What type of influenza (flu) vaccine is recommended for a 61-year-old woman?

Influenza Vaccine Recommendations for a 61-Year-Old Woman

For a 61-year-old woman, a standard-dose inactivated influenza vaccine (IIV3) is recommended, though she will be eligible for high-dose or adjuvanted formulations when she reaches age 65. 1

Vaccine Options for Adults Aged 61 Years

According to the Advisory Committee on Immunization Practices (ACIP) 2024-25 influenza season recommendations, the following vaccine types are appropriate for a 61-year-old woman:

Standard-Dose Options (Recommended)

• Standard-dose inactivated influenza vaccines (IIV3s) such as:
  • Afluria (0.5 mL prefilled syringe)
  • Fluarix (0.5 mL prefilled syringe)
  • FluLaval (0.5 mL prefilled syringe)
  • Fluzone (0.5 mL prefilled syringe)
  • Flucelvax (cell culture-based, 0.5 mL prefilled syringe)
• Recombinant influenza vaccine (RIV3) such as:
  • Flublok (0.5 mL prefilled syringe) - approved for adults ≥18 years

Contraindicated Options

• Live attenuated influenza vaccine (LAIV3) such as FluMist is only approved for ages 2-49 years and is contraindicated in this case 1

Special Considerations

Age-Specific Recommendations

• High-dose influenza vaccine (HD-IIV3) and adjuvanted influenza vaccine (aIIV3) are specifically licensed for adults ≥65 years 1
• At 61 years old, the patient does not yet qualify for these enhanced formulations under standard recommendations
• She will become eligible for these options in 4 years when she turns 65

Efficacy Considerations

• Studies have demonstrated that high-dose and adjuvanted vaccines provide superior protection in adults ≥65 years compared to standard-dose vaccines 1
• The high-dose vaccine contains 60 μg of hemagglutinin per strain (4 times the standard dose) 2
• The adjuvanted vaccine contains the MF59 adjuvant to enhance immune response 1

Special Populations Exception

While the patient doesn't qualify for high-dose or adjuvanted vaccines based on age alone, these might be considered if she has certain medical conditions:

• If she is a solid organ transplant recipient on immunosuppressive medications, either HD-IIV3 or aIIV3 would be acceptable options despite being under 65 years of age 1
• If she has rheumatic or musculoskeletal disease and is taking immunosuppressive medication, high-dose or adjuvanted influenza vaccination would be conditionally recommended over standard-dose 1

Administration Guidance

• The vaccine should be administered as a single 0.5 mL dose via intramuscular injection 1
• Vaccination should be given as soon as possible before or during the influenza season
• No preference is stated among the standard-dose options for a 61-year-old woman without specific risk factors

Bottom Line

For a 61-year-old woman without special risk factors, any standard-dose inactivated influenza vaccine (IIV3) or recombinant vaccine (RIV3) is appropriate. She should receive the vaccine annually, and when she reaches age 65, she will become eligible for the high-dose or adjuvanted formulations which have demonstrated superior efficacy in older adults.