Effectiveness of the Flu Vaccine

How effective is the flu vaccine?

How well the flu vaccine works (or its ability to prevent flu illness) can range widely from season to season. The vaccine’s effectiveness also can vary depending on who is being vaccinated. At least two factors play an important role in determining the likelihood that flu vaccine will protect a person from flu illness: 1) characteristics of the person being vaccinated (such as their age and health), and 2) the similarity or “match” between the flu viruses the flu vaccine is designed to protect against and the flu viruses spreading in the community. During years when the flu vaccine is not well matched to circulating viruses, it’s possible that no benefit from flu vaccination may be observed. During years when there is a good match between the flu vaccine and circulating viruses, it’s possible to measure substantial benefits from vaccination in terms of preventing flu illness. However, even during years when the vaccine match is very good, the benefits of vaccination will vary across the population, depending on characteristics of the person being vaccinated and even, potentially, which vaccine was used.

Each season researchers try to determine how well flu vaccines work to regularly assess and confirm the value of flu vaccination as a public health intervention. Study results about how well a flu vaccine works can vary based on study design, outcome(s) measured, population studied and the season in which the flu vaccine was studied. These differences can make it difficult to compare one study’s results with another’s.

While determining how well a flu vaccine works is challenging, in general, recent studies have supported the conclusion that flu vaccination benefits public health, especially when the flu vaccine is well matched to circulating flu viruses.

Is the flu vaccine effective against all types of flu and cold viruses?

Seasonal flu vaccines are designed to protect against infection and illness caused by the three flu viruses research indicates will be most common this season. (Note that for the 2013-2014 flu season, some seasonal flu vaccines will be formulated to protect against four flu viruses. These vaccines are called “quadrivalent” flu vaccines.) Flu vaccines will NOT protect against infection and illness caused by other viruses that can also cause flu-like symptoms. There are many other viruses besides flu viruses that can result in flu-like illness* (also known as influenza-like illness or “ILI”) that spread during the flu season.

Does the flu vaccine work the same for everyone?

No. While the flu vaccine is the single best way to prevent the flu, protection can vary widely depending on who is being vaccinated (in addition to how well matched the flu vaccine is with circulating viruses). In general, the flu vaccine works best among healthy adults and older children. Some older people and people with certain chronic illnesses might develop less immunity than healthy children and adults after vaccination. However, even for these people, the flu vaccine still may provide some protection.

How effective is the flu vaccine in the elderly?

Older people with weaker immune systems often have a lower protective immune response after flu vaccination compared to younger, healthier people. This can result in lower vaccine effectiveness in these people.

How effective is the flu vaccine in children?

In general, the flu vaccine works best among healthy adults and children older than 2 years of age. Reduced benefits of flu vaccine are often found in studies of young children (e.g., those younger than 2 years of age) and older adults (e.g., adults 65 years of age and older).

How is vaccine effectiveness measured?

How well a vaccine works can be measured through different kinds of studies. “Randomized studies,” in which people are randomly assigned to receive either vaccine or placebo (i.e., salt water solution), and then followed to see how many in each group get the flu, are the “gold standard” (best method) for determining how well a vaccine works. The measurement of vaccine effect from a randomized (placebo-controlled) study is referred to as “efficacy.” “Observational studies” are studies in which subjects who choose to be vaccinated are compared to those who chose not to be vaccinated. This means that vaccination of study subjects is not randomized. The measurement of vaccine effect from an observational study is referred to as “effectiveness.” Randomized studies are expensive and are not conducted after a recommendation for vaccination has been issued, as withholding vaccine from people recommended for vaccination would place them at risk for infection, illness and possibly serious complications. For that reason, most recent studies of how well flu vaccines work in the elderly have been observational studies.