What influenza vaccines may be used in adults for the 2024-25 season?

All nine 2024-25 influenza vaccines approved for adults are trivalent, containing two influenza A strains and one influenza B strain.

There are five injectable inactivated influenza vaccine (IIV) options approved for use in all adults age 18 years or older. Four egg-based standard dose IIV vaccines (SD-IIVs) and one cell culture-based one (ccIIV) are available, all given as an intramuscular (IM) injection:

• Afluria (CSL Seqirus): 0.5 mL/dose
• Fluarix (GSK): 0.5 mL/dose
• FluLaval (GSK): 0.5 mL/dose
• Fluzone (Sanofi): 0.5 mL/dose
• Flucelvax (ccIIV, CSL Seqirus) cell culture-based (no egg antigen): 0.5 mL/dose

One egg-based live attenuated nasal spray vaccine, FluMist (LAIV, AstraZeneca), is an option for healthy, non-pregnant adults through age 49 years: 0.2 mL (given intranasally, 0.1 mL in each nostril).

Three injectable vaccines, all given IM, are ACIP-preferred options for adults age 65 years or older:

• Recombinant influenza vaccine, Flublok (RIV, Sanofi): 0.5 mL/dose, licensed for use in adults age 18 or older
• Fluzone High-Dose (egg-based HD-IIV, Sanofi): 0.5 mL/dose, licensed for adults age 65 years and older
• Fluad (egg-based aIIV with MF59 adjuvant, CSL Seqirus): 0.5 mL/dose, licensed for adults age 65 years and older

Although licensed by FDA for use in adults age 65 years or older, ACIP also recommends off-label use of Fluzone HD or Fluad as acceptable options for influenza vaccination of solid organ transplant recipients age 18 through 64 years who are on immunosuppressive medication regimens, without a preference over other age-appropriate IIVs or RIV.