In this article, the safety and efficacy of the standard dose influenza vaccine and the high dose influenza vaccine were compared. Randomized controlled trials were reviewed from Medline, EMBASE, Cochrane Library, clinicaltrials.gov, gray literature, and reference lists. The trials were reviewed independently by two different reviewers and the Cochrane Risk of Bias tool was utilized to determine risk of bias. Only trials classified as having a low or unclear bias risk were included in this analysis. Two of the trials, which included a total of 41,141 patients, showed 24% greater efficacy in the high-dose group as compared to the standard-dose group. Immunogenicity, seroprotection, and safety were also examined during trial review. Immunogenicity assessment showed higher hemagglutination inhibition (HAI) in the high-dose vaccination group than in the standard-dose vaccination group. All three vaccine components studies showed higher seroprotection in the high-does vaccination group. No trials reported Guillain-Barre Syndrome, anaphylaxis, or vaccine-related mortality.
Overall, I think this article dose a great job highlighting why a high-dose influenza vaccine would be more beneficial in the geriatric population as compared with a younger population. When taking into consideration that a geriatric patient’s immune response may not be that of a younger patients, as well as the detrimental effects an influenza inflection may have on this population, it is crucial to ensure that patients for whom the high-dose vaccination are designed receive the correct dose. Due to weakened immune systems, multiple co-morbidities, shared spaces, shared staff, and the high mortality rates caused by the influenza infection in long-term care facility patients, high-dose annual influenza vaccines are necessary. Additionally, is important to properly educate the patients, caregivers, and families as to the detrimental effects of an influenza infection, such as pneumonia, bronchitis, hospitalization, and morbidity and mortality rates to ensure qualified patients receive the high-dose influenza vaccination.
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