Seasonal influenza disease can be particularly severe in older people, but conventional trivalent and quadrivalent inactivated influenza vaccines can be ineffective in this age group when influenza A(H3N2) strains predominate. New enhanced trivalent vaccines are available and should be used in people aged 65 years and over.
- In Australia, the vast majority of cases of serious influenza disease and influenza-related deaths occur in adults aged 65 years and over; long-term sequelae that impact on activities of daily living are also common in this group.
- Standard influenza vaccines induce suboptimal antibody titres and show suboptimal levels of effectiveness in older adults. Two enhanced influenza vaccines are now available in Australia and should be used in older people; both have a good safety profile.
- During the 2019 influenza season in Australia, an adjuvanted trivalent vaccine that has been shown to provide enhanced protection in older adults is recommended and funded under the National Immunisation Program (NIP) for people aged 65 years and over.
- A high-dose version of the standard trivalent vaccine also provides enhanced protection in older people and is recommended for use in this group but is not funded under the NIP this year.
- The additional benefit of extra influenza B coverage and hence the need for a quadrivalent vaccine in older people has not been established. However, the benefit would be substantially less than the additional protection provided by enhanced vaccines.
- Influenza vaccine coverage in older people is about 75% each year; general practice staff are key partners in increasing this level of vaccination.