Enhanced Flu Vaccine Suggested For Older Adults

Overview

Flu (influenza) is a common illness caused by a virus. It hits the nose, throat and lungs, and it can make you feel very unwell for a week or more. For most healthy adults it is unpleasant but not dangerous. As we get older, our immune system — the body's defence against germs — does not respond as strongly to infections or to vaccines. Because of this, some countries offer older adults an 'enhanced' flu vaccine. An enhanced vaccine is a flu jab that has been made to trigger a stronger immune response. Some contain a small extra ingredient called an adjuvant, which helps wake up the immune system. Others contain a higher amount of the flu virus material. Both types are designed to give older bodies better protection than a standard flu jab.

Flu is very common. It spreads easily from person to person, and in temperate parts of the world it comes around every winter. In a typical season, a large share of older adults will be offered a flu vaccine, and many countries now offer an enhanced version to those aged 65 and over.

Flu affects people of all ages, but it is most serious for older adults, especially those over 65, people living in care homes, and anyone with a long-term health condition such as heart disease, lung disease or diabetes. Pregnant women, young children and people with a weakened immune system are also at higher risk.

Symptoms

Common symptoms

• Sudden high temperature or feeling feverish and shivery
• Aching muscles and joints, and feeling generally exhausted
• A dry cough and sore throat
• Headache
• Blocked or runny nose
• Feeling sick, or loose stools in some people
• Trouble sleeping and low appetite

Symptoms in children

• High temperature that may last several days
• Being unusually tired or irritable
• Poor feeding or drinking less than usual
• Ear pain or ear infection
• Stomach upset, being sick, or loose stools, which are more common in children than adults

Symptoms in older adults

• Flu can look different in older adults — sometimes there is no high temperature at all
• New confusion or drowsiness, or a sudden change in usual behaviour
• Falls or unsteadiness that is new
• Worsening of an existing heart or lung condition, such as more breathlessness
• Dehydration, dry mouth and passing less urine
• Tiredness that is far worse than usual and lasts longer than expected

Causes

Main causes

• Flu is caused by influenza viruses, which spread through tiny droplets when someone coughs or sneezes
• You can also catch it by touching a surface with the virus on it and then touching your mouth, nose or eyes
• The virus changes slightly each year, which is why a new vaccine is needed every season

Risk factors

• Age 65 and over — the immune system becomes less efficient with age
• Living in a care home or other shared living setting
• Long-term conditions such as heart disease, lung disease, kidney disease, diabetes or liver disease
• A weakened immune system, for example from some medical treatments or illnesses
• Pregnancy
• Smoking
• Being very overweight
• Working in health or social care, where you are more likely to be exposed

When to see a doctor

See a doctor urgently if:

• Breathing becomes difficult or fast, or you feel breathless at rest
• Chest pain, or a high fever that will not come down
• New confusion, drowsiness, or someone becoming hard to wake
• You cannot keep fluids down, or you are passing very little urine
• A long-term condition suddenly gets worse

Book a routine appointment if:

• You are unsure whether you or a relative should have a flu vaccine this season
• You want to know whether an enhanced flu vaccine is available to you
• Flu symptoms are not improving after about a week
• You have a persistent cough, ear pain or a sore throat that is not settling
• You are planning travel or a big event and want advice about timing your vaccine

Diagnosis

In most cases, a doctor or nurse recognises flu from your symptoms and the time of year, without needing any tests. They will ask about your temperature, cough, aches, how quickly it started, and whether you have any long-term conditions. Because flu and colds can look similar, they may also check how ill you seem and listen to your chest.

Tests that may be done

• A swab from your nose or throat can confirm flu, but this is usually only done if it would change your care — for example if you are very unwell or in hospital
• Blood tests or a chest X-ray may be arranged if there are concerns about complications such as a chest infection
• A blood pressure and oxygen level check is common if you feel very unwell

What to expect at your appointment

A typical appointment is short. Your clinician will ask questions, check your breathing and temperature, and give you advice on rest and fluids. If you have a long-term condition, they may talk with you about how to manage it while you are ill. You may also be offered a flu vaccine at the same visit if the season is right, or told where to book one.

Treatment

Most people recover from flu at home with rest and plenty of fluids. The main job of treatment is to keep you comfortable, watch for complications, and make sure any long-term conditions stay under control. In some situations a doctor may consider antiviral medicine, which works best when started early, so it is worth asking about if you are in a higher-risk group and symptoms have just begun.

Self-care at home

• Rest as much as you need to — it is normal to feel very tired for several days
• Drink plenty of fluids, such as water, squash or warm drinks, to avoid dehydration
• Take things easy and stay warm
• Stay home while you feel unwell, to avoid passing flu to others
• Ask a pharmacist for advice about over-the-counter remedies that are safe for you, especially if you take other medicines
• Keep taking your regular prescribed medicines unless a doctor tells you otherwise
• Check on older relatives and neighbours daily while they are ill

Medical treatments

If you are in a higher-risk group, your doctor may consider antiviral medicine, which can reduce how long you are ill and how severe it is. These work best when started within the first couple of days of symptoms, so contact your doctor early if you are eligible. Beyond that, treatment focuses on relieving symptoms, managing any chest infection or dehydration, and adjusting care for long-term conditions. If you become very unwell, hospital care may be needed for oxygen, fluids and monitoring. Always ask your doctor or pharmacist before starting any new medicine, including ones you can buy without a prescription.

When is surgery considered?

Surgery is not used to treat flu. It plays no part in flu care or in vaccination.

Living with this condition

While you are ill, expect to feel wiped out for a few days and tired for a week or two afterwards. Plan for a slow return to normal activities. If you have a long-term condition, keep an eye on your usual symptoms and have a plan for who to call if they get worse. Arrange a little help with shopping or meals before the flu season if you can, so you do not have to go out while unwell.

Lifestyle tips

• Wash your hands regularly with soap and water, and keep surfaces clean
• Catch coughs and sneezes in a tissue, then bin it
• Keep rooms well ventilated when you have visitors
• Avoid close contact with people who are unwell during flu season
• Stay physically active through the year, as this supports your immune system
• If you smoke, ask for help to stop — this lowers your risk of chest infections

Diet and exercise

There is no special flu diet, but eating regularly and drinking enough helps your body cope. Warm drinks and simple meals are fine when your appetite is low. Once you are recovering, gentle activity such as short walks can help you rebuild strength — but wait until fever and chest symptoms have settled, and build up slowly. Ask your doctor if you are unsure how much activity is safe with your heart or lung condition.

Mental health and emotional wellbeing

Being ill and stuck indoors can feel lonely or worrying, especially if you live alone or care for someone else. Feeling low or anxious during recovery is common and usually passes. Keep in touch with family and friends by phone or video, and tell your doctor if low mood or worry is not lifting. If you ever have thoughts of harming yourself, contact your local emergency number or a crisis support service straight away — you deserve help quickly.

Prevention

You cannot fully prevent flu, but vaccination is the single most effective step. Good hand hygiene, covering coughs and sneezes, and staying away from others when unwell also reduce the spread. Because the flu virus changes each year, protection from last year's vaccine fades, so a fresh jab each autumn is recommended.

Vaccines

Flu vaccines are given as a quick injection, usually in the upper arm, and are offered each autumn before flu season. For older adults, some health services offer an enhanced flu vaccine — one designed to produce a stronger immune response, either by including an adjuvant (an ingredient that boosts the immune system) or by using a higher amount of virus material. Your doctor, nurse or pharmacist can tell you which vaccine is recommended for you and whether an enhanced one is available where you live. The vaccine cannot give you flu. A sore arm, mild achiness or feeling a bit tired for a day or two is normal and settles on its own. Tell your clinician if you have had a serious allergic reaction to a vaccine before. If you are aged 65 or over, or in another higher-risk group, ask about booking your flu vaccine — and check whether you are also due other routine vaccines.

Screening programmes

There is no screening test for flu. Instead, health services identify people at higher risk — such as everyone over a certain age, care home residents and people with certain long-term conditions — and invite them for vaccination each year. If you have not received an invitation and think you are eligible, contact your GP surgery or pharmacist.

Complications

If left untreated

• Chest infections such as pneumonia, which can be serious in older adults
• Worsening of existing heart, lung or kidney conditions
• Dehydration and a drop in blood pressure, which can lead to falls
• Confusion or delirium, especially in frail older people
• A longer recovery, with weakness and tiredness lasting weeks
• In severe cases, hospital admission and intensive care

Long-term outlook

The great majority of people recover fully from flu, especially with rest and good support. Older adults tend to recover more slowly and are more likely to need extra care, which is exactly why the enhanced vaccine is offered — it is a practical way to lower the risk of serious illness. Vaccination does not remove all risk, but it makes severe illness much less likely, and it protects those around you too. If you are unsure about vaccination, a short conversation with your doctor or pharmacist is a good place to start.

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