Is the mRNA Influenza Vaccine More Efficacious in Older Adults?

In a study published earlier this year in the New England Journal of Medicine, the mRNA-1010 mRNA influenza vaccine prevented disease in adults 50 years and older more effectively than standard vaccines. Specifically, data showed that confirmed influenza-like illness occurred in 2.0% of mRNA-1010 vaccine recipients and 2.8% of comparator recipients, with a relative vaccine efficacy of 26.6% (95% CI, 16.7 to 35.4). And in adults 65 and older, the results were slightly better, with a relative vaccine efficacy of 27.4%.¹

“mRNA-1010 was superior to standard-dose licensed vaccines for prevention of RT-PCR–confirmed, protocol-defined influenza-like illness in adults 50 years of age or older,” the authors concluded.

Influenza Disease Burden in Older Adults

Adults over age 50 face a higher risk of hospitalization and death from influenza each year. For the 2023–24 respiratory virus season, adults 65 and older accounted for only 8% of flu-related medical visits but 68% of deaths and 50% of hospitalizations, while adults 50 through 64 accounted for 20% of flu-related hospitalizations and 20% of flu-related deaths, according to the Centers for Disease Control and Prevention (CDC). Additionally, the federal agency estimates that influenza causes 9.4–51 million illnesses, 120,000–710,000 hospitalizations, and 6,300–52,000 deaths annually in the US.²

“The flu is not just a bad cold; it is really a serious disease,” said Deborah Fuller, PhD, professor in the Department of Microbiology at the University of Washington School of Medicine, and associate director of research at the Washington National Primate Research Center. She points out the challenges older adults face. “A lot of times, we have other issues such as risks of heart attack, kidney disease, diabetes. All of these, what we call comorbidities, can increase the risk of an elderly person succumbing to influenza.”

She also points out that higher vaccine efficacy is especially important as people age and develop immunosenescence, or the immune system’s declining ability to fight off infections and respond to vaccines.

Prospective mRNA Vaccine Benefits

Fuller and her team of investigators have been studying both mRNA and DNA vaccines for years and have been working with vaccine manufacturers to develop the next generation of immunizations.

She points out that the current crop of mRNA vaccines can produce antibodies that recognize a broader range of influenza viruses and also train certain white blood cells to provide another layer of immune protection.

Additionally, the advent of mRNA vaccines allows public health officials to determine much later which strains of flu are going to affect the Northern Hemisphere during the Southern Hemisphere’s respiratory virus season.

“It’s roughly three to four months to be able to manufacture a new mRNA vaccine,” Fuller said. “And it’s roughly eight to nine months to manufacture a traditional vaccine.”

Addressing Vaccine Hesitancy

One of the consequences of the COVID pandemic was the development of hesitancy toward mRNA vaccines due to disinformation and misinformation. Fuller points out that people who have concerns around vaccines should be listened to and helped to understand how the technology works and why the vaccines are safe.

She helps dispel some of the myths that are out there.

“mRNA vaccines are not as new as they sound…we’ve been working on this for over 30 years, even before COVID came about. And since 2020, billions of doses of mRNA vaccines have been given worldwide and studied more closely than any other vaccine. We really have studied how this vaccine works in terms of both safety as well as efficacy. Second, it doesn’t change your DNA. This is something I hear all the time. You know, the mRNA vaccine never goes into the part of your body or your cell where DNA is located. It’s a very short-lived set of instructions. And the body breaks it down within hours or days,” Fuller said.

References
1. Leroux-Roels I, Huang G, Ferguson M, et al. Efficacy and Safety of an mRNA Seasonal Influenza Vaccine in Adults. N Engl J Med. 2026;394(18):1803-1813. doi:10.1056/NEJMoa2516491
2. How serious a problem is influenza in the United States? Immunize.org. Updated October 11, 2026. Accessed November 9, 2026. https://www.immunize.org/ask-experts/how-serious-a-problem-is-influenza-in-the-u-s/