A new high-dose flu vaccine for seniors may not be worth the extra cost, says the BC Centre for Disease Control.
BCCDC's Influenza lead, Danuta Skowronski, said the vaccine is promising in terms of increased protection for people over the age of 65 but not enough to warrant paying eight to 10 times the price.
Seniors in B.C. can get a standard dose of the flu vaccine for free but could shell out between $70 and $98, depending on the pharmacy, for the Fluzone high-dose shot.
Still, the Tri-Cities Seniors Planning Network is recommending the elderly get the high-dose vaccine, even at the higher cost, because of increased protection, something that is more important for people of advanced age and with health problems.
“When you put out $70 to $80 and compare that to the inconvenience of being [sick] in hospital and extra costs and all that, we want to keep people healthy and out of the hospital,” said Ken Kuhn, a retired teacher who is with the network of seniors, caregivers and seniors' support groups.
He said his group voted in support of the high-dose vaccine and recently held an information seminar. The network would like to see more doctors carry it vaccine as an option, even though seniors have to pay for it.
The issue arises as flu season approaches. Last year, the National Advisory Committee on Immunization (NACI) said the Fluzone high-dose influenza vaccine provided “superior protection” compared with the standard dose but, according to Fraser Health, did not recommend it over the standard dose.
In its report, NACI said in a randomized control trial, people 65 years and older who received the high-dose were 18 to 24% less likely to get the flu. There were, however, higher rates of post-injection reaction, although they were short lived.
The BCCDC’s Skowronski noted the trial was over just a single flu season and the rate of protection amounted to about 50% protection against the disease compared to 40% that year for a standard flu shot.
“Is it worthwhile to pay four to eight times the price for that relative improvement in protection, which translates into — depending on what you’re starting at — to modest improvement? Some people might feel it’s worthwhile,” she said.
Some seniors may be able to afford the higher cost of the high-dose vaccine but Skowronski said B.C.’s communicable disease policy committee couldn’t justify spending an additional $15 million to provide it for free to seniors given.
“When NACI indicated that there is good evidence that high-dose gives superior protection to the standard vaccine, they don’t take into consideration the cost. We live in the real world. If we invest here, we don’t invest there. Is that worth while?” she said. “It’s a big switch and for us to do that we would need much clearer evidence of benefit over the standard-dose vaccine.”
She admitted that the protection rates for standard flu shots for strains such as H3N2 are “not where we would like it to be,” especially given the rate of hospitalization for those who catch it.
But she said the goal should be higher protection against the flu overall. “We want better vaccines but we don’t want more tinkering at the edges of low vaccine effectiveness.”
Fraser Health is recommending people get their flu shot now, before flu season gets underway in earnest, and free shots are available for children, pregnant women, people 65 years and older, those with medical conditions and their caregivers a swell as people providing community health services.
Dr. Aamir Bharmal, medical health officer for Fraser Health, said it’s important for people to get annual flu shots to maintain their immunity and to get protection for flu strains that vary each year. While it’s too early to say whether this year’s flu shots will closely match this year’s strains — B.C. is closely watching Australia where flu season is particularly bad, with H3N2 being the major culprit — a flu shot will provide some protection.
This year’s shot provides protection for up to four viruses, depending on the vaccine.
“The flu shot is something that’s safe, it’s effective,” Bharmal said. “People should get it and be protected for the flu season and what might be coming.”
• For information, visit www.fraserhealth.ca.
