This past flu season was a harsh one — especially for the elderly. “In a typical flu season, about 70 to 80 percent of cases are influenza A,” says Dr. Jay Keystone, Professor of Medicine, in the Tropical Disease Unit at Toronto General Hospital. “What made this season so unusual is that we had almost as much Influenza B in some parts of Canada.”

Because this was not the same influenza B strain contained in the standard flu shot, many elderly patients were not adequately protected — despite being vaccinated. In addition, the age-related immune system deterioration that makes elderly patients more susceptible to influenza infections also makes them less responsive to standard flu vaccines. These two factors accounted for a substantial increase in influenza-related hospitalizations and deaths among senior patients this year.

New types of vaccines, known as enhanced vaccines, offer about 25 percent greater protection against the flu in elderly people. There are two types — the high-dose vaccine and the adjuvanted vaccine — both of which are designed to trigger a stronger immune response compared to standard influenza vaccines.

Enhanced vaccines are already widely used in Europe and the U.S., where data shows they are helping to reduce hospitalizations and deaths. In response to previously harsh influenza seasons, Australia and the U.K. have implemented an enhanced vaccination program for seniors for the 2018/19 season, using both types of enhanced vaccines. “Even in cases where they aren’t 100 percent effective against contracting the flu, they can reduce morbidity and mortality rates,” notes Dr. Keystone.

That’s important, given that about 90 percent of deaths from influenza occur in those over 65. What’s more, “there’s relatively new information suggesting that influenza also increases the risk of heart attack by about 3 to 5 times and stroke by 2 to 3 times,” says Dr. Keystone.  Even without those two comorbidities, the prolonged confinement to bedrest required to recover from the flu can lead to frailty and diminished quality of life in the elderly.  “They lose enormous muscle strength and can no longer function independently,” says Dr. Keystone.

Though available in Canada, enhanced vaccines are not widely used. Dr. Keystone believes that adopting an enhanced vaccine program would benefit Canadians over age 65, but in the meantime, he encourages these patients to discuss having the enhanced vaccine with their health care professionals. “Even if you think that influenza won’t kill you, when you think about heart attack, stroke, and frailty, think twice before refusing a flu shot,” he says.