Flu Vaccines for 2025-26 (United States)<br class="t-last-br" />

Flu Vaccines for 2025-26 (United States)

For the 2025-26 influenza season, US influenza vaccines are all trivalent (two influenza A-like viruses and one influenza B-type virus).¹ Current ACIP recommendation is for single-dose, thimerosal-free preparations only.² The American Academy of Pediatrics (AAP) and WHO both continue to support the use of multi-dose vials of influenza vaccine containing thimerosal as a preservative.¹⁰ This chart reviews approved influenza vaccines for the 2025-26 season. It includes approved ages for use, route of administration, dose, cost, and egg and thimerosal content. For information about efficacy, administration with other vaccines, use in patients who are immunocompromised or pregnant, and more, see our resource, Communicating About Flu Vaccination.

--None of the available flu vaccines for 2025-26 contain latex. Information in table is from product labeling, unless otherwise noted^a--

Brand Name Manufacturer	Route	Approved Ages for Use	Availability (Cost/dose^b)	Contains Thimerosal?^c	Dose	Comments
Trivalent inactivated influenza vaccine (IIV3)
Afluria Seqirus	IM	≥6 months *Administering Afluria with the PharmaJet Stratis needle-free injector is only approved for ages 18 to 64 years.	0.5 mL PFS (~$22) 5 mL MDV (~$20)	No (PFS) Yes (MDV)	6 to 35 months: 0.25 mL ≥36 months: 0.5 mL	May contain trace amounts of neomycin and polymyxin B.
Fluad Seqirus	IM	≥65 years	0.5 mL PFS (~$79)	No	≥65 years: 0.5 mL	A preferred optionfor ≥65 years old.³ This adjuvanted vaccine may be abbreviated aIIV3.⁵ May contain trace amounts of neomycin and kanamycin. Per ACIP, adjuvanted influenza vaccines arean option for solid organ transplant recipients ages 18 to 64 years who are taking immunosuppressants.⁸
Fluarix GSK	IM	≥6 months	0.5 mL PFS (~$20)	No	0.5 mL	May contain trace amounts of gentamicin.
Flucelvax Seqirus	IM	≥6 months	0.5 mL PFS (~$43) 5 mL MDV (~$43)	No (PFS) Yes (MDV)	0.5 mL	This cell-cultured vaccine may be abbreviated ccIIV3.⁵ Egg-free
FluLaval GSK	IM	≥6 months	0.5 mL PFS (~$20)	No	0.5 mL	None
Fluzone Sanofi Pasteur	IM	≥6 months	0.5 mL PFS (~$20) 5 mL MDV (~$20)	No (PFS) Yes (MDV)	6 to 35 months: 0.25 mL or 0.5 mL ≥36 months: 0.5 mL	None
Fluzone High-Dose Sanofi Pasteur	IM	≥65 years	0.5 mL PFS (~$79)	No	0.5 mL	A preferred option for ≥65 years old.³ Per ACIP, high-dose influenza vaccines are an option for solid organ transplant recipients ages 18 to 64 years who are taking immunosuppressants.⁸ Contains 60 mcg of each virus strain compared to 15 mcg in standard-dose IM vaccines.⁶ Fluzone High-Dose has a higher risk of adverse effects (injection site reactions, myalgia, headache) compared to Fluzone. This high-dose vaccine may be abbreviated HD-IIV3.⁵
Trivalent recombinant influenza vaccine (RIV3)
Flublok Sanofi Pasteur	IM	≥9 years	0.5 mL PFS (~$79)	No	0.5 mL	A preferred option for ≥65 years old.³ Egg-free Contains 45 mcg of each virus strain compared to 15 mcg in standard-dose IM vaccines.⁶
Trivalent live-attenuated influenza vaccine (LAIV3)
FluMist Intransal Spray MedImmune (an AstraZeneca company)	Intranasal	2 to 49 years	0.2 mL prefilled intranasal sprayer (~$26)	No	0.1 mL per nostril	Not recommended for patients who are pregnant, immunocompromised, or with certain medical conditions.⁷ See our resource, Communicating About Flu Vaccination, for more on who should NOT receive live intranasal flu vaccine. Has not been studied in patients with severe asthma or active wheezing. May contain trace amounts of gentamicin. FluMist is also available for at-home administration in some states through an online pharmacy.⁹

Information is from product labeling, unless otherwise noted: Afluria (June 2025); Fluad (July 2025); Fluarix (July 2025); Flucelvax (July 2025); FluLaval (July 2025); Fluzone (July 2025); Fluzone High-Dose Northern Hemisphere (July 2025); Flublok Trivalent (July 2025); FluMist (July 2025).
Pricing based on one dose at wholesale acquisition cost (WAC). Medication pricing by Elsevier, accessed August 2025.
For more information on the safety of thimerosal, see the Children’s Hospital of Philadelphia (https://www.chop.edu/vaccine-education-center/vaccine-safety/vaccine-ingredients/thimerosal) and immunize.org (https://www.immunize.org/ask-experts/does-the-thimerosal-in-some-vaccines-pose-a-risk/).

Abbreviations: ACIP = Advisory Committee on Immunization Practices; GSK = GlaxoSmithKline; IM = intramuscular; MDV = multidose vial; PFS = pre-filled syringe; SDV = single-dose vial.

References

American Academy of Pediatrics Committee on Infectious Diseases. Recommendations for Prevention and Control of Influenza in Children, 2025–2026: Policy Statement. Pediatrics. 2025; doi: 10.1542/peds.2025-073620.
CDC. ACIP recommendations. July 28, 2025. https://www.cdc.gov/acip/vaccine-recommendations/index.html. (Accessed August 5, 2025).
CDC. Influenza (Flu). Who needs a flu vaccine. October 3, 2024. https://www.cdc.gov/flu/vaccines/vaccinations.html#:~:text=For%20people%20younger%20than%2065,Fluad%20adjuvanted%20inactivated%20flu%20vaccine. (Accessed August 5, 2025).
Goldberg R. Influenza vaccines in older adults: aIIV3 more effective than HD-IIV3e and IIV4e. June 5, 2024. https://www.pulmonologyadvisor.com/news/influenza-vaccines-in-adults-65-aiiv3-vs-hd-iiv3e-vs-iiv4e/. (Accessed August 5, 2025).
CDC. Vaccine abbreviations. July 29, 2025. https://www.cdc.gov/vaccines/hcp/vaccines-us/abbreviations.html?CDC_AAref_Val=https://www.cdc.gov/vaccines/terms/vacc-abbrev.html. (Accessed August 5, 2025).
DiazGranados CA, Dunning AJ, Kimmel M, et al.Efficacy of high-dose versus standard-dose influenza vaccine in older adults. N Engl J Med. 2014 Aug 14;371(7):635-45.
CDC. Influenza (flu). Key facts about seasonal flu vaccine. September 17, 2024. https://www.cdc.gov/flu/prevent/keyfacts.htm. (Accessed August 5, 2025).
CDC. CDC updates vaccine recommendations. July 12, 2024. https://www.cdc.gov/ncird/whats-new/cdc-updates-vaccine-recommendations-july-2024.html. (Accessed August 5, 2025).
AstraZenaca. FluMist – protection without the injection. https://www.flumisthcp.com/content/dam/physician-services/us/567-flumistquadrivalent-hcp/US-100878-(Populated%20version)-FINAL-6-26-25-Digital.pdf. (Accessed August 8, 2025).
American Academy of Pediatrics. AAP releases 2025-26 flu vaccine recommendations; efforts to increase vaccination ‘urgently needed’. July 28, 2025. https://publications.aap.org/aapnews/news/32712/AAP-releases-2025-26-flu-vaccine-recommendations?autologincheck=redirected. (Accessed August 8, 2025).

Cite this document as follows: Clinical Resource, Flu Vaccines for 2024-25 (United States). Pharmacist’s Letter/Pharmacy Technician’s Letter/Prescriber Insights. September 2025. [410961]

Flu Vaccines for 2025-26 (United States)

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