Know What’s New for 2025-2026 Flu Immunizations

You’ll hear lots of questions about flu vaccines for 2025-2026...as confusion and misinformation abound.

An annual influenza vaccine is still recommended for everyone 6 months and older.

And all flu vaccines will be trivalent again...with 1 updated A (H3N2) strain plus the same A (H1N1) and B/Victoria strains as last year.

Now the new Advisory Committee on Immunization Practices recommends only single-dose flu vaccines without the preservative thimerosal.

But this is due to theoretical risks and concerns about cumulative exposure to thimerosal...NOT any new data.

And several large well-done studies show NO evidence of harm caused by the low amounts of thimerosal in vaccine multidose vials (MDVs).

Look for most flu vaccines to be single-dose and thimerosal-free.

But don’t expect your pharmacist to recommend delaying vaccination if an MDV is what’s in stock. The benefits of vaccination (preventing flu complications, etc) far outweigh any theoretical risks with thimerosal.

This aligns with evidence-based recommendations from the Am Academy of Pediatrics and other medical organizations...and most payers will still cover flu vaccine from an MDV. But follow your state law, protocol, etc.

In general, continue to focus on getting patients vaccinated with any licensed flu vaccine appropriate for their age and health status.

For patients 65 or older, dispense a higher-dose or adjuvanted flu vaccine...Fluzone High-Dose, Flublok, or Fluad...if available.

Keep in mind, a high-dose or adjuvanted flu vaccine is still an option for adults 18 to 64 who’ve received a solid organ transplant and are taking immunosuppressants (tacrolimus, etc).

Be aware of other changes. For instance, the egg-free recombinant vaccine Flublok can now be given to patients as young as 9 years.

And in some states, the live FluMist nasal spray for ages 2 to 49 will be available for SELF-administration by a patient or caregiver at home...by ordering and completing a questionnaire on the product website.

But point out that FluMist Home won’t be an option for those without insurance or on the Vaccines for Children Program this year. And patients must pay shipping...refrigerate it...and return the sprayer for disposal.

Dispense your FluMist stock as usual...NOT for home- or self-use.

Use our Flu Vaccines for 2025-26 chart to compare products. And get our resource, Communicating About Flu Vaccination, for answers to FAQs about immunizing patients who are pregnant, have an egg allergy, etc.

• Chart: Flu Vaccines for 2025-26 (United States)
  
• FAQ: Communicating About Flu Vaccination