Seniors Encouraged To Get Standard Dose If High Dose Is Unavailable 

Strong demand for flu shots is encouraging

Mon, 09/28/2020 - 4:30pm

Here at Pen Bay Medical Center and Waldo County General Hospital, we are thrilled with our community’s enthusiastic response to our efforts to make flu shots widely and conveniently available. Being proactive about this is good for individuals, good for the community, and maximizes the likelihood that hospitals will not be overwhelmed by potentially simultaneous increases in illness due to COVID-19 and influenza this winter.  

It is important to remember that, on average, an estimated 20,000 to 40,000 Americans die of influenza annually. Getting a flu shot is one important way to reduce that number. In anticipation of increased demand for flu shots, our hospitals and offices ordered extra vaccine supplies to prepare for the 2020-2021 flu season. To date, PBMC and WCGH have administered twice the number of flu vaccines that were given by this time last year – this is fantastic.

Flu vaccines are available in several versions in the U.S. Most commonly, we use injectable “standard dose” or “high dose” inactivated (in other words, containing no live virus) flu shots.  

As we age, our ability to mount an effective immune response to influenza vaccination tends to decline. Some research has indicated that a double dose of inactivated flu vaccine is more likely to protect older people. On this basis, the first high dose flu vaccine formulation was FDA-approved in 2013 for use in adults age 65 and over.  

However, it is important to know that the advantage of high dose over standard dose vaccine is quite small. In the most often cited study to support high dose flu shots – a trial involving over 30,000 people, 1.4% of older adults who received high dose flu vaccine were later diagnosed with the flu versus 1.9% of those who received standard dose vaccine.  

Given all of the above, since 2013 the Advisory Committee on Immunization Practices (ACIP) – the expert panel that advises CDC on immunization guidelines – has expressed no preference for high dose over standard dose flu vaccine in Americans 65 and over. Moreover, ACIP advises against delaying flu shots if a specific formulation is not available at a given vaccination opportunity.  

Meanwhile, we also know that the severity of flu season in a given community can depend significantly on the proportion of community members vaccinated. Yes, we are talking about herd immunity.

So why take time talking about these details? High dose flu vaccine has been heavily marketed in the past five years, leaving many of us convinced that this is the only kind of flu shot we should get at or after age 65. Demand for flu shots in our area, and in many parts of the country, has been so brisk this season that many providers are running low on doses of standard and/or high dose flu vaccine.  

Fortunately, PBMC and WCGH are doing very well with maintaining supplies of standard dose vaccine. However, supplies of high dose flu shots are not guaranteed.  

What should you do if you are 65 or older? Get immunized as soon as it is convenient, and get the shot that is available that day, especially if it is not easy for you to come back. If high dose flu shots are not available when you have the opportunity to be vaccinated, then get standard dose. Just get a flu shot. And get it by Thanksgiving at the latest, but preferably by the end of October. There are a lot of us to vaccinate; the more we cover, the better off we will all be.


If you still need to get your flu shot, they are available at a drive-thru clinic at PBMC on Tuesdays from 8 a.m.-1 p.m. and Wednesdays from noon-5 p.m. through Oct. 28. Clinics at Waldoboro Family Medicine, 27 Mill St., Waldoboro, will be held on Monday, Sept. 28, and Monday, Oct. 26, from 9 a.m.-4 p.m. 

PBMC is also offering a family friendly option at Pen Bay Family Medicine, 7 Madelyn Lane, Rockport, on three Saturdays. These drive-thru clinics, which will have vaccines for children 6 months of age and older and for their families, will be held Sept. 26, Oct. 24 and Nov. 21 from 9 a.m.-1 p.m.

At WCGH, clinics will be held at 125 Northport Ave., across the street from the main hospital building, on Thursdays from 8 a.m.-noon through Oct. 29. 

Cheryl Liechty, MD, MPH, is an infectious disease physician and epidemiologist who continues to lead PBMC’s and WCGH’s response to the COVID-19 pandemic. She worked for the U.S. Centers for Disease Control and Prevention in Uganda before joining Pen Bay Internal Medicine in 2005. She lives in Rockport with her husband and two sons.

Pen Bay Medical Center, in Rockport, and Waldo County General Hospital, in Belfast,  are part of MaineHealth, a nonprofit health system consisting of eight local hospital systems, a behavioral healthcare network, diagnostic services, home health agencies, and more than 1,600 employed and independent physicians working together through an Accountable Care Organization. For more information, please visit