Why the flu hits harder when you’re 65 or over

The flu is much more than just an annoying cold, especially if you’re over 65 (1). It affects you much more than when you were younger (2): you’re more susceptible to catching it and it will hit you harder. The virus may completely knock you off your feet, leaving you bedridden and feeling weak – and needing more time to recover.

Let’s look at why it is so serious now you’re older, and how you can protect yourself.

Why you’re more at risk with the flu

Flu symptoms typically include a sudden fever, a headache, chills, aches and pains in your muscles and joints, extreme tiredness and a cough or a sore throat (1) (3). But the risk of your flu developing into a serious illness rises with age (2).

There are two reasons for this. Firstly, once you reach 65 years, your immune system becomes less effective than when you were younger (3). Added to that, you’re also more likely to have long-term health problems. Those health conditions make you vulnerable to developing serious complications whenever you catch the flu (2). These could land you in hospital for a while (2) or could even have devastating consequences.

If you are over the age of 65, you’re also at higher risk than others of experiencing serious complications that last beyond the virus itself (4) – particularly if you have kidney, heart, liver or lung problems, or diabetes. These health conditions weaken your already less effective immune system, making you even more vulnerable to complications from the flu.

Flu complications may last

If you do catch the flu, call your doctor right away. You’re more likely than others to develop serious short- or long-term complications (4):

  • Pneumonia: A bacterial infection with symptoms that include chest pain, coughs, shaking and sweating, and lower than normal body temperatures.
  • Bronchitis: Inflamed lungs with a cough as its main symptom. Bronchitis can work through the system in a few weeks or keep returning time after time.
  • Sinus and ear infections: The flu can make your body susceptible to infections, including sinus and ear infections.
  • Dehydration: You already have less water in your bodies than when they were younger. A fever can mean you quickly become dehydrated, potentially leading to kidney problems or seizures.
  • Heart failure: You’re more likely to have a heart attack after a bout of the flu since your heart is more vulnerable to bacteria and other harmful substances.
  • Long-term medical conditions: The flu can also make your existing conditions worse (5).


There are antiviral drugs that can make your flu illness milder, make you feel better faster and prevent these serious flu complications (6). These drugs work best if you start them within 48 hours after symptoms appear.

If you experience any of the following warning signs of severe flu, seek medical attention right away (6):

  • Difficulty breathing or shortness of breath
  • Pain or pressure in the chest or abdomen
  • Sudden dizziness
  • Confusion
  • Severe or persistent vomiting
  • Flu-like symptoms that improve but then return with fever and worse cough.


The flu is preventable

The flu is a highly infectious disease (3). Coughs and sneezes propel infected droplets of saliva or nasal secretions into the air, which are then breathed in by others. It is also spread when people touch the surfaces that the droplets have landed on, then their mouth, nose or eyes (3). Someone with the flu can infect you up to a day before they start showing any symptoms, then for another five to seven days after their symptoms show (4).

But the flu is also preventable. During the flu season, you can help keep the flu away by (1):

  • Washing your hands regularly
  • Avoiding touching your eyes, nose and mouth
  • Cleaning frequently touched surfaces
  • Avoiding crowds
  • Getting your annual flu vaccine.


The standard flu vaccine has been found to be somewhat less effective in the elderly compared to younger adults; it’s typically between 70% and 90% as effective (7). Nevertheless, it is still the best way to protect yourself (3). A new type of flu vaccine (known as an adjuvanted vaccine) is more effective for the elderly than the standard flu shot. Research has shown that it reduces your risk of spending time in hospital for pneumonia or the flu by a further 25% compared to the standard flu shot (7).

A flu vaccine gives you the best possible chance of avoiding the flu and other more serious complications (2). And if you do still succumb to the virus, your symptoms are likely to be milder symptoms if you’ve been vaccinated (5). Flu vaccines are updated each flu season to keep up with changing viruses and your immunity wanes over a year, so you need a vaccination every year (3) (6).

If you’re aged 65 or over, your seasonal flu vaccine is vital. Have you had yours?



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