Reactions to high-dose flu shots

Ordinary flu vaccine has always worked out for Carolyn Hendrickson, so the 77-year-old was perplexed when her clinic gave her a high-dose version without asking first.

Ordinary flu vaccine has always worked out for Carolyn Hendrickson, so the 77-year-old was perplexed when her clinic gave her a high-dose version without asking first.

Confusion turned to anger that night as she lay in bed at home in Brooklyn Park, Minn. Her muscles ached, her head pounded and her stomach churned.

“I’ve had the flu shot before and never had a problem,” she said. “Why was this different?”

Hendrickson had learned the hard way that a new influenza vaccine, Fluzone High-Dose, is available. The vaccine is loaded with four times the usual virus-fighting antigen, so public health experts believe it will better protect seniors whose immune systems have weakened with age.

But it also causes a slightly higher rate of side effects, mostly short-term aches and flu-like symptoms.

Hendrickson was back to full strength a few days later. But in hindsight, she wonders if she would have taken the high-dose version if her clinic had offered her a choice.

Fluzone High-Dose was first offered midway through last flu season. Manufacturer Sanofi Pasteur estimates that 10 percent of seniors who were vaccinated last season received the high-dose version.

Studies have shown that the larger dose stimulates the immune system to respond more aggressively against influenza. But research hasn’t yet proven that the vaccine is more effective for seniors. Answers to that question are expected in 2014 or 2015.

For now, it is “between the provider and patient” to decide when to use Fluzone High-Dose — assuming a clinic has any in stock, said Kristen Ehresmann, who directs immunization programs for the Minnesota Department of Health.

“Some clinics may have decided to offer high-dose flu vaccine to their senior population,” she said. “That would be reasonable. When physicians prescribe a medication, they don’t necessarily say, ‘There are six antidepressants on the market; which one would you like to take?’ The providers use their judgment and prescribe a medication. The same could be said for flu vaccine.”