- With Mayo Clinic internist
James M. Steckelberg, M.D.
read biographyclose windowBiography of
James M. Steckelberg, M.D.
James Steckelberg, M.D.
Dr. James Steckelberg is a consultant in the Division of Infectious Diseases and a professor of medicine at Mayo Medical School.
A native of Fremont, Neb., Dr. Steckelberg was a Rhodes Scholar and graduated from the Mayo Graduate School of Medicine as a resident in internal medicine and a fellow in infectious diseases, and is board certified in both. He is the former director of the Infectious Diseases Research Laboratory at Mayo Clinic.
Dr. Steckelberg belongs to numerous professional organizations. He is a founding member of the Musculoskeletal Infection Society and a fellow of the American College of Physicians and of the Infectious Diseases Society of America. He has served on many Mayo Clinic committees and is a member of the Department of Medicine Leadership Committee and of the executive committee of the Division of Infectious Diseases. He also served on the editorial boards of "Mayo Clinic Proceedings" and "Antimicrobial Agents and Chemotherapy" and has been an editorial reviewer for more than a dozen publications.
Dr. Steckelberg's research interests include experimental models of infection, epidemiology of infection, and antimicrobial resistance and therapy of bacterial infections.
Definition (1)
- What's the difference between H1N1 flu and influenza A?
Treatments and drugs (1)
- Flu and pregnancy: Is antiviral medication safe?
Prevention (5)
- Flu vaccine: Safe for people with egg allergy?
- Flu mask: Should I wear one?
- Fluzone High-Dose: What distinguishes it from other flu vaccines?
- see all in Prevention
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Question
Fluzone High-Dose: What distinguishes it from other flu vaccines?
How does Fluzone High-Dose differ from other flu vaccines?
Answer
from James M. Steckelberg, M.D.
Fluzone High-Dose is an injected flu vaccine formulated for people age 65 years and older. Like other flu vaccines, Fluzone High-Dose is made up of the three flu strains most likely to cause the flu during the upcoming season. The high-dose vaccine, however, contains four times as much flu virus antigen — the part of the vaccine that stimulates the immune system — as regular Fluzone and other standard flu vaccines.
In response to a regular flu shot, older people produce 50 to 75 percent fewer antibodies, which protect against the vaccine antigens, than do younger adults. Evidence that a high-dose flu vaccine can compensate for this difference comes from studies that found higher post-vaccine antibody levels in older people who received high-dose flu vaccine than in those who received standard flu vaccine. But whether higher antibody levels actually translate into fewer cases of the flu in this age group is unknown.
In the largest of three clinical studies comparing high-dose and standard-dose flu vaccine, those who received the high-dose vaccine were more likely to develop side effects, such as fever and soreness at the injection site, during the week after vaccination.
The risks of flu complications are highest for people age 65 years and older, so protecting older people from the flu is particularly important. The Food and Drug Administration accelerated its approval of Fluzone High-Dose on the condition that studies will continue to evaluate the new vaccine's effect on seasonal flu outcomes, such as cases of flu and flu complications, in older people. If, over the next few years, Fluzone High-Dose turns out to be superior to regular flu vaccine by these measures, high-dose vaccine may become the vaccine of choice for older people.
Next questionImmunization: Are you immune to a disease?
- Centers for Disease Control and Prevention, et al. Licensure of a high-dose inactivated influenza vaccine for persons >65 years of age (Fluzone High-Dose) and guidance for use — United States, 2010. MMWR. 2010;59:485. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5916a2.htm. Accessed June 6, 2011.
- Fluzone and Fluzone High-Dose FAQs. http://www.cdc.gov/flu/protect/vaccine/qa_fluzone.htm. Accessed June 6, 2011.
- Sullivan SJ, et al. Advances in the vaccination of the elderly against influenza: Role of a high-dose vaccine. Expert Review of Vaccines. 2010;9:1127.
- Couch RB, et al. Safety and immunogenicity of a high dosage trivalent influenza vaccine among elderly subjects. Vaccine. 2007;25:7656.
- Falsey AR, et al. Randomized, double-blind controlled phase 3 trial comparing the immunogenicity of high-dose and standard-dose influenza vaccine in adults age 65 and older. Journal of Infectious Diseases. 2009;200:172.
- Keitel WA, et al. Safety of high doses of influenza vaccine and effect on antibody responses in elderly persons. Archives of Internal Medicine. 2006;166:1121.
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