ARE TWO DOSES OF FLU VACCINE BETTER THAN ONE?

Adam’s journal

Here’s a question from a reader: I’m a 77-year-old male who’s very active. For years, I’ve gotten the annual flu vaccine in mid-October.

This year, in February, I got the flu. Fortunately, my symptoms were mild. But wouldn’t a second flu shot have helped me be better protected?

— Name withheld by request

Dr. James prescribes

Happily, our reader did not seem to experience complications from his infection. However, as a group, older people are at higher risk for serious illness and even death from the flu.

So, it makes sense to search for ways to better protect them.

It is true that in some groups — organ transplant recipients and children being vaccinated for the first time — getting two doses of the same flu vaccine during the same flu season appears to be helpful. So, researchers tried this approach with people in their 70s.

However, in both of these studies, the second dose of vaccine failed to increase subjects’ levels of antibodies against influenza.

In addition, as the number of flu vaccinations a person receives over their lifetime grows, studies have shown that both antibody responses and vaccine effectiveness diminish.

Make no mistake: You’re better protected if you receive a flu shot than if you don’t. But getting a second one won’t help; in fact, it might even blunt your body’s ability to form protective responses.

For those 65 and over, the Food and Drug Administration has approved high-dose flu vaccines. These vaccines contain four times as much immunestimulating antigen than the standarddose vaccine.

As a result, it produces substantially higher levels of antibodies in those who receive it. In post-approval studies, the most prevalent of these vaccines, Fluzone, was found to be 24% more effective than standard vaccines in preventing flu infections among those 65 and over. It also seems to reduce serious complications of flu in older people, including pneumonia and worsening of heart and lung disease.

In sum, when it comes to flu vaccines, two doses are not better than one. But in older individuals like our reader, the high-dose vaccine can offer added protection.

James is executive vice president and chief medical officer of the Oklahoma Medical Research Foundation. Cohen, a marathoner, is OMRF’s senior vice president and general counsel. Send your health questions to contact@omrf.org.

GETTY IMAGES Would getting two doses of the same flu vaccine during the same flu season be helpful?