'Tis the season... Have you had your flu shot yet?

The Bottom Line

  • The flu is a major cause of hospitalization, pneumonia and death among older adults.
  • Although the flu vaccine is the best available defense against the flu virus, a significant number of older adults don’t get the annual shot.
  • Studies confirm that the flu vaccine can: reduce the risk of serious consequences of flu infection (such as pneumonia and death) among older adults living in long term care facilities; protect even when not well-matched to that season’s circulating strain; and reduce influenza and influenza-like-illness. 
  • Older adults are vulnerable enough to diseases and chronic conditions (dementia, arthritis, etc.) over which they have little control. The flu is one illness we have a fighting chance of beating – assuming we get the shot!

We’ve no sooner put away the lawn furniture and dug out the sweaters when we’re bombarded once again with radio and TV ads, signs and displays at every mall and pharmacy asking the same question... “Have you had your flu shot?”  Yes, flu season is here and it’s time to get the shot!

Influenza (aka ‘the flu’) generally makes its appearance a month or two before the holidays and hangs around through the winter. But unlike other seasonal traditions, this one does not spread joy and good cheer – but rather germs and misery.

The annual vaccine remains the best way to avoid getting the flu (1) and suffering the miserable symptoms that go along with it, not to mention more serious consequences such as pneumonia, hospitalization and even death (2;3). It is estimated that there are 3 to 5 million cases of severe influenza illness worldwide and approximately 250,000 to 500,000 deaths every year (3).

While the flu affects everyone, older adults whose immune systems naturally weaken with age are especially vulnerable. Influenza is transmitted from person to person, through coughing, sneezing, hand to hand contact with subsequent touching (auto-inoculation) of the nose (3). Seniors living in long term care facilities are particularly susceptible: not only do they have weakened immune systems, they’re also a “captive market” for viruses spread by other residents, visitors and staff. As a result, there are significantly higher rates of influenza related hospitalizations and death among older adults living in long term care (4).

Canadian targets aim for 80% of older adults to get the flu shot to help prevent the spread of infection. Yet every year at least 30% of older adults in Canada – including those in nursing homes and other long term care facilities – are not vaccinated (5). Access, convenience, encouragement and cost are among the factors that affect vaccination decisions (6).

The purpose of one systematic review was to summarize the results from only high quality studies to accurately determine whether getting the flu shot helps lower the risk of pneumonia and death in older adults living in long term care. The review included 11 studies with a total of 11,262 participants. Some received the flu vaccine while others didn’t; three or more months later the researchers measured the number of cases of flu, pneumonia, hospitalization and death (7).

What the research tells us

The flu shot was found to lower the risk of serious consequences due to flu infections – including pneumonia and death – and is strongly recommended for older adults living in long term care facilities (7). Another high quality systematic review showed that the flu vaccine even protects when not well-matched to that season’s circulating strain (8). Additionally, an even more recent systematic review found that older adults who received the flu vaccine may experience less influenza and influenza-like-illness over that season (9), so - as they say - it’s worth a shot!

The evidence and arguments for getting the flu shot are strong and compelling, particularly for older adults. Older adults are vulnerable enough to diseases and chronic conditions (dementia, arthritis, etc.) over which they have little control. The flu is one illness we have a fighting chance of beating – assuming we get the shot! 

If you are a senior, protect yourself from infection. Whether you are living in your own home, with family, in a retirement community or in a long term care facility, the flu shot can help you stay healthy through the winter and make sure no unwanted guests – like flu viruses – ruin your holiday plans.

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Author Details


  1. Centers for Disease Control and Prevention (CDC). Prevention and control of influenza with vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP). Morb Mortal Weekly Rep 2011; 60:1128-1132. 
  2. Thompson WW, Shay DK, Weintraub E, et al. Mortality associated with influenza and respiratory syncytial virus in the United States. JAMA 2003;289:179-186.
  3. World Health Organization. Influenza (seasonal). [Internet] 2016. [cited Nov 2017]. Available from http://www.who.int/mediacentre/factsheets/fs211/en 
  4. Chan TC, Hung IF, Cheng VC et al. Is nursing home residence an independent predictor of recurrent hospitalization in older adults? J Am Med Dir Assoc. 2013; 14:706-707. 
  5. Gionet, L. Flu vaccination rates in Canada. Health at a glance. [Internet] 2015. [cited Dec 2015]. Available from http://www.statcan.gc.ca/pub/82-624-x/2015001/article/14218-eng.htm#a4
  6. Thomas RE, Lorenzetti D. Interventions to increase influenza vaccination rates of those 60 years and older in the community. Cochrane Database Syst Rev. 2014(7), CD005188.
  7. Chan TC, Hung IF, Luk J et al. Effectiveness of influenza vaccination in institutionalized older adults: A systematic review. J Am Med Dir Assoc. 2014; 15:226.e1-6. 
  8. Tricco AC, Chit A, Soobiah C, et al. Comparing influenza vaccine efficacy against mismatched and matched strains: A systematic review and meta-analysis. BMC medicine, 2013; 11(1), 153.
  9. Demicheli V, Jefferson T, Di Pietrantonj C, et al. Vaccines for preventing influenza in the elderly. Cochrane Database Syst Rev. 2018; 2:CD004876. doi: 10.1002/14651858.CD004876.pub4. 

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