Talking About Influenza Vaccination

Make a strong influenza vaccine recommendation (SHARE)

It is important that all patients be informed about the benefits, side effects, and more serious, rare adverse events that can happen after influenza vaccination. As a healthcare provider, you are best positioned to recommend what is best for your patient; however, CDC research has shown that a strong recommendation in favor of vaccination is an important factor in whether or not someone gets vaccinated. CDC suggests using the SHARE approach to help patients make informed decisions about vaccinations:

SHARE the reasons why an influenza vaccine may be beneficial, including the fact that it can reduce the risk of influenza and its potentially serious complications. This could be especially important for certain patients, depending on their age, health status, lifestyle, occupation, or other risk factors.

HIGHLIGHT your experiences with influenza vaccines (personal or in your practice), as appropriate, to reinforce the benefits and encourage influenza vaccination if that is in your patients' best interest.

ADDRESS patient questions and any concerns about influenza vaccines, including side effects, safety, and vaccine effectiveness in plain language. Acknowledge that while people who get an influenza vaccine may still get sick with, and spread influenza, there are studies that show that vaccination can make illness less severe, potentially preventing hospital stays or worse.

REMIND patients that influenza vaccines can help protect them and their loved ones from influenza illness and serious complications that can result from influenza, such as hospitalization or even death for some people. Remind them that even if they are not at higher risk of getting very sick from flu, people around them – babies, older people, people with weakened immune systems – may be at higher risk, so getting vaccinated can help protect the people around them.

EXPLAIN the potential costs of getting influenza, including potential serious health effects for the patient, time lost (such as missing work or family obligations), financial costs, and potentially spreading influenza to more vulnerable family or friends.

After making your recommendation, if your patient declines vaccination, follow up with them during subsequent visits. Offer them the opportunity to continue the discussion about vaccination if you believe it is in your patients' best interest.

Information about influenza vaccines

All influenza vaccines this season are trivalent (three-component) vaccines, designed to protect against three influenza viruses, including an influenza A(H1N1) virus, an influenza A(H3N2) virus, and one influenza B/Victoria Lineage virus.

Vaccine indications

There are many different influenza vaccine options, including several standard-dose inactivated vaccines, high-dose and adjuvanted inactivated vaccines for older patients, a recombinant vaccine, and a nasal spray vaccine. Different vaccines are approved for different age groups. Information on the appropriate age for a vaccine can be found in its product package insert.*

Three flu vaccines are preferentially recommended for people 65 years and older. These are Fluzone High-Dose inactivated flu vaccine, Flublok recombinant flu vaccine, and Fluad adjuvanted inactivated flu vaccine. This recommendation was based on a review of available studies which suggests that these vaccines are potentially more effective than standard dose unadjuvanted flu vaccines in this age group.

There is no preferential recommendation for people younger than 65 years. People who chose to get vaccinated should receive an influenza vaccine that is approved for their age, with one exception for solid organ transplant recipients (described below). Although the high-dose (Fluzone High-Dose) and adjuvanted (Fluad) inactivated influenza vaccines are approved for people 65 years and older, they are also acceptable options for solid organ transplant recipients who are 18 through 64 years old and are taking immunosuppressive medications. There is no preference for these vaccines over other age-appropriate vaccines for this group.

Available influenza vaccines this season include:

• Egg-based standard-dose inactivated influenza vaccines
  • Approved for people aged 6 months and older
• Cell-Based standard-dose inactivated influenza vaccine
  • Approved for people aged 6 months and older
  • Produced by growing virus in cultured cells of mammalian origin instead of in eggs
• High-Dose inactivated influenza vaccine
  • Approved for adults aged 65 years and older.
  • Contains four times the antigen for each virus compared with standard-dose inactivated vaccines.
  • One of three flu vaccines that are preferentially recommended for adults aged 65 years and older.
  • An acceptable option for solid organ transplant recipients who are 18 through 64 years old and are taking immunosuppressive medications, without a preference over other age-appropriate vaccines.
    
• Adjuvanted inactivated influenza vaccine
  • Approved for adults aged 65 years and older.
  • Contains an adjuvant (an ingredient intended to help promote a better immune response).
  • One of three flu vaccines that are preferentially recommend for adults aged 65 years and older.
  • An acceptable option for solid organ transplant recipients who are 18 through 64 years old and are taking immunosuppressive medication, without a preference over other age-appropriate vaccines.
    
• Recombinant influenza vaccine
  • Approved for persons aged 9 years and older.
  • Contains three times the antigen for each virus compared with standard-dose inactivated vaccines.
  • Produced without influenza viruses or eggs
  • One of three flu vaccines that are preferentially recommended for adults aged 65 years and older.
• Live Attenuated Influenza Vaccine (Nasal Spray Vaccine)
  • Approved for people 2 through 49 years old.
  • Contains live influenza viruses that that are grown in eggs and are weakened so that they don't cause influenza illness.
  • Not recommended during pregnancy or for people with certain medical conditions.

*Manufacturer package inserts and updated guidance should be consulted for additional information including, but not limited to, indications, contraindications, warnings, precautions. Package inserts for U.S.-licensed vaccines are available from FDA at Vaccines Licensed for Use in the United States. Information presented concerning vaccines expected to be available and their approved indications is subject to change. Availability and characteristics of specific products and presentations might change or differ from what is described in the text of this page. The list of products on this page is not exhaustive of all available licensed products.