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 For adults 65 years of age and older, the National Advisory Committee on Immunization (NACI) recommends that Quadrivalent High-Dose should be used over Quadrivalent-Standard Dose, given the burden of influenza A(H3N2) disease affecting older adults and the good evidence of better protection of Trivalent-High Dose compared to Trivalent-Standard Dose in adults 65 years of age and older.

Any of the available influenza vaccines would be preferable to remaining unvaccinated or requesting individuals to return for vaccine. Therefore, in the absence of a specific product, NACI recommends that any of the available influenza vaccines authorized for this age group should be used.

There is only one high-dose Quadrivalent Influenza vaccine currently authorized for use in Canada by NACI. (IIV4-HD or Fluzone High-Dose Quadrivalent)

There is good evidence that Fluzone High-Dose provides superior protection compared with standard-dose TIV in the elderly (Grade A Evidence); 2) there is fair evidence that the MF59-adjuvanted Fluad (that will be provided to those over 65 in BC) may be effective at reducing the risk of hospitalization for influenza and influenza complications in the elderly compared to unvaccinated individuals (Grade B Evidence).

Coles Notes Version:

• High-Dose Quadrivalent Influenza Vaccine has 4 times the antigen of a standard dose vaccine to account for “immunosenescence”. (weakening of the immune system over time)

• This superior protection (greater than 24% over the standard dose) increases with those much older than 65 and with pre-existing underlying chronic conditions. (protection for an 80 yr old is about 37% better than standard dose)

• The NACI recommends High-Dose Quadrivalent (IIV4-HD) compared with the standard dose for adults 65 years (2022/2023)

• Unfortunately, the BC government, is only going to offer a TRI-valent influenza vaccine (IIV3-Adj) (covering 3 strains) for seniors to be announced in October 2022. Other provinces: AB, SK, ON, NB, PE, YK will offer the recommended NACI High-Dose QUADrivalent (IIV4-HD) (covering 4 strains) for free for ALL those over 65 years of age. Again, seniors in BC are being short-changed in their health. Did our BC Ministry of Health not learn anything during COVID about caring for seniors?

Those seniors over 65 in long-term care or assisted living residences, or First Nations will receive the NACI-recommended High-Dose Quadrivalent (IIV4-HD) at no cost. (The Federal government is paying for it.) Those seniors still living on their own will have to pay between $75 to $90 for this vaccine as the BC government is only providing the Fluad Trivalent for free. In other words, most seniors throughout the province will be charged a fee to receive the NACI-recommended Influenza vaccine—or choose the free Fluad vaccine. If they lived in Alberta, Saskatchewan, or Ontario it would be FREE.

 

Give me your BEST shot! Seniors are worth it. Let’s keep seniors out of hospitals.