# Frailty and Influenza Vaccination Among Older Adults

> **NIH VA IK2** · VA GREATER LOS ANGELES HEALTHCARE SYSTEM · 2024 · —

## Abstract

Respiratory infections and pneumonia account for approximately 5% of deaths in the United
States since 1999 and are a major burden on older adults. Vaccination against influenza has
been the cornerstone of mitigating this burden. Older adults are a particularly important target
for vaccination, with specific CDC recommendations for vaccination against S. pneumoniae and
for preferential use of enhanced influenza vaccines. However, older adults have wide variation
in health and functional status, which may reflect underlying physiologic aging in particular and
immunosenescence in particular. Measures of frailty are useful clinical tools for assessing
physiologic aging in older adults, and evidence of differential influenza vaccine effectiveness by
frailty is limited. Assessing whether frailty is associated with reduced effectiveness of influenza
vaccination among older adults has important implications for vaccination strategies. Revealing
the links among frailty, immunosenescence, and vaccine responses will improve approaches to
developing vaccines for those at the greatest risk of adverse outcomes if infected. Aim 1 will
assess whether frailty, assessed electronically by the VA Frailty Index (VA-FI), is an effect
modifier of influenza vaccine effectiveness among community-dwelling Veterans. Aim 2 will
assess whether frailty is associated with poor outcomes among vaccinated Veterans in
Community Living Centers (CLCs) and whether influenza infection is a mediator of such an
association. Aim 3 will develop a pilot cohort to study the links among frailty, markers of
immunosenescence, and outcomes following vaccination, identifying the physiologic pathways
that affect vaccine responses among older adults. The first two Aims will establish the role of
frailty in vaccine-related outcomes among older Veterans to inform VA vaccination policies,
while the third Aim will provide the basis for a fully-powered study to find the biology of
immunosenesence that links frailty and vaccine outcomes in humans. In addition, the career
development and mentoring programs outlined in this award will accelerate Dr. Seligman’s path
toward becoming an independent investigator at the intersection of geriatric medicine and
infectious diseases.

## Key facts

- **NIH application ID:** 10700514
- **Project number:** 1IK2CX002648-01
- **Recipient organization:** VA GREATER LOS ANGELES HEALTHCARE SYSTEM
- **Principal Investigator:** Benjamin Joseph Seligman
- **Activity code:** IK2 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2024
- **Award amount:** —
- **Award type:** 1
- **Project period:** 2024-01-01 → 2028-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10700514

## Citation

> US National Institutes of Health, RePORTER application 10700514, Frailty and Influenza Vaccination Among Older Adults (1IK2CX002648-01). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10700514. Licensed CC0.

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