Thread This Needle: There’s A New Flu Shot For Seniors Using mRNA Technology

While we’re still a couple of months away from the start of this year’s flu season, it’s good to plan ahead to know what your options are and how to keep yourself as healthy as possible. Older adults who become sick with the flu are at heightened risk for serious illness. Estimates are that adults over age 65 account for nearly 70% of hospitalizations due to flu and up to 85% of flu-related deaths. It is estimated that the flu kills between 6,300 and 52,000 people each year. Even though receiving a flu vaccine does not guarantee you will not become sick, it does significantly lower your risk of serious illness or hospitalization, and it does help protect those around you from becoming sick with the flu. Medicare Part B covers a flu shot for you every season at no cost, provided you go to a pharmacy or provider who accepts Medicare. So why not get your annual flu shot? Reasons given include “I just didn’t think I needed it,” or perhaps individuals have had concern over effectiveness or side effects. A recent study published in BMC Public Health examined factors that lead to greater acceptance of the flu shot. Those factors include a previous acceptance of the shot, regular visits to a primary care physician, and having a spouse who’s received a flu shot. Dementia seems to be a factor in not receiving a flu shot; in fact, people with a dementia diagnosis are 22% less likely to receive a flu vaccine than those without such a diagnosis.

Perhaps there’s one additional reason you might want to take a flu shot this year: According to new research published in the journal Eurosurveillance, those who have received their yearly flu shot had half the risk of a heart attack or stroke compared to those who were unvaccinated. This held even if the person became sick with the flu after having been vaccinated. As study authors made clear, “The influenza vaccine can significantly reduce the risk of flu-related heart attack or stroke, even among folks who become infected after vaccination.” Apparently, shortly after becoming sick with the flu, your risk of suffering a stroke is 3x higher, and your risk for a heart attack is 5x higher. So protect your heart, receive the shot, and read more here.

For older adults over age 65, for whom a higher-dose flu shot is recommended, the news is even better. According to a recent study published in JAMA Network Open, the higher-dose flu shot is associated with a reduction of severe illness in older adults by almost 40% compared to those who receive the standard-dose flu vaccine. Because older adults tend to have a lower immune response to vaccinations and are at higher risk for flu-related hospitalization compared to younger adults, the evidence seems solid that older adults are better off receiving the higher-dose version of the flu vaccine. 

For this coming Fall, however, it’s not just a matter of making sure you are vaccinated and opting for a higher-dose vaccine. What will be new this flu season is the availability of an mRNA flu vaccine, which uses the Nobel-prize-winning technology that led to the swift development of the COVID-19 vaccine, which saved millions of lives as a result. While in some circles that technology remains controversial (HHS Secretary Robert F Kennedy JR is an opponent of the technology and has even cancelled millions of dollars of further research into mRNA technology), and even the FDA originally declined to consider this new flu vaccine, the reality is that research into the new mRNA flu vaccine reports important benefits for individuals and the broader public health.  

Due to the technology used to develop the current flu vaccine, there is a lag time between when the vaccine is developed and the strain of virus that circulates. As you may remember from last year, there was something of a mismatch between the virus actually circulating and the vaccine intended to protect people. The benefit of developing a flu vaccine using mRNA technology is that mRNA vaccines take less time to develop and manufacture, so there is likely a closer match between the vaccine and the circulating virus, which should improve its efficacy. And the new mRNA flu vaccine can also be rejiggered quickly to respond to emerging strains of the virus.  

Manufactured by Moderna, one of the developers of the COVID-19 vaccine, this new flu vaccine is expected to be available in pharmacies and physician offices this fall. It is specifically FDA-approved for adults aged 50 and above and will be marketed under the name mFlusiva. It has been given standard FDA approval for adults aged 50-64 and accelerated approval for adults aged 65 and above. The reason for these two different sets of approvals is due to the clinical trials that tested the vaccine. mFlusiva was originally tested against the usual standard-dose flu vaccine, and in those trials, participants who received the mRNA vaccine were 27% less likely to get the flu than participants receiving the standard-dose vaccine. There was a smaller trial comparing the mRNA vaccine to the high-dose vaccine currently taken by older adults, and in that trial, the new mRNA vaccine was at least as efficacious as the high-dose vaccine. Moderna will do a Phase 4 trial (post-licensing) to specifically compare the current high-dose vaccine with the mRNA vaccine to further confirm that this new vaccine is, in fact, better than the current high-dose vaccine.

Data from the clinical trials showed no major risks and modest, temporary side effects from the new vaccine, including injection-site pain, fatigue, headaches, and fever, all of which resolved shortly. It is possible that some pharmacies and physician offices may not offer this new vaccine this fall, as they had already placed their orders for flu vaccines before the FDA approval and the availability of this new shot. As with all flu vaccines, it’s advisable to get this new vaccine in either September or October, so that its full power is in effect when the flu season typically starts in November. For those on Medicare, this new vaccine should be covered in the same no-cost way as other flu vaccines, though for those under 65, it’s unclear whether there will be insurance coverage or not.  

Bottom line? There’s every reason for older adults to get a flu shot this fall. And this year, there will be even more choices available to help protect you and your loved ones from the potential ravages of the flu.