What people aged 50 and older need to know about flu shots : NPR

NPR’s Ayesha Rascoe asks Dr. Ann Falsey of the University of Rochester Medical School about flu shots for people aged 50 and older.

Transcript

AYESHA RASCOE, HOST:

Flu activity is rising earlier than usual, according to the Centers for Disease Control and Prevention, but it’s not too late to get your flu vaccine. And if you’re 50 or older, there’s a whole bunch of vaccines available, including one that’s all new this year. Dr. Ann Falsey teaches about infectious diseases at the University of Rochester School of Medicine, and she joins us now. Welcome to the program.

ANN FALSEY: Well, thank you very much. I’m excited to be here.

RASCOE: Let’s start with the new flu vaccine, and this is one that is made with the same technology as was used with the COVID shots. Remind us how that’s made.

FALSEY: Sure. This is an RNA vaccine, and what that does is you give the message to your body so that your body can then make the protein and have an immune reaction to the protein.

RASCOE: OK, so meaning, like, the other vaccines that traditionally we use, it’s like they give you…

FALSEY: They give you a piece.

RASCOE: A piece of it, and then your body fights it. And so for the purpose of us talking about the new and the – we’ll call them traditional flu vaccines – start with growing pieces of viruses, often in chicken eggs or vats of cells. How long does that process usually take?

FALSEY: It takes a long time, particularly with the chicken eggs. They try to guess which strains are going to be circulating in the winter. So they have to start six to nine months ahead of time, predicting in order to grow up enough flu vaccine, either in eggs or in cells. Whereas with the RNA, it’s just much faster. So you can pick an antigen, the protein you want to react against, and make it up pretty quickly so you can adapt to a new strain of flu that comes on the scene. And then you can actually bring it up to scale faster, so you can make more doses available quickly.

RASCOE: And is the MRNA vaccine more effective than the traditional vaccines?

FALSEY: Well, the first study came out just recently, and it did show that it was about 27% more effective than standard-dose regular old (ph) flu vaccine.

RASCOE: Why is the MRNA vaccine just for people 50 and older? Like, why can’t I get one of these new MRNA flu shots?

FALSEY: So the simple answer is that that’s the age group in which the vaccine was studied. And so the FDA will only approve it for those people in whom you did the study. And it’s because those folks are more at risk for serious infection or illness if they catch the flu. RNA vaccines are great. I’m a firm believer in them, but they do carry with them a little bit more reactogenicity. And so you might get a little bit more sore arm. You might feel a little punky the next day, and it’s always a trade-off.

RASCOE: But it would work fine for younger people, too. It’s just prioritizing…

FALSEY: Yes.

RASCOE: …Older people.

FALSEY: Yeah.

RASCOE: There have been concerns about MRNA vaccines and the way they were developed with COVID. Now you’re doing it with the flu. What do you say to people who have concerns about this process or people who may be listening, like, I don’t know about this, this is untested, or this is new?

FALSEY: Well, what I would say is, you know, one of the misconceptions was they were brand new during the COVID pandemic. They had been working on RNA vaccines for a couple of decades. But what I would say to those individuals is tell me what your specific worry is. Sometimes people are like, oh, I’m worried it’s going to integrate into my DNA, and I can tell them 100% certainty that will not happen. It just can’t happen.

And a lot more time has gone by. We’ve had the COVID shots for a long time, and so we have more data to allay the fear of, like, well, it’s new, so you don’t really know what’s going to happen. And it’s just a marvelous technology that works really well, so, you know, we need to deploy it sensibly.

RASCOE: Do you think that the future of flu vaccines is more in the MRNA direction? Like, are the days of protein flu vaccines numbered?

FALSEY: Well, I don’t think so. I think there’s a certain segment of the population that, I don’t know, RNA just gives them the heebie-jeebies and they don’t ever want it. So I think that we will always want to have options. And so for our older adults now, we have a high dose flu vaccine made with protein just in traditional eggs. We have a vaccine that has a – what’s called an adjuvant, which is where it’s a little something to goose the immune system, do a little better. And then we have a cell-based vaccine that’s a higher dose.

So there’s options for older people. For those people ages 50 to 64, the high dose flu vaccine and the adjuvant vaccine are not approved. So if they want some extra protection, this would be one option for them.

RASCOE: That’s Ann Falsey of the University of Rochester School of Medicine. Dr. Falsey, thank you so much for joining us.

FALSEY: Thank you. It was a pleasure to be here.

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