Each week, OMRF Chief Medical Officer Dr. Judith James opens “Adam’s Journal” to answer a medical question from Adam Cohen, OMRF’s senior vice president & general counsel.
Adam’s Journal
Here’s a question from a reader:
I’m a 77-year-old male who’s very active. For years, I’ve gotten the annual flu vaccine in mid-October.
This year, in February, I got the flu. Fortunately, my symptoms were mild. But wouldn’t a second flu shot have helped me be better protected?
Dr. James Prescribes
Happily, our reader did not seem to experience complications from his infection. However, as a group, older people are at higher risk for serious illness and even death from the flu.
So, it makes sense to search for ways to better protect them.
It is true that in some groups – organ transplant recipients and children being vaccinated for the first time – getting two doses of the same flu vaccine during the same flu season appears to be helpful. So, researchers tried this approach with people in their 70s.
However, in both of these studies, the second dose of vaccine failed to increase subjects’ levels of antibodies against influenza.
In addition, as the number of flu vaccinations a person receives over their lifetime grows, studies have shown that both antibody responses and vaccine effectiveness diminish.
Make no mistake: You’re better protected if you receive a flu shot than if you don’t. But getting a second one won’t help; in fact, it might even blunt your body’s ability to form protective responses.
For those 65 and over, the Food and Drug Administration has approved high-dose flu vaccines. These vaccines contain four times as much immune-stimulating antigen than the standard-dose vaccine.
As a result, it produces substantially higher levels of antibodies in those who receive it. In post-approval studies, the most prevalent of these vaccines, Fluzone, was found to be 24% more effective than standard vaccines in preventing flu infections among those 65 and over. It also seems to reduce serious complications of flu in older people, including pneumonia and worsening of heart and lung disease.
In sum, when it comes to flu vaccines, two doses are not better than one. But in older individuals like our reader, the high-dose vaccine can offer added protection.
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James is executive vice president and chief medical officer of the Oklahoma Medical Research Foundation. Cohen, a marathoner, is OMRF’s senior vice president and general counsel. Send your health questions to contact@omrf.org.
