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Not All Flu Vaccines Are The Same. What High-Risk Patients Should Know

9/30/2024

Influenza remains a serious public health threat. As of June 15, the Centers for Disease Control (CDC) estimated there were between 35-65 million flu illnesses, 390,000-830,000 flu hospitalizations and 25,000-72,000 flu deaths during the 2023-2024 flu season in the United States.1

The concern intensifies when we consider that certain conditions can result in a higher risk of complications from the flu, including:2

  • Heart Disease: Among adults hospitalized with flu during recent flu seasons, heart disease was one of the most common chronic conditions—about 50% of adults hospitalized with flu reported to CDC had heart disease.3 Studies have also shown that flu illness is associated with an increase in heart attacks and stroke.3

  • Asthma: Even if the asthma is mild or symptoms are well-controlled by medication, people with asthma are at higher risk of developing serious flu complications.4 People with asthma can develop swollen and sensitive airways, and flu can cause further inflammation of the airways and lungs.4 Flu can also trigger asthma attacks and cause worsening of asthma symptoms, and in some cases, even lead to pneumonia and other acute respiratory diseases.4 

  • Diabetes: People with diabetes (type 1, 2 or gestational), even when well-managed, are at higher risk of developing serious flu complications that can result in hospitalization and sometimes, even death.5 In recent seasons, about 30% of adults hospitalized with flu reported to CDC had diabetes.5 Acute illnesses like flu can make it harder to control blood sugar levels too.5 Flu may raise a patient’s blood sugar levels, however illness may result in reduced appetite, and a reduced appetite can cause blood sugar levels to fall.

  • Older Adults: People 65 years and older are at higher risk of developing serious flu complications compared with young, healthy adults, due in part to changes in immune defenses with increasing age.6 Though flu can vary in severity, during most seasons, people 65 years and older bear the greatest burden of severe flu.6 In recent years, it’s estimated that between 70–85% of seasonal flu-related deaths have occurred in people 65 years and older, and between 50–70% of seasonal flu-related hospitalizations have occurred among people in this age group.6

In fact, it's estimated 90% of flu hospitalizations are of people living with at least one chronic medical condition.7 

Sanofi’s Commitment to Flu Protection 

As one of the first worldwide suppliers of the influenza vaccines, and now, with over 70 years of innovation in influenza vaccines, Sanofi remains committed to protecting populations against the flu, and especially those at risk.8 

Vaccination is especially important for those who are at an increased risk of serious complications from the flu and flu vaccines remain one of the best defenses against the respiratory virus, but not all flu vaccines are the same.2

Fluzone® High-Dose (Influenza Vaccine) is the #1 administered flu vaccine over 659

Fluzone High-Dose is a vaccine indicated for active immunization for the prevention of disease caused by influenza A subtype viruses and type B virus contained in the vaccine.10 Fluzone High-Dose vaccine is given to people 65 years of age and older.10 Fluzone High-Dose should not be given to anyone who has had a severe allergic reaction to any component of the vaccine, including eggs or egg products, or after a previous dose of any influenza vaccine.10 Please see additional Important Safety Information below.

Fluzone High-Dose is the #1 administered flu vaccine for those over 65 (Internal calculations by Sanofi based on IQVIA database of total flu vaccines administered from 7/23 to 4/24 in people 65+. Not inclusive of all federal payers. Study details and information maintained by Sanofi).9 Fluzone High-Dose is the first and only high-dose flu vaccine clinically proven to provide superior flu protection in people 65+ compared to a standard-dose flu vaccine.10,11 In a randomized, controlled trial conducted in 2011-2012 and 2012-2013 in approximately 32,000 adults 65+, Fluzone High-Dose was 24% (95% CI: 10,37) more effective (rVE) against influenza due to ANY lab- confirmed circulating strains than standard-dose Fluzone (Influenza Vaccine).11 The prespecified statistical superiority criterion for the primary endpoint (lower limit of 2-sided 95% CI of the vaccine efficacy of Fluzone High-Dose relative to Fluzone >9.1%) was met.11 Solicited systemic adverse reactions and solicited injection-site reactions were slightly more frequent after vaccination with Fluzone High-Dose as compared with a standard dose vaccine in a phase 3 safety study conducted during the 2006-2007 season.12

A systematic review and meta-analysis of randomized and observational studies to evaluate the relative vaccine effectiveness of Fluzone High-Dose vs standard-dose influenza vaccines against influenza-associated outcomes in more than 45 million adults aged 65+ was conducted over 12 influenza seasons (2009-2010 to 2019-2020 and 2021-2022).13

“It’s incredibly important to remember that not all flu vaccines are created the same, and it’s important for older adults to consider higher dose flu vaccines like Fluzone High-Dose. As we know, flu-related complications can become severe, particularly in at-risk patient populations, and the type of protection they get matters. Member pharmacies of the VMC Pharmacy Program, an independent community pharmacy buying group, stock and are able to provide these and other higher-dose vaccines to their patients.” – Adam Salus, VMC Pharmacy Operations Manager VMC.

With four times the antigen,11 Fluzone High-Dose was designated as one of the preferred, recommended options for adults over 65 beginning in 2022 by the CDC’s Advisory Committee on Immunization Practices (ACIP).14

Considering the amount of severe flu cases each year, understanding expert recommendations and the latest options for flu vaccines is critical, especially for healthcare professionals counseling the most at-risk groups. While every flu season is unpredictable, getting a flu vaccine doesn’t have to be. It’s important for healthcare providers to communicate to patients that the vaccine they take matters and prioritize finding the most appropriate vaccine option tailored to them. To learn about Sanofi’s Fluzone High-Dose vaccine, go to SanofiFlu.com.

IMPORTANT SAFETY INFORMATION FOR FLUZONE HIGH-DOSE (INFLUENZA VACCINE)

Do not administer Fluzone High-Dose to anyone with a history of a severe allergic reaction (e.g., anaphylaxis) to any component of the vaccine, including egg protein, or after previous dose of any influenza vaccine.

Appropriate medical treatment must be immediately available to manage potential anaphylactic reactions following administration of Fluzone High-Dose.

If Guillain-Barré syndrome has occurred within 6 weeks following previous influenza vaccination, the decision to give Fluzone High-Dose should be based on careful consideration of the potential benefits and risks.

If Fluzone High-Dose is administered to immunocompromised persons, including those receiving immunosuppressive therapy, the expected immune response may not be obtained.

Vaccination with Fluzone High-Dose may not protect all recipients.

Syncope (fainting) has been reported following vaccination with Fluzone High-Dose. Procedures should be in place to avoid injury from fainting.

In adults 65 years of age and older, the most common injection-site reaction was pain; the most common solicited systemic adverse reactions were myalgia, malaise, and headache. Other adverse reactions may occur.

Please see the full Prescribing Information for Fluzone High-Dose.


1 Centers for Disease Control and Prevention. 2023-2024 U.S. Flu Season: Preliminary In-Season Burden Estimates. Available at: https://www.cdc.gov/flu-burden/php/data-vis/2023-2024.html. Accessed September 2024.

2 Centers for Disease Control and Prevention. People at Higher Risk of Flu Complications. Available at: https://www.cdc.gov/flu/highrisk/index.htm. Accessed September 2024.

3 Centers for Disease Control and Prevention. Flu and People with Heart Disease or History of Stroke. Available at: https://cdc.gov/flu/highrisk/heartdisease.htm. Accessed September 2024.

4 Centers for Disease Control and Prevention. Flu & People with Asthma. Available at: https://www.cdc.gov/flu/highrisk/asthma.htm. Accessed September 2024.

5 Centers for Disease Control and Prevention. Flu and People with Diabetes. Available at: https://www.cdc.gov/flu/highrisk/diabetes.htm. Accessed September 2024.

6 Centers for Disease Control and Prevention. Flu & People 65 Years and Older. Available at: https://cdc.gov/flu/highrisk/65over.htm. Accessed September 2024.

7 Centers for Disease Control and Prevention. People with Chronic Medical Conditions Continue to Account for The Majority of Flu Hospitalizations This Season. Available at: https://www.cdc.gov/flu/spotlights/2023-2024/higher-risk-hospitalizations.htm. Accessed September Vaccines2024.

8 Sanofi Influenza Vaccines. Available at https://www.sanofi.com/en/our-company/our-legacy. Accessed September 2024.

9 Sanofi Pasteur Inc. Data on File.

10 Fluzone High-Dose [Prescribing Information]. Swiftwater, PA.

11 DiazGranados, Carlos A et. al. Efficacy of High-Dose versus Standard-Dose Influenza Vaccine for Older Adults. The New England Journal of Medicine. 2014 Aug 14; 371:635-645. DOI: 10.1056/NEJMoa1315727. Accessed September 2024. 

12 Falsey, A.R., et. al. Randomized, double-blind controlled phase 3 trial comparing the immunogenicity of high-dose and standard-dose influenza vaccine in adults 65 years of age and older. Journal of Infectious Diseases. 2009 Jul 15 Vol 200(2): 172-80. doi: 10.1086/599790. Accessed September 2024.

13 Lee JKH, Lam GKL, Yin JK, Loiacono MM, Samson SI. High-dose influenza vaccine in older adults by age and seasonal characteristics: Systematic review and meta-analysis update. Vaccine X. 2023 Jun 5;14:100327. doi:10.1016/j.jvacx.2023.100327. PMID: 37333054; PMCID: PMC10276206. Accessed September 2024.

14 Centers for Disease Control and Prevention. Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee in Immunization Practices United States, 2024-25 Influenza Season. Available at: https://www.cdc.gov/mmwr/volumes/73/rr/pdfs/rr7305a1-H.pdf. Accessed September 2024.

MAT-US-2409022-v1.0-09/2024

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