Supplemental guidance from NACI on influenza vaccination in adults 65 years of age and older

What

The following recommendations for influenza vaccination in adults 65 years of age and older supplement the National Advisory Committee on Immunization (NACI)'s overarching recommendations for influenza vaccination, which are available in the NACI Seasonal Influenza Vaccine Statement. NACI recommends that high-dose inactivated influenza vaccine (IIV-HD), adjuvanted inactivated influenza vaccine (IIV-Adj) or recombinant influenza vaccine (RIV) should be offered, when available, over other influenza vaccines for adults 65 years of age and older. If a preferred product is not available, any of the available age-appropriate influenza vaccines should be used.

Who

Adults 65 years of age and older are prioritized to receive influenza vaccines because of the increased risks of severe disease in this population. This supplemental statement provides an evidence summary on the preferential use of 1 or more of the age-appropriate influenza vaccines for adults 65 years of age and older, over other age-appropriate influenza vaccines.

How

Inactivated high-dose, adjuvanted or recombinant influenza vaccines should be offered, when available, over other influenza vaccines for adults 65 years of age and older. If a preferred product is not available, any available age-appropriate influenza vaccines should be used. Influenza vaccination may be given at the same time as, or at any time before or after administration of another vaccine, including COVID-19 vaccine.

Why

Annual influenza vaccination is safe and the best way to prevent influenza and its complications. Adults 65 years of age and older are at higher risk of serious complications from influenza; therefore, NACI undertook a review of evidence to determine whether any age-appropriate influenza vaccines should be preferentially used in this age group. A systematic review of economic literature was also undertaken to inform public health program decision-making. Overall, the evidence supports IIV-HD, IIV-Adj and RIV as having increased benefit as compared to IIV-SD, with no difference in safety.