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Vaccines for the 2018-2019 Influenza Season

By Courtney Myers, PharmD, BCGP


For the 2018-2019 flu season, recommendations say to administer either the standard flu vaccine or high-dose flu vaccine.1 When compared to the standard flu vaccine, the high dose contains a higher amount of antigen, which is supposed to give older adults a better immune response. Data from clinical trials comparing the standard flu vaccine with the high dose indicates that the high dose flu vaccine causes a stronger immune response or a higher antibody level. However, further studies are needed to confirm that a stronger immune response leads to greater protection against the flu. Some studies suggest the high dose is more effective in preventing the flu in those 65 years and older and lowers the risk of hospitalizations when compared to the standard dose.2,3 When looking at safety of the high dose flu vaccine, it is similar to that of the standard flu vaccine, but some adverse effects were more frequently reported with the high dose. The most common adverse events experienced were mild and temporary including injection site redness, headache, malaise and muscle aches.


New This Season

  • The flu vaccine influenza B component as well as influenza A (H3N2) has been updated.
  • No intradermal vaccines will be available this year.

CDC Recommendations for Vaccination in Elderly Adults

  • Routine annual influenza vaccination for all persons six months or older who do not have contraindications.
  • Persons 65 years or older may receive any age- appropriate vaccine including standard or high-dose, trivalent or quadrivalent, adjuvanted or unadjuvanted, or recombinant vaccines.
  • High-dose IIV3 exhibited superior efficacy over comparator standard-dose IIV3 in a large randomized trial. This may provide better protection than standard dose IIV3 for this age group.
  • Vaccinations should not be delayed to find a particular product if an appropriate one is available.
  • Inactivated flu vaccines may be administered concurrently or sequentially with other inactivated or live vaccines at separate anatomic sites.
  • Live flu vaccines may be administered simultaneously with other live vaccines at different anatomical sites. However, if not given simultaneously, four weeks or more should pass.

Flu Vaccinations Available at Absolute Pharmacy

  • Flucelvax Quadrivalent Vaccine – grown in cell culture
  • Fluzone High-Dose – grown in egg culture
  • Other vaccines may be made available upon request

If there are any other questions regarding flu vaccines this season, contact your pharmacist for more information.



  1. “Centers for Disease Control and Prevention.” CDC. 26 Apr. 2017,
  2. DiazGranados CA, Dunning AJ, Kimmel M. et al. Efficacy of high-hose versus standard-dose influenza vaccine in older adults. N Engl J Med. 2014;371:635-45. DOI:10.1056/NEJMoa1315727.
  3. Gravenstein S, Davidson HE, Taljaard M, et al. Comparative effectiveness of high-dose versus standard-dose influenza vaccination on numbers of US nursing home residents admitted to hospital: a cluster-randomized trial. The Lancet. 2017; Vol5, Issue 9: 738-746. DOI: 10.1016/S2213-2600(17)30235-7