Flu: High-dose vaccine shows benefit in LTC residents

A high-dose flu vaccine is significantly better than a regular flu shot at boosting the immune response to the flu virus in frail, older residents of long-term care (LTC) facilities, according to the results of a University of Pittsburgh School of Medicine study funded by a vaccine manufacturer.

The university says the study, published in the Journal of Infectious Diseases and funded by Sanofi Pasteur, is the first evaluation of the vaccine (Fluzone High-Dose) in LTC residents—specifically, those living in nursing facilities, assisted or personal care homes, and independent living facilities. It found that, with the exception of one strain of flu (A/H1N1) circulating in the 2012–2013 season, the high-dose flu vaccine helped participants mount a better immune response to influenza than the standard flu shot. The trial did not evaluate whether fewer of the high-dose recipients actually contracted the flu than those receiving the standard vaccine.

“The elderly living in LTC facilities have higher influenza exposure risks, lower immune defenses and a much greater likelihood of flu-related death than the general population,” lead author David A. Nace, MD, MPH, director of LTC and flu programs in Pitt’s Division of Geriatric Medicine and chief medical officer for UPMC Senior Communities, said in a statement. “For these reasons, we need more effective flu vaccine options for frail, older adults.”

In a separate study of community-dwelling adults 65 years of age and older, the trivalent inactivated influenza vaccine “induced higher immune responses and provided superior protection against laboratory-confirmed influenza illness compared with standard-dose influenza vaccine,” David P. Greenberg, MD, vice president of scientific and medical affairs and chief medical officer at Sanofi Pasteur U.S., said in a statement.

“The high-dose vaccine is not a guarantee against contracting the flu, even though it significantly decreases the likelihood,” Nace said. “That is why it is so important to take a ‘bundled approach’ to preventing flu in LTC facilities, including vaccination of healthcare workers, asking people with flu-like illness not to visit residents, practicing proper cough etiquette and hand hygiene and frequent sanitation of commonly used areas and equipment.”

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