New ACIP Supports Previous Universal Flu Vaccination

The CDC’s newly appointed Advisory Committee on Immunization Practices (ACIP) voted to recommend annual influenza vaccination for all persons aged 6 months or older with no contraindications. Of the seven members who participated in the vote, the vote was yes to recommend vaccination from six members, with one abstention.

The 2024-2025 flu season was classified as high severity across all age groups, said Vivien Dugan, MD, of the CDC’s Influenza Division. In children younger than 18 years, a total of 246 influenza-associated deaths from the 2024-2025 season have been reported as of June 7, 2025, she said.

Dugan also presented estimates of the disease burden of influenza and the alleviation of this burden via vaccines. Data from multiple surveillance networks showed an overall vaccine coverage rate ranging from 38% to 56% for outpatient visits and 35% to 71% for inpatient visits, with variation by age group and flu type, she said.

“Estimated influenza disease burden was the highest the US has seen in the last decade,” she noted in her presentation. However, vaccination likely prevented approximately 240,000 influenza-related hospitalizations, mainly in adults aged 65 years or older, she said.

Flu Vaccination Options Increase

Options for influenza vaccination for the upcoming season include not only an injectable vaccine but also the needle-free FluMist nasal spray (live attenuated influenza vaccine, trivalent).

A recombinant flu vaccine (Flublok) contains no eggs and was recently approved for use in individuals aged 9 years or older by the FDA after an extensive review of safety and efficacy data. Some of these data were shared at the ACIP meeting.

Pedro Folegatti, MD, an employee of Flublok manufacturer Sanofi, presented data on the safety and effectiveness of the latest quadrivalent flu vaccine (RIV4) among individuals aged 9-17 years compared with those aged 18-49 years in a phase 3 study. The RIV4 showed similar safety and effectiveness in a younger age group, with noninferiority of hemagglutination inhibition immune response and a similar safety profile. A trivalent Flublok was approved by the FDA in March 2025 for individuals aged 9 years or older, according to an approval letter.

Discuss Different Delivery Systems With Patients

“As influenza vaccines are recommended for all individuals over 6 months of age, having multiple products available increases accessibility, particularly in the rare event that a child has a contraindication to other currently available flu vaccines,” said Lori Handy, MD, MSCE, associate director of the Vaccine Education Center at the Children’s Hospital of Philadelphia and assistant professor of clinical pediatrics at the Perelman School of Medicine at the University of Pennsylvania, Philadelphia, in an interview.

Having a supply of influenza vaccine that does not rely on eggs puts the US in a better position in the event of influenza pandemics or egg shortages, she noted. Although it is hard to predict whether parents have preferences for different manufacturing processes, the expanded Flublok indication may improve vaccination rates, Handy said.

Vaccine Components Similar to Last Year

Dugan also presented the influenza vaccine composition for the 2025-2026 season, which includes:

● A/Victoria/4897/2022 (H1N1) pdm09-like virus for egg-based vaccines or an A/Wisconsin/67/2022 (H1N1) pdm09-like virus for cell and recombinant vaccines

● A/Croatia/Y10136RV/2023 (H3N2)-like virus for egg-based vaccines or an A/District of Columbia/27/2023 (H3N2)-like virus for cell and recombinant vaccines

● B/Austria/1359417/2021 (B/Victoria lineage)-like virus

The next ACIP meeting is tentatively scheduled for the third quarter of 2025. 

The study on Flublok was sponsored by manufacturer Sanofi, and Folegatti is employed by Sanofi.

Handy had no financial conflicts to disclose.