Debate over stronger flu shot use at nursing homes

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GUILFORD COUNTY, N.C. -- Medical professionals are split over whether a high dose flu vaccine will be a greater benefit for seniors than a traditional flu shot.

“This particular vaccine does have higher immune response. It has more antigens. It has four times more antigens than the regular flu vaccine,” Vicki Smith, nursing services and immunization supervisor at Guilford County Department of Health and Human Services, said.

The high dose flu vaccine is specifically for people 65 and older.

In the largest study of its kind, researchers with Case Western Reserve University found that shots with four times the strength of standard flu shots lessened the chance of nursing home patients being hospitalized by a little more than one percent.

According to the study, given the estimated 1.5 million people in nursing homes, that would mean thousands of fewer trips to the hospital.

However, professionals at some retirement and assisted living communities have concerns.

“They have a decreased immune system and therefore with the quadrivalent or the high dose, they will have greater risks for side effects,” Tina Long, registered nurse and director of clinical services with Ridge Care, said.

Ridge Care operates 13 senior living communities and says it collaborates with doctors and pharmacists who are encouraging staff to give the standard flu shot.

“To switch over from standard dose to high dose across the board in folks over 65 doesn't seem reasonable based on the evidence,” Dr. Natalie Marshburn, pharmacy manager at Peak Pharmacy, said.

“And we need to keep in mind the standard flu shot isn't really standard. Each year the CDC conducts testing and determines which strains they believe will be the most popular,” Long said.

Medical professionals say risks associated with the high dose flu vaccine include pain, swelling, a rash at the injection site, or even flu-like symptoms such as nausea or fever.

Experts say those reactions would typically happen shortly after getting the vaccine, but could happen within one or two days of getting the vaccine.

Last flu season in North Carolina, October 2014 to May 2015, there were 180 flu-related deaths among people age 65 and older.

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