By JUDD MATSUNAGA, ESQ.
It’s that time of the year again, i.e., flu season. Every year in the U.S., the flu results in millions of illnesses, hundreds of thousands of hospitalizations, and tens of thousands of deaths.
According to the Centers for Disease Control (CDC), (www.cdc.go/flu), the flu is one of the deadliest vaccine-preventable diseases in the U.S. More importantly, did you know that seniors are at higher risk of getting dangerously ill from catching the flu?
Let’s start with the basics — What is the flu? The flu is a contagious respiratory illness caused by the influenza A or influenza B virus. You might be confused: “Is the flu and influenza the same thing?” YES. I’ll admit it — I didn’t realize that the “flu” in the middle of “inFLUenza” is short for the official medical name influenza until I started researching for this Rafu Shimpo article.
The main way people get exposed to the flu is when they breathe in air droplets containing the influenza virus. These droplets are created when people infected with influenza virus talk, sneeze, or cough. The flu can cause mild to severe illness. It usually causes symptoms such as sore throat, stuffy nose, cough, fever, and body aches. Most people who catch the flu experience uncomplicated influenza and get better without needing hospitalization.
Everyone is at risk from the flu. But senior citizens, young children, pregnant women, and people with chronic medical conditions are especially vulnerable. This is especially important since last year’s flu season (2025-26) was particularly bad, with the highest levels of hospitalization and deaths seen in over ten years. So, the CDC is urging that people get the flu vaccination early in the fall (i.e., before the end of October 2026), before the flu begins circulating in your community.
According to the CDC, getting a flu vaccination is the best defense we have against flu-related illness, hospitalization, and death. Although the vaccine isn’t 100% effective, it lowers the chances of having severe complications from the flu. This is especially true for people who are at high risk of flu complications. Getting vaccinated helps protect you, your loved ones, and your community. The best time to get vaccinated is before the flu begins circulating in your community.
Flu vaccines are updated each year, and annual vaccination is recommended. The flu vaccine works by stimulating the body to produce antibodies against whatever strains of influenza were included in that year’s vaccine. The journey the vaccine takes in your body and out of your body is a smooth one. Vaccines are like a life raft to protect you against germs. Once in the system, one key part, the antigen, creates an immune response. Your body learns from the antigen how to beat germs in case of a future infection.
Our bodies are able to fight off viral infections much more quickly if we already have matching antibodies available when a virus tries to create illness in our bodies. If we don’t have matching antibodies available, then we’ll experience more illness, and it will take longer for our immune systems to control the infection.
After vaccination, it takes about two weeks for the body’s immune system to create its influenza antibodies. After your immune system learns what it needs to do, the ingredients unique to the vaccine are harmlessly flushed out of your body. Vaccines don’t cause long-term side effects because all the ingredients of the vaccine are harmlessly flushed from the body within a week or so. All that remains is the immune system’s memory of how to fight infection. (Source: www.vaccineyourfamily.org)
September and October are the optimal window to get your vaccination. It ensures your body has time to build immunity (about two weeks) before flu activity peaks, which typically happens between December and February. Getting vaccinated too early can cause your immunity to wane before the flu season finishes peaking in the late winter or spring. Vaccination remains beneficial and recommended as long as flu viruses are actively circulating in your community.
In “uncomplicated” influenza, the flu causes symptoms similar to, but usually worse than, a very bad cold, and will usually get better over 5-7 days. The CDC estimates that a person infected with the influenza virus may be contagious for one day prior to developing symptoms and 5-7 days after getting sick. Influenza virus can also survive for up to two days. The virus survives for much less time on soft surfaces, such as used tissues and bed linens.
Some people, however, get very sick from the flu. As mentioned above, seniors are at higher risk of getting dangerously ill from catching the flu. This is because seniors are more likely to have other chronic conditions, such as any heart or lung conditions or a weakened immune system. The flu does sometimes cause more serious health problems, which doctors will call “complications.” The most common complication of influenza is pneumonia, which means a serious infection of the lungs. These complications of influenza often cause hospitalization or even death.
Besides the flu shot, according to the Mayo Clinic (www.mayoclinic.org), you can take steps to lower the spread of infection, including:
- Wash your hands. Use soap and water if you can, and wash for at least 20 seconds. Or use a hand sanitizer with at least 60% alcohol.
- Don’t touch your face. Try to keep your hands away from your eyes, nose, and mouth. Those are places where germs can get into the body.
- Cover your coughs and sneezes. Cough or sneeze into a tissue or your elbow. Then wash your hands.
- Clean surfaces. Regularly clean often-touched surfaces to prevent the spread of infection from touching a surface with the virus on it and then your face.
COVID precautions, such as wearing an N95-type mask indoors and ventilating indoor spaces, will also help minimize your exposure to influenza. Both viruses are mostly spread through an airborne route. This means that steps you take to protect yourself from COVID-19, such as social distancing measures and avoiding crowded indoor spaces, will likely reduce your risk of catching influenza as well. Ask your doctor about getting the flu shot and the COVID-19 shot at the same time.
Now, you may have heard people say that the flu shot doesn’t work in older people. This is not entirely correct. Although it is true that the flu vaccine is usually less effective in older adults because aging immune systems tend not to respond as vigorously to the vaccine, i.e., older adults tend to create fewer antibodies in response to vaccination. So, if they are later exposed to flu virus, they have a higher chance of falling ill compared to younger adults.
According to board-certified gerontologist Dr. Leslie Kernisan, MD, MPH (www.betterhealthwhileaging.net), “less effective” doesn’t mean “not at all effective.” There is a preferential flu vaccine recommendation to better protect people aged 65 years and older. Older adults should receive a high-dose, adjuvanted, or recombinant flu vaccine. What is most important is to get any type of flu vaccination that is approved for your age.
Over the past several years, vaccine makers have developed vaccines that are designed to work better with an aging immune system. Most research studies to date show that these stimulate aging immune systems to produce more antibodies to influenza. There’s also some evidence that using certain influenza vaccines specifically for older adults reduces the risk of being hospitalized for influenza.
For 2026-27, there are three influenza vaccines that are specifically recommended for people aged 65 and older, plus the new mRNA influenza vaccine, which is recommended for ages 50+: Research suggests that older adults are more likely to benefit from an influenza vaccine designed to provide a stronger stimulus to the immune system, such as Fluzone High-Dose, Fluad, Flublok, or mFLUSIVA.
In conclusion, some older adults just refuse to get the flu vaccine. They might object, “I know somebody that got the flu from the flu shot.” Here’s the truth — you can’t get the flu from a flu shot. Most of the currently recommended vaccines are made with “inactivated” virus (which means the virus has been killed and can’t become alive again). There is also one vaccine available that was made using “recombinant” technology (which means they have cobbled together virus proteins). It is not possible for these vaccines to give you influenza.
The most common side effect of the flu shot is arm soreness, and sometimes redness. People do sometimes report body aches, fever, or cough after the flu shot. But a randomized trial found that these are equally common in people who had just had saline injected, so these symptoms are either due to getting sick from something else after your flu shot, or perhaps to even expecting to feel lousy after your flu shot.
If your older loved one won’t get a flu shot, here are some things you can try:
(1) Ask them to clarify what their concerns are. It’s important to start by listening, in order to understand what an older person believes about the flu and the flu shot.
(2) Provide information to dispel myths and misunderstandings. Sometimes all people need is a little of the right kind of information.
(3) Point out that it can benefit an older person’s family members and neighbors. Getting a flu shot can reduce the risk that we pass the flu on to another person. People are sometimes more willing to take action to protect others than to protect their own health.
(4) Make sure they know they won’t have to pay for the flu shot. If you get the shot from a provider who takes Medicare, it shouldn’t cost anything.
(5) Offer to go together to get your flu shots. Sometimes it helps to make it a family outing.
There are also some older adults for whom it’s hard to get a flu shot, such as people who are homebound or have very limited transportation options.
Final thought: COVID-19 vaccines DO NOT protect you against the flu. It’s recommended that you get a flu vaccine by the end of October, BEFORE flu starts spreading in your community, although vaccination later in the season can still be beneficial. Flu vaccination can be convenient and free. Vaccines may be available at doctors’ offices, pharmacies, clinics, local health departments, schools, and workplaces.
Judd Matsunaga, Esq., is the founding partner of the Elder Law Services of California, specializing in estate/Medi-Cal planning, probate, personal injury and real estate law. With offices in Torrance, Encino, Pasadena and Fountain Valley, he can be reached at (310) 318-2995. Opinions expressed in this column are not necessarily those of The Rafu Shimpo.