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Your recommendation matters. A health care provider’s (HCP) strong, confident recommendation for flu vaccine is a very powerful and persuasive tool in determining if your patients are vaccinated. Citation 1.

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.1,2

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.

Questions Patients Age 65 and Older Frequently Ask Their HCP

Yes. In fact, you are at a higher risk for complications due to flu because of your age. As you age, your immune system becomes less effective, making you more vulnerable to diseases like the flu.5

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, especially if you were exposed to a flu virus that is different from the viruses the flu vaccine is designed to protect against.6,7 Even if you do get influenza despite vaccination, the vaccine helps protect you from severe illness.6

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 of the vaccine recipient.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.5,8 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 reduces the risk of heart attack or stroke.9,10

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 family, friends, and other people who are around you.11

Flu vaccines have excellent 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.12 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 flu vaccines often have not worked as well in older adults compared to young, healthy adults,7 vaccination will help reduce the severity of your symptoms and will also help prevent potentially serious complications and/or disability.5,13 There are new recommendations from the CDC for specific vaccines (higher-dose and adjuvanted) that work better in older adults and you should ask your provider about these new recommendations.14

Tips for Talking with Older Patients15

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. At the next visit, remind your patient that you continue to recommend the flu vaccination. Some patients need multiple opportunities to hear your message.


Looking for clear-cut ways to improve your practice’s efficiency in administering vaccines and increase your immunization rates? Check out this resource for suggestions.

1. Nowak GJ, Sheedy K, Bursey K, et al. Promoting Influenza Vaccination: Insights From A Qualitative Meta-Analysis of 14 Years of Influenza-Related Communications Research by U.S. Centers for Disease Control and Prevention (CDC). Vaccine. 2015;33:2741-2756. doi:10.1016/j.vaccine.2015.04.064 2. How to Give a Strong Recommendation to Adult Patients Who Require Vaccination. Medscape. Accessed September 2022. 3. Centers for Disease Control and Prevention. Misconceptions about Seasonal Flu and Flu Vaccines. Accessed September 2022. 4. Immunization in the United States: Recommendations, Barriers, and Measures to Improve Compliance: Part 2: Adult Vaccination, Pharmacy and Therapeutics. 2015:41(8):506. 5. Call to Action: Reinvigorating Influenza Prevention in U.S. Adults Age 65 Years and older. National Foundation for Infectious Diseases. Accessed September 2022 6. Centers for Disease Control and Prevention. Key Facts About Seasonal Flu Vaccine. Accessed September 2022. 7. Centers for Disease Control and Prevention. Vaccine effectiveness – How Well Do the Flu Vaccines Work. Accessed September 2022. 8. Jhung MA, D’Mello T, Perez A, et al. Hospital-onset influenza hospitalizations—United States, 2010-2011. Am J Infect Control 2014;42(1):7-11. doi: 10.1016/j.ajic.2013.06.018 9. Kwong JC, Schwartz KL, Campitelli MA, et al. Acute Myocardial Infarction after Laboratory-Confirmed Influenza Infection. N Engl J Med. 2018;378:345–353. doi:10.1056/NEJMoa1702090 10. Udell JA, Zawi R, Bhatt DL, et al. Association between influenza vaccination and cardiovascular outcomes in high-risk patients: a meta-analysis. JAMA 2013;310(16):1711-1720. doi:10.1001/jama.2013.279206 11. Vaccines Protect Your Community. Accessed September 2022. 12. Centers for Disease Control and Prevention. Flu Vaccine Safety Information. Accessed September 2022. 13. Centers for Disease Control and Prevention. What are the Benefits of Flu Vaccination? Accessed September 2022. 14. Grohskopf LA, Blanton LH, Ferdinands JM, et al. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices – United States, 2022-23 influenza season. MMWR Recomm Rep. 2022;71(1):1–28. doi:10.15585/mmwr.rr7101a1 15. Robinson TE, White GL Jr, Houchins JC. Improving Communication with Older Patients: Tips from the Literature. Fam Pract Manag. 2005:13(8):73-78. Accessed October 2022.

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