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Question #: 288

Question: WE HAVE NOTICED THAT CDC RECOMMENDS BEGIN VACCINATING WITH SEASONAL INFLUENZA VACCINE AS EARLY SEPTEMBER OR EVEN EARLIER. DOES PROTECTION FROM DECLINE WANE WITHIN 3 4 MONTHS OF VACCINATION? SHOULD I WAIT UNTIL OCTOBER NOVEMBER TO VACCINATE MY ELDERLY MEDICALLY FRAIL PATIENTS?

Current Solution

CDC recommends that seasonal influenza vaccine be administered to all age groups as soon as it becomes available. Antibody to seasonal inactivated influenza vaccine declines in the months following vaccination. However, antibody level at a point several months after vaccination does not necessarily correlate with clinical vaccine effectiveness. There are no studies that compare vaccine effectiveness according to the month when the vaccination was given. The authors of a review on antibody declines among the elderly after vaccination reported, "In conclusion, we found no compelling evidence for more rapid decline of the influenza vaccine-induced antibody response in the elderly, compared with young adults, or evidence that seroprotection is lost at 4 months if it has been initially achieved after immunization." (See Skowronski, et al., Rapid Decline of Influenza Vaccine-Induced Antibody in the Elderly: Is it Real, or Is It Relevant? Journal of Infectious Diseases 2008;197:490-502).In addition, there is a lack of evidence for late-season outbreaks among vaccinated persons that can be attributed to waning immunity.

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