2009 H1N1 Influenza Vaccine and Seniors

September 30, 2009, 2:30 PM ET

Why aren'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 are not included in the groups recommended to get the initial doses of 2009 H1N1 vaccine:

1. People age 65 and older are least likely to get sick with this virus, and,
2. There will be limited amounts of vaccine available at first, so the first doses are recommended to go to those who are most likely to get infected and become very ill.

There has been very little 2009 H1N1 illness in people 65 and older since the 2009 H1N1 virus emerged. This has been true both in the United States and in the Southern Hemisphere during their flu season. Studies of who is most likely to be infected with 2009 H1N1 show that people 65 and older are the 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. This has been true both in the United States and in the Southern Hemisphere during their flu season.) Laboratory tests on blood samples indicate that older people likely have some pre-existing immunity to the 2009 H1N1 flu virus.

Because there has been so little 2009 H1N1 illness in people 65 and older, 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 are more likely to get infected with the 2009 H1N1 flu virus. This includes all children and young adults 6 months through 24 years old, pregnant women, and adults 25 through 64 years of age who have health conditions associated with higher risk of medical complications from flu. In addition, the 2009 H1N1 vaccine is prioritized for people who live with or care for children younger than 6 months of age, and health care and emergency medical services personnel with direct patient contact. Persons 65 and older are a high priority for seasonal vaccine, just as they have been in past years. Please visit http://www.cdc.gov/h1n1flu/vaccination/acip.htm to see a summary of ACIP’s 2009 H1N1 vaccine recommendations.

Will people age 65 years and older be able to get the 2009 H1N1 vaccine this season?

Yes. The U.S. government has purchased 250 million doses of 2009 H1N1 vaccine, so anyone who wants to get the vaccine will have the opportunity to do so. While people 65 and older are not included in the groups recommended to get the earliest doses of vaccine, they can get the 2009 H1N1 influenza vaccine as soon as the high risk groups have had the opportunity to be vaccinated. Some communities and providers will offer the 2009 H1N1 vaccine to people 65 and over sooner than others, depending on how quickly they meet the needs of the initial prioritized populations. While the early doses of 2009 H1N1 vaccine are being given to those in high risk groups, CDC's priority for people 65 and older is to have them get their seasonal flu vaccine first, and to seek medical advice quickly if they develop flu-like symptoms this season. This will determine whether they need medical evaluation and possible treatment with antiviral medications.

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

Yes. CDC's priority for people 65 and older is to have them get their regular, or “seasonal,” flu vaccine as soon as possible while we are waiting for more doses of the 2009 H1N1 vaccine. 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.

Why are people 65 and older prioritized for antiviral treatment if they get sick with the flu, but they are not in one of the early groups prioritized to get 2009 H1N1 vaccine?

People 65 and older are the least likely to be infected with 2009 H1N1 flu, but, if they become infected, they are more likely than people in some other groups to develop serious complications from their illness. That is why people 65 years and older are prioritized for treatment with antiviral drugs this season if they do become sick.