it’s taking so long to find the right mix for a vaccine. Salk didn’t create the polio vaccine overnight but when it was proven that it worked, families lined up in front schools to get their shot. The shots were also free. Big Pharma’s concern was to halt the spread, not make money.
You’ve provided a great public service. Keep printing this story throughout the winter. Keep reminding people there’s a heck of a lot more than COVID out there and that they, not just their doctor, have to advocate for themselves.
Again. a most timely article and thank you.
Thanks, Lesley – we love the feedback!