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Seasonal Influenza Prevention & Control

2024-2025 Influenza Season

The influenza vaccine recommendations change every year. In addition to communicating these updates, AAFP recommends offering annual flu shots to patients 6 months and older who don't have contraindications for the immunization.

All flu vaccines for the 2024-2025 season will be trivalent vaccines, designed to protect against three different flu viruses, including two influenza A viruses and an influenza B/Victoria virus. Different vaccines are licensed for use in different age groups, and some vaccines are not recommended for some groups of people.

AAFP recommends that patients aged 65 years and older, with no preferentially recommendation for a specific vaccine when more than one licensed and recommended vaccine is available, receive any one of the following higher doses or adjuvanted influenza vaccines: trivalent high-dose inactivated influenza vaccine (HD-IIV3), trivalent recombinant influenza vaccine (RIV3), or trivalent adjuvanted inactivated influenza vaccine (aIIV3). If none of these three vaccines is available at an opportunity for vaccine administration, then any other age-appropriate influenza vaccine should be used.

To protect your patients from severe illness and health complications, promote the influenza vaccination as soon as it's available each year and provide the vaccine throughout the flu season (i.e., as long as influenza viruses are circulating in the community).

As flu season approaches, your patients may have questions about getting the flu, COVID-19, and RSV vaccines. The CDC offers updated guidance on co-administration of vaccines with other vaccines.

Influenza Vaccine Recommendations

Find clinical recommendations and resources on this season's influenza vaccine in Morbidity and Mortality Weekly Report.

Resources for 2024-25 Flu Season

CDC Resources

FAQS: What's New for 2024-2025 Season: A few things are different for the 2024-2025 influenza (flu) season.
Information on Influenza Virus Testing, Treatment: Updated testing information and algorithms for influenza during the COVID-19 pandemic.

Supporting Patient Flu Vaccine Conversations

These resources for family physicians were developed in partnership with Sanofi Pasteur Inc. to promote the importance of annual influenza vaccination.

The resources for family physicians listed below were developed in partnership with AstraZeneca to promote the importance of annual influenza vaccination.

Influenza Vaccine Updates

Routine annual influenza vaccination of all persons aged ≥6 months who do not have contraindications continues to be recommended. Primary updates to this report include the following two topics:

The composition of 2024-25 U.S. seasonal influenza vaccines
Updated recommendations regarding influenza vaccination of persons with egg allergy

The composition of 2024-25 U.S. influenza vaccines includes an update to the influenza A(H3N2) component. U.S.-licensed influenza vaccines will contain hemagglutinin (HA) derived from 1) an influenza A/Victoria/4897/2022 (H1N1)pdm09-like virus (for egg-based vaccines) or an influenza A/Wisconsin/67/2022 (H1N1)pdm09-like virus (for cell culture-based and recombinant vaccines, 2) an influenza A/Thailand/8/2022 (H3N2)-like virus (for egg-based vaccines) or an influenza A/Massachusetts/18/2022 (H3N2)-like virus (for cell culture-based and recombinant vaccines), and 3) an influenza B/Austria/1359417/2021 (Victoria lineage)-like virus (for egg-based, cell culture-based, and recombinant vaccines).
ACIP recommends that all persons aged ≥6 months with egg allergy should receive influenza vaccine. Any influenza vaccine (egg based or nonegg based) that is otherwise appropriate for the recipient’s age and health status can be used. It is no longer recommended that persons who have had an allergic reaction to egg involving symptoms other than urticaria should be vaccinated in an inpatient or outpatient medical setting supervised by a health care provider who is able to recognize and manage severe allergic reactions if an egg-based vaccine is used. Egg allergy alone necessitates no additional safety measures for influenza vaccination beyond those recommended for any recipient of any vaccine, regardless of severity of previous reaction to egg. All vaccines should be administered in settings in which personnel and equipment needed for rapid recognition and treatment of acute hypersensitivity reactions are available.
On the basis of review of evidence concerning high-dose inactivated influenza vaccine (HD-IIV), recombinant influenza vaccine (RIV), and MF59-adjuvanted inactivated influenza vaccine (aIIV), recommendations for influenza vaccination of persons aged ≥65 years have been modified. ACIP recommends that adults aged ≥65 years preferentially receive any one of the following higher dose or adjuvanted influenza vaccines: high-dose inactivated influenza vaccine (HD-IIV3), recombinant influenza vaccine (RIV3), or adjuvanted inactivated influenza vaccine (aIIV3). If none of these three vaccines is available at an opportunity for vaccine administration, then any other age-appropriate influenza vaccine should be administered Higher dose vaccines include HD-IIV and RIV, both of which contain a higher dose of HA antigen per virus than standard-dose vaccines (60 µg for HD-IIV3 and 45 µg for RIV3, compared with 15 µg for standard-dose inactivated vaccines). The adjuvanted vaccine contains 15 μg of HA per virus, similarly to nonadjuvanted SD-IIVs, but contains the adjuvant MF59.

Influenza Vaccine Additional Recommendations

Populations at Higher Risk for Medical Complications Attributable to Severe Influenza

All persons aged ≥6 months who do not have contraindications should be vaccinated annually. However, vaccination to prevent influenza is particularly important for persons who are at increased risk for severe illness and complications from influenza and for influenza-related outpatient, emergency department, or hospital visits. When vaccine supply is limited, vaccination efforts should focus on vaccination of persons at higher risk for medical complications attributable to severe influenza who do not have contraindications. These persons include the following (no hierarchy is implied by order of listing):

All children aged 6 through 59 months.
All persons aged ≥50 years.
Adults and children who have chronic pulmonary (including asthma), cardiovascular (excluding isolated hypertension), renal, hepatic, neurologic, hematologic, or metabolic disorders (including diabetes mellitus).
Persons who are immunocompromised due to any cause (including but not limited to immunosuppression caused by medications or HIV infection).
Persons who are or will be pregnant during the influenza season.
Children and adolescents (aged 6 months through 18 years) who are receiving aspirin- or salicylate-containing medications and who might be at risk for experiencing Reye syndrome after influenza virus infection.
Residents of nursing homes and other long-term care facilities.
American Indian or Alaska Native persons.
Persons who are extremely obese (body mass index ≥40 for adults).