ACIP Recommends Specific Flu Vaccines for Older Adults

Amid a spike in flu cases in the southern hemisphere, experts anticipate the United States will see a more severe flu season this year compared to previous years.

Ahead of the upcoming 2022-2023 flu season, Dr Gregg Sylvester sat down with Pharmacy Learning Network to discuss the Advisory Committee on Immunization Practices (ACIP)’s recent recommendation for flu vaccines in older adults.

Can you discuss the new ACIP recommendation regarding flu vaccines? What prompted the update?

With flu, there are 2 age groups we are concerned about. Very young people seem to have high disease complications. The other age group is older adults. We know our immune system tends to decline as we get older, which we call immunosenescence.

Right now, the United States has a recommendation for everyone aged 6 months and older to be immunized if they are not contraindicated for receiving the flu vaccine. The ACIP, with the help of the CDC, evaluated all the licensed vaccines for older adults and decided adjuvanted and higher-dose influenza vaccines should be recommended or preferred over standard egg-based vaccines for this age group. This is a big deal because of our waning immune system and our need for a more robust immune response when it comes to influenza.

How do you think the recommendation will impact health systems and outcomes?

About 75% to 80% of adults are already receiving adjuvanted and/or higher-dose vaccines. But this recommendation will say to adults that are not receiving them, “This is a good idea. This is something we recommend. This is something you ought to be talking about with your health care provider, local pharmacist, clinic, or wherever you are going to get your annual influenza vaccine.”

I think, in the long run, this recommendation will reduce morbidity and mortality. The data shared at the ACIP showed there would be reductions in these outcomes if more older adults receive this new category of vaccines.

Thank you, Dr Sylvester. Moving into this year's flu season, what should pharmacists and other providers keep in mind when treating and vaccinating patients?

In the southern hemisphere, where we do fairly good surveillance, whether it is Australia or Argentina, we are seeing a dramatic increase in influenza cases and disease severity. We have not seen that in the last 2 years because of the COVID-19 pandemic here in the United States and around the globe. That is not to say what happens in Australia happens in the United States, but it might indicate what we can expect.

The number one thing is to make sure patients get vaccinated. My advice to health care providers, to anyone offering a vaccine to somebody aged 65 years and older, is to follow the new recommendations and make sure patients get vaccinated.

As a pediatrician, whenever we let a little baby or a young toddler leave without getting vaccinated, we called it a missed opportunity. We do not know whether they will come back again. Let us not have any missed opportunities in that older adult age group. If a patient goes to their primary care physician, pharmacist, or clinic, let us make sure that person gets vaccinated.

Number two is, let us ensure we have these preferred vaccines, because the ACIP is recommending them over the standard influenza vaccines.

Is there anything else you would like to add that you feel we missed today?

We recently shipped our first influenza vaccines, and that is a big deal in the pharmaceutical industry. I think pharmacists, physicians, and other health care providers take a sigh of relief knowing we received our numbers back in February, were told what strains to put in, created the vaccine, and now it is not sitting in some warehouse or still being developed, but we are actually sending it out.

That does not have much to do with the ACIP recommendation but bolsters confidence that we have vaccines available. We are going to ship at least 55 million doses of vaccines in the United States across all age ranges, and we are excited about that.

But the underlying and most important message is to be vaccinated and, if you are in that new category aged 65 years and older, to receive one of the preferred vaccines.

About Dr Sylvester

Gregg C Sylvester, MD, MPH, is the chief health officer for CSL Seqirus. He is a pediatrician and preventive medicine physician.