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2009 H1N1 Influenza Vaccine and People 65 Years and Older

Updated December 21, 2009, 2:00 PM ET

Can people age 65 years and older get the 2009 H1N1 vaccine this season?

Yes. While people 65 and older were not included in the initial groups recommended to get the earliest doses of vaccine, supplies of the vaccines to protect against the 2009 H1N1 virus are increasing and many places have opened up vaccination to anyone who wants it. This vaccine is the best way to protect against the 2009 H1N1 pandemic virus. Those who have been patiently waiting to receive the 2009 H1N1 vaccine, including people 65 years and older, are now encouraged to get vaccinated. While older people are thought to be less likely to be infected with the 2009 H1N1 virus compared to younger persons, there have been severe infections and deaths from 2009 H1N1 in every age group, including people 65 and older. Some outbreaks among older people living in long-term care facilities also have been reported. CDC recommends that anyone who wants to be protected from the 2009 H1N1 virus be vaccinated, regardless of age, as soon as vaccine is available for all in their community.

Why weren't people 65 and older recommended to get early doses of 2009 H1N1 vaccine?

There are two main reasons why people age 65 and older were not included in the groups recommended to get the initial doses of 2009 H1N1 vaccine:

1. People age 65 and older were less likely to get sick with this virus, and,
2. There were limited amounts of 2009 H1N1 vaccine available at first and it was decided that the first doses available should go to those who people who were more likely to get infected and become very ill.

From the beginning of the 2009 H1N1 pandemic, illness in people 65 and older has been less common than illness in younger people. This was true both in the United States and in the Southern Hemisphere during their flu season. In fact, people 65 and older were the group least likely to get sick with this virus. (One analysis showed that only 1.3 people for every 100,000 people 65 and older are had been infected with 2009 H1N1. This is compared to 26.7 per 100,000 of those 5 years to 24 years of age and 22.9 per 100,000 in those younger than 5 years old. Rates among younger persons were 15 to 20 times higher.) Laboratory tests on blood samples indicate that some older people likely have some pre-existing immunity to the 2009 H1N1 flu virus.

Because there had been relatively little 2009 H1N1 illness in people 65 and older, in July, 2009, the Advisory Committee on Immunization Practices (ACIP) recommended that CDC and immunization programs focus on getting the first doses of 2009 H1N1 vaccine to those people who were more likely to get infected with the 2009 H1N1 flu virus. This included all children and young adults 6 months through 24 years old, pregnant women, and adults 25 through 64 years of age with a health condition associated with higher risk of medical complications from flu. In addition, the 2009 H1N1 vaccine was prioritized for people living with or caring for children younger than 6 months of age, and health care and emergency medical services personnel with direct patient contact. Persons 65 and older were a high priority for seasonal vaccine, just as they have been in past years, because for seasonal flu they are the group hit hardest in terms of serious illness and deaths.

The rationale for how the initial target groups were identified is described in the transcript (1MB) and slide presentations from the July ACIP meeting. The rationale behind this decision was again covered in an ACIP meeting in October 2009 and the slides from this meeting are publicly available as well. The full Recommendations of the Advisory Committee on Immunization Practices (ACIP), 2009 on the use of 2009 H1N1 vaccine are available online.

Should people age 65 and older get the regular flu vaccine this year?

Yes. As always, people 65 and older should get their regular, or “seasonal,” flu vaccine as soon as possible. While influenza is unpredictable seasonal flu viruses are expected to circulate along with 2009 H1N1 viruses this season. People age 65 and older are at increased risk for complications from seasonal influenza compared to younger people and are recommended for annual seasonal flu vaccines. This year is no exception.

What should people age 65 and older do if they feel like they have the flu?

People age 65 and older should seek medical advice quickly if they develop flu symptoms this season to see whether they might need medical evaluation and possible treatment with antiviral medications. People 65 and older are prioritized to get antiviral drugs if they become sick with the flu according to CDC’s antiviral guidance this season.

Related Links

• WebMD Article: Do People 65 and Older Need the H1N1 Vaccine?