HCPs play an important role in ensuring adults age 65 and older are vaccinated against the flu. It has been shown that most adults believe that vaccines are important and are likely to receive them if recommended by their HCP.2
There are a variety of misperceptions about influenza and the influenza vaccine that may influence your older patients and make them skeptical of getting the vaccine.3, 4 Countering these misperceptions requires hard facts. Below you’ll find a series of potential questions your older adult patients may be asking, with suggested evidence-based responses to help guide your discussion with them on their changing risks and the importance of an annual flu vaccination.
The flu vaccine cannot give you the flu. Flu vaccines used in older adults use inactivated (“killed”) viruses, or those with no flu virus at all (known as a recombinant vaccine), neither of which has the ability to cause flu-related infection. Sometimes people may not feel well shortly after they get vaccinated and assume there is a connection, but any flu-like symptoms you might experience may be part of your body’s reaction as it develops immunity, or it could be an unrelated illness. If you actually do get flu soon after getting the shot, it could be that you were exposed before you were vaccinated; it takes about 2 weeks after getting the shot for you to develop immunity. It’s also possible for you to get the flu despite getting vaccinated if you were exposed to a flu virus that is very different from the viruses the flu vaccine is designed to protect against.6,7
On average, getting the flu vaccine reduces the chance of getting the flu by 40-60% among the overall population.7 The “match” between the virus strains that are in the vaccine and those that are “going around” can affect how well the vaccines work each year, as well as underlying individual characteristics.7 But, getting a flu shot each year is the single best way to prevent getting the flu.6 Even if you do get the flu after having gotten a flu shot, vaccination can help prevent hospitalization, death, and long-term physical decline.5 This is especially important for older adults who are more at risk for these serious complications.5
The Centers for Disease Control and Prevention (CDC) recommends that all people 6 months of age and older should receive an annual flu vaccine.6
Flu viruses are constantly changing, and each year’s vaccine is updated to try to keep up with these changes.6 Also, your immune system doesn’t work as well as you age.6 For these reasons, an annual vaccination is especially important.
Another benefit of flu vaccination for older adults is that it might reduce the risk of heart attack or stroke.8
Just because you haven’t had the flu before, that does not mean you can’t get it this flu season. There is no way to know if you will get the flu this year or not, or how severe your illness will be. As you get older, you are at higher risk for complications, including hospitalization or even death.6 You could also have problems even after you recover from the flu itself that could impact what you can do in your everyday life.6 Bottom line: by getting vaccinated you are not only helping to protect yourself, but also your children, grandchildren, and other loved ones who are around you.9
Flu vaccines have good safety records. Hundreds of millions of Americans have safely received flu vaccines over the past 50 years, and there has been extensive research supporting the safety of flu vaccines.10 The Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices (ACIP) recommends that all people 6 months of age and older should receive an annual ﬂu vaccine.6
Getting a flu shot every year is the best way to help prevent getting the flu.6 Though in recent flu seasons flu vaccines have not worked as well in older adults as in young, healthy adults,11,12 should you in fact get the flu, vaccination will help reduce the severity of your symptoms and will also help prevent potentially serious complications and/or disability.5
Tips for Talking with Older Patients13
Communicating with patients can be challenging and is often further complicated by age-associated issues such as sensory loss, decline in memory, and a slower processing of information. Following are tips to keep in mind when discussing flu prevention with adults age 65 and older to ensure a productive conversation.
Don’t underestimate the power of eye contact. Sit face-to-face with the patient and focus on the conversation at hand.
Older patients generally desire more information than younger patients. Allow extra time to discuss concerns and answer questions they may have about health care decisions.
Exercise patience. Listen without interrupting the patient, giving them a chance to ask questions as they arise, and encourage them to restate their understanding of the information you conveyed.
Use patient-friendly words and sentences when recommending flu protection by vaccination, and summarize the most important points of the conversation.
Speak clearly and slowly, ensuring that the patient can hear you.
Looking for clear-cut ways to improve your practice’s efficiency in administering vaccines and increase your immunization rates? Check out this IAC resource for suggestions.
From the Centers for Disease Control and Prevention
- People 65 Years and Older & Influenza (web page)
- Influenza (Flu) Communication Resource Center (web section)
- Reminder Systems and Strategies for Increasing Adult Vaccination Rates (web page)
- Vaccine Recommendation: A Series on Standards for Adult Immunization Practice (PDF)
From the Immunization Action Coalition
- Vaccine Information Statement (VIS) for Inactivated or Recombinant Influenza (Flu) Vaccine (PDF)
- Vaccine Information Statement (VIS) for Inactivated or Recombinant Influenza Vaccine — Translations in more than 30 languages (web page)
- Free, CDC-reviewed, ready-to-print influenza educational materials for healthcare personnel and patients (web section)
- Suggestions to Improve Your Immunization Services (PDF)
- Vaccinating Adults: A Step-by-Step Guide (142-page book of practical information to help you implement or enhance adult immunization services in your healthcare setting – PDF)
From the National Foundation for Infectious Diseases
From the Literature
1. Villacorta R, Sood N. Determinants of Healthcare Provider Recommendations For Influenza Vaccinations. Preventive Medicine Reports. 2015;2:355-370. doi:10.1016/j.pmedr.2015.04.017. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4721324/ 2. How to Give a Strong Recommendation to Adult Patients Who Require Vaccination. Medscape. https://www.medscape.com/viewarticle/842874_2 3. Misconceptions about Seasonal Flu and Flu Vaccines. Centers for Disease Control and Prevention. https://www.cdc.gov/flu/about/qa/misconceptions.htm 4. Immunization in the United States: Recommendations, Barriers, and Measures to Improve Compliance: Part 2: Adult Vaccinations. Pharmacy and Therapeutics. 2016;41(8):492-506. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4959618/ 5. Call to Action: Reinvigorating Influenza Prevention in U.S. Adults Age 65 Years and Older. National Foundation for Infectious Diseases. http://www.nfid.org/flu-older-adults. 6. Key Facts About Seasonal Flu Vaccine. Centers for Disease Control and Prevention. https://www.cdc.gov/flu/protect/keyfacts.htm. 7. Vaccine Effectiveness – How Well Does the Flu Vaccine Work? Centers for Disease Control and Prevention. https://www.cdc.gov/flu/about/qa/vaccineeffect.htm 8. Kwong JC, et al. Acute Myocardial Infarction after Laboratory-Confirmed Influenza Infection. New England Journal of Medicine 2018; 378:345-353. 9. Community Immunity (“Herd Immunity”). The National Institute of Allergy and Infectious Diseases (NIAID). Vaccines.gov. https://www.vaccines.gov/basics/protection/index.html 10. Flu Vaccine Safety Information. Centers for Disease Control and Prevention. https://www.cdc.gov/flu/protect/vaccine/general.htm 11. Jackson ML, Chung JR, Jackson LA, et al. Influenza Vaccine Effectiveness in the United States during the 2015–2016 Season. The New England Journal of Medicine. 2017;377(6):534-543. doi:10.1056/NEJMoa1700153. 12. Flannery B, Chung JR, Belongia EA, et al. Interim Estimates of 2017–18 Seasonal Influenza Vaccine Effectiveness — United States, February 2018. MMWR Morb Mortal Wkly Rep 2018;67:180–185. DOI: http://dx.doi.org/10.15585/mmwr.mm6706a2 13. Thomas E. Robinson II, PhD, George L. White Jr., PhD, MSPH, and John C. Houchins, MD. Improving Communication with Older Patients: Tips from the Literature. Fam Pract Manag. 2006 Sep;13(8):73-78.