Health & Science

Flu and Older Adults

October 30 2022

Each year, millions of people suffer from seasonal influenza, which is often called the flu. Flu is a respiratory illness caused by viruses that infect the nose, throat, and sometimes the lungs.

Flu is a mild illness for some people. But for others, including older adults and those with chronic (long-lasting) health conditions, the flu can be very serious and even life-threatening. Getting a flu vaccine every year can help prevent the flu. The vaccine is safe, effective, and available for little to no cost to you.

How serious is the flu?

Most people who get the flu feel better after a few days to two weeks. However, the flu can make you seriously ill. Some people develop other health issues, called complications, because of the flu. Complications can be mild, such as a sinus or ear infection, or more serious, like pneumonia.

Anyone can get sick from the flu, but some people are more likely to have complications. You are more at risk for flu and its complications if you:

Are age 65 or older
Have certain medical conditions such as asthma, diabetes, or chronic kidney disease
Have heart disease or have had a stroke
Live in a nursing home or other long-term care facility

Pregnant people and children younger than five years old are also more likely to get very sick from the flu. Flu vaccination is especially important for people in these higher-risk groups. Learn more about people at increased risk for flu and its complications.

Why is the flu more dangerous for older adults?

The flu is more dangerous for older adults for a few reasons. One reason is that the immune system — which helps your body fight infections — weakens as you age. For example, because your body is busy fighting off the flu, you might pick up a secondary infection such as pneumonia. A second reason is that older adults are also more likely to have other health conditions, like diabetes, that increase their risk for complications from the flu.

The good news is the flu vaccine reduces your risk of getting the flu and of getting seriously ill if you do get sick with the flu. Flu vaccination is especially helpful for people with chronic health conditions. For example, it has been linked to lower rates of heart problems (cardiac events) among people with heart disease and fewer hospitalizations among people who have chronic lung disease or diabetes. Learn more about the benefits of flu vaccination.

How does the flu spread?

The flu is contagious, which means it spreads from person to person. It mostly spreads through droplets in the air when people with flu cough, sneeze, or talk. It can spread from up to six feet away. Although it isn't as common, the flu can also spread from surfaces — for example, if you touch something the virus is on and then touch your nose, mouth, or eyes.

It's possible to spread the flu before you feel sick and when you have symptoms. Typically, people with the flu can spread it a day before, and up to a week after feeling sick. Young children and people with weakened immune systems may be able to spread the flu for even longer. If you or someone you know is sick with the flu, take steps to help prevent spreading the disease

Is it the flu, a cold, or COVID-19?

The common cold, flu, and COVID-19 are respiratory illnesses caused by different viruses. They can all cause similar symptoms. If you have symptoms, a health care provider can determine the cause of your illness and help you take steps to feel better.

A cold is often milder than the flu. The flu and COVID-19 have similar symptoms, but COVID-19 spreads more easily and symptoms tend to be more severe. It's also more common to have a change in your sense of smell or taste with COVID-19.

People with the flu can have fever, chills, dry cough, general aches and pains, and a headache. They feel very tired. Sore throat, sneezing, stuffy nose, or stomach problems are less common. What some people call "stomach flu" is not influenza. Learn more about the differences between the flu and a cold and flu and COVID-19.

Recognizing a fever in older adults

Average normal body temperatures in older adults are slightly lower than in younger adults. So when an older adult is sick, their fever temperatures may also be lower. According to the CDC, the following temperatures in older adults may be signs of an infection, such as COVID-19 or the flu:

A single temperature reading higher than 100°F (37.8°C)
Multiple temperature readings above 99°F (37.2°C)
A rise in temperature greater than 2°F (1.1°C) above the person’s normal body temperature

If you are concerned that you may have a fever, talk with a health care provider to find out what steps you can take to feel better.

Common symptoms of a cold, the flu, and COVID-19

The chart below shows common symptoms of the three illnesses. Not everyone will have these symptoms. Your symptoms may be more or less severe, or you may only have a few. If you feel sick, stay home and call a health care provider.

Chart showing differences between cold, flu, and COVID-19. Click image to link to open full description.

How can you prevent the flu?

The most effective way to prevent the flu is to get a flu vaccine every year. Everyone 6 months and older should get a flu vaccine. It makes it less likely that you will get the flu. It also reduces your chances of being hospitalized or dying if you do get sick with the flu.

In addition to getting your flu vaccine, you can help stop the spread of flu by:

Washing your hands
Covering your mouth when you cough or sneeze
Avoiding touching your eyes, nose, or mouth
Staying home when you are sick
Avoiding close contact with people who are sick
Cleaning and disinfecting frequently touched surfaces at home, work, or school

Who should you get a flu vaccine and which one should you choose?

You can get the flu at any time of year, but it's most common in the fall and winter. It usually starts to spread in October and peaks between December and February. That's why this time is called the flu season

It takes at least two weeks for your flu vaccine to start working, so try to get vaccinated by the end of October. However, getting vaccinated after October can still help protect you from the flu. Because older adults may lose protection from a flu vaccine more quickly, try to avoid getting vaccinated too early (before September).

There are flu vaccines designed specifically for older adults. The CDC recommendsthat people age 65 and older receive a higher-dose flu vaccine or an adjuvanted flu vaccine (one with an additional ingredient called an adjuvant that helps create a stronger immune response). These vaccines are potentially more effective than the standard flu vaccine for people in this age group. Talk with a health care provider or pharmacist about which vaccine is best for you.

Where can you get a flu vaccine?

You can get your flu vaccine at a doctor's office or from your local health department. Many grocery stores, drug stores, and pharmacies also offer flu vaccines. Visit Vaccines.gov to find a location near you.

Why do you need a flu vaccine every year?

You need a flu vaccine every year for two reasons. First, flu viruses change and the flu vaccine is updated each year to target the flu viruses that are anticipated to spread that year. Second, the protection you get from a flu vaccine lessens with time, especially in older adults. Getting your flu vaccine every fall gives you the best protection from that year's flu viruses.

What are the side effects of flu vaccines?

The flu vaccine is safe and cannot give you the flu. Most people have no problems after getting a flu vaccine.

When side effects occur, they are generally mild and go away on their own. The most common side effects are soreness, redness, or swelling at the site where you got the shot. Some people also get a headache, fever, nausea, or muscle aches. These side effects start shortly after getting the vaccine and can last up to two days. They typically do not get in the way of daily activities.

If you have allergies, talk with a health care provider about your options for flu vaccines. Even people with mild egg allergies can safely get most flu vaccines. Egg-free flu vaccines are also available. You should not get vaccinated if you have had a severe allergic reaction to the flu vaccine in the past.

How much does getting a flu vaccine cost?

Most people can get a flu vaccine for little to no out-of-pocket cost. Medicare and most private health insurance plans will cover the cost of your flu vaccine. However, some insurance plans require that you receive your vaccine at a specific location. Check with your insurance company. If you do not have health insurance, contact your local or state health department.

What can you do if you get the flu?

If you get the flu, there are steps you can take to feel better. Act fast! First, talk with a health care provider. The flu and COVID-19 have similar symptoms, so you may need to get tested for an accurate diagnosis. This will also help determine which medications might make you feel better.

There are prescription drugs, called antivirals, that are used to treat people with the flu. If you take them within 48 hours after flu symptoms begin, these drugs can make you feel better more quickly. Antivirals can also help reduce your risk of complications from flu. Antibiotics do not help you recover from the flu. However, they are sometimes prescribed to treat a secondary infection if it is caused by bacteria. Bacteria are a different type of germ than viruses.

If you are sick, rest and like juice and water, but not alcohol. Over-the-counter medicines, such as acetaminophen or ibuprofen, can bring down your fever and might help with the aches and pains.

It is important not to smoke if you are sick with the flu. It is a respiratory illness that can infect your lungs as well as your nasal passages. These same areas are also affected by smoking.

Monitor your symptoms and talk with a health care provider if you start feeling worse. For example, contact your provider right away if you:

Have shortness of breath or difficulty breathing
Feel weak, dizzy, or confused
Develop ongoing pain or pressure in the chest or abdomen
Have a fever or cough that goes away and then comes back, which may be a sign of a secondary infection
Experience worsening of other chronic health problems, such as asthma or heart disease
Develop any other symptoms that worry you