Influenza vaccines provide diminished protection but are cost-saving in older adults.

Influenza is associated with substantial morbidity and mortality in adults aged over 65 years. Although vaccination remains the most effective method of preventing influenza and its sequellae, current vaccination strategies provide less protection to older adults than to younger persons. Influenza vaccination in community-dwelling older adults is cost-effective, though there is room for improvement. Newer vaccine strategies considered for use in older adults include alternate routes of administration (intradermal or intranasal), addition of adjuvant, and novel methods of antigen presentation. Measuring cell-mediated immune response to new vaccines in addition to antibody response may correlate better with vaccine efficacy in this population. Whilst pandemic influenza A/H1N1 2009 (pH1N1) has largely spared older adults, the impact of pH1N1 vaccination has yet to be determined.