High-Dose vs Standard-Dose Influenza Vaccines in Older Adults: A Meta-Analysis

This recent paper in JAMA Network Open (American Medical Association) aims to summarise the findings from 8 randomised clinical trials (total 605,098 participants) comparing high-dose inactivated influenza vaccine (HD-IIV) and standard-dose inactivated influenza vaccine (SD-IIV) for the prevention of hospitalisation events and mortality among older adults (65+).

Key Points:

"Question: Among adults 65 years and older, does high-dose inactivated influenza vaccine (HD-IIV) provide superior protection against hospitalization and mortality compared with the standard dose?

Findings: In a meta-analysis of 8 randomized trials including 605 098 participants, HD-IIV was associated with significantly reduced hospitalizations for influenza, laboratory-confirmed influenza, pneumonia or influenza, cardiorespiratory disease, and all causes compared with the standard-dose vaccine; however, HD-IIV was not associated with reduced all-cause mortality. Relative vaccine effectiveness estimates were consistent across subgroups and sensitivity analyses.

Meaning: These findings suggest that HD-IIV offers clinically relevant improvements in prevention of hospitalization outcomes compared with standard-dose in older adults, which may inform decision-makers in developing vaccine recommendations and policies."

Skaarup, K.G., Lassen, M.C.H., Hosseini, K., Johansen, N.D., Loiacono, M.M., Harris, R.C., Samson, S.I., Palmu, A.A., McConeghy, K., Gravenstein, S., Vardeny, O., Claggett, B., Solomon, S.D., Martinón-Torres, F. and Biering-Sørensen, T. (2026). High-Dose vs Standard-Dose Influenza Vaccines in Older Adults. JAMA Network Open, 9(5), p.e2614620. doi:10.1001/jamanetworkopen.2026.14620.