High-Dose vs Standard-Dose Influenza Vaccines in Older Adults

Among adults 65 years and older, does high-dose inactivated influenza vaccine (HD-IIV) provide superior protection against hospitalization and mortality compared with the standard dose?In a meta-analysis of 8 randomized trials including 605 098 participants, HD-IIV was associated with significantly reduced hospitalizations for influenza, laboratory-confirmed influenza, pneumonia or influenza, cardiorespiratory disease, and all causes compared with the standard-dose vaccine; however, HD-IIV was not associated with reduced all-cause mortality. Relative vaccine effectiveness estimates were consistent across subgroups and sensitivity analyses.These findings suggest that HD-IIV offers clinically relevant improvements in prevention of hospitalization outcomes compared with standard-dose in older adults, which may inform decision-makers in developing vaccine recommendations and policies.

Corresponding Author: Tor Biering-Sørensen, MD, MPH, MSc, PhD, Center for Translational Cardiology and Pragmatic Randomised Trials, Department of Cardiology, Copenhagen University Hospital–Herlev and Gentofte, Gentofte Hospitalsvej 8, 3th, 2900 Hellerup, Denmark (tor.biering@gmail.com).

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