Michael Greenberg, MD: Improving Access to High-Dose Flu Vaccines for Older Patients


Dr. Greenberg urges the ACIP to update their vaccine guidelines for patients 65 years and older to recommend high-dose flu vaccines.

For the first time in over 10 years, the Advisory Committee on Immunization Practices (ACIP) at the Centers for Disease Control and Prevention (CDC) is considering recommending certain high-dose influenza vaccines more strongly to Americans 65 years and older.

With influenza cases steadily rising early in the year, as well as medical professionals speaking of a potential “twindemic” involving the ongoing COVID-19 pandemic, a potential change in vaccine recommendations could aid countless older patients across the country.

In an interview with HCPLive, Michael Greenberg, MD, North America Medical Head at Sanofi-Pastuer, spoke of the available high-dose flu vaccines currently out in the marketplace such as Fluezone HD, and how greater access to these types of vaccines could help mend the equity gap across different patient populations.

“(The flu) disproportionately affects people over the age of 65, people who have underlying medical conditions such as heart disease, diabetes, chronic lung disease, the very young, and as well different parts of our society,” Greenberg said. “Underrepresented minority groups are disproportionately affected by flu with more likelihood of landing in the hospital, so it's a serious problem.”

Patient groups such as the elderly and those with skin of color have also been hindered by a lack of access to high dose flu vaccines, as earlier studies have suggested. In a recent study published last year in The Lancet, among adults 65 years and older who received a flu vaccine, those from racial and ethnic minority groups were 26%-32% less likely to receive the more effective high-dose vaccine option.

“In the absence of (clear guidance from ACIP), clinics that have to purchase their flu vaccine in February or March for the next flu season will do so on the basis of what information is available to them, the recommendations from the CDC, and then of course, the cost of vaccines,” Greenberg said. “If they're not led by the by the evidence, then oftentimes, those health care facilities or pharmacies, where people of color may be going, may not have the same stock of the high dose vaccine, for example, and therefore the likelihood of getting it and access is going to be different in those communities.”

Greenberg noted that even prior to the COVID-19 pandemic, influenza was responsible for up to 52,000 deaths every year in America as well as the hospitalization of hundreds of thousands of other patients. Of the 3 available high-dose flu vaccines on the market, all of which are manufactured by Sanofi-Pasteur, Fluezone High Dose (HD) demonstrated to superior efficacy compared to a standard dose flu vaccine among patients 65 years and older.

He hopes that the ACIP with grant a stronger recommendation of high-dose flu vaccines regardless of the manufacturer to help protect some of the most vulnerable patients in the country.

“We need to make sure that that there are better flu vaccines available and that they're shown to be effective against the things that matter to patients,” Greenberg said. “You need to be able to demonstrate that your vaccine can protect beyond that typical flu infection and actually reduce hospitalizations for cardiac and respiratory diseases, that it can reduce the likelihood of having an NMI or a stroke in people who are at higher risk, because that's what matters to patients. And right now, the ACIP has that opportunity to do it.”

To hear more from Dr. Greenberg, watch the video above.

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