The Medical Letter on Drugs and Therapeutics
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ISSUE 1738
ISSUE 1738
September 29, 2025
Issue 1738
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Influenza Vaccines for 2025-2026
September 29, 2025 (Issue: 1738)
Annual vaccination against influenza A and B viruses
is recommended in the US for everyone ≥6 months
old without a contraindication. Influenza vaccines
available in the US for the 2025-2026 season are listed
in Table 2.
- LA Grohskopf et al. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices – United States, 2025-2026 influenza season. MMWR Recomm Rep 2025; 74:500. doi:10.15585/mmwr.mm7432a2
- Committee on Infectious Diseases. Recommendations for prevention and control of influenza in children, 2025-2026: policy statement. Pediatrics 2025 July 28 (epub). doi:10.1542/peds.2025-073620
- AS Monto et al. The end of B/Yamagata influenza transmission – transitioning from quadrivalent vaccines. N Engl J Med 2024; 390:1256. doi:10.1056/nejmp2314801
- YR Bhat. Influenza B infections in children: a review. World J Clin Pediatr 2020; 9:44. doi:10.5409/wjcp.v9.i3.44
- JM Ferdinands et al. Waning vaccine effectiveness against influenza-associated hospitalizations among adults, 2015-2016 to 2018-2019, United States Hospitalized Adult Influenza Vaccine Effectiveness Network. Clin Infect Dis 2021; 73:726. doi:10.1093/cid/ciab045
- C Arriola et al. Influenza vaccination modifies disease severity among community-dwelling adults hospitalized with influenza. Clin Infect Dis 2017; 65:1289. doi:10.1093/cid/cix468
- B Flannery et al. Influenza vaccine effectiveness against pediatric deaths: 2010-2014. Pediatrics 2017; 139:e20164244. doi:10.1542/peds.2016-4244
- AP Campbell et al. Effect of vaccination on preventing influenza-associated hospitalizations among children during a severe season associated with B/Victoria viruses, 2019-2020. Clin Infect Dis 2021; 73:e947. doi:10.1093/cid/ciab060
- S Garg et al. Influenza vaccination reduces risk of severe outcomes among adults hospitalized with influenza A(H1N1) pdm09, FluSurv-NET, 2013–2018. Open Forum Infect Dis 2019; 6(Suppl 2):S26. doi:10.1093/ofid/ofz359.057
- SM Olson et al. Vaccine effectiveness against life-threatening influenza illness in US children. Clin Infect Dis 2022; 75:230. doi:10.1093/cid/ciab931
- M Darvishian et al. Effectiveness of seasonal influenza vaccine in community-dwelling elderly people: a meta-analysis of test-negative design case-control studies. Lancet Infect Dis 2014; 14:1228. doi:10.1016/s1473-3099(14)70960-0
- NM Lewis et al. Vaccine effectiveness against influenza A-associated hospitalization, organ failure, and death: United States, 2022-2023. Clin Infect Dis 2024; 78:1056. doi:10.1093/cid/ciad677
- LC Sahni et al. Sustained within-season vaccine effectiveness against influenza-associated hospitalization in children: evidence from the New Vaccine Surveillance Network, 2015-2016 through 2019-2020. Clin Infect Dis 2023; 76:e1031. doi:10.1093/cid/ciac577
- AM Frutos et al. Interim estimates of 2024-2025 seasonal influenza vaccine effectiveness – four vaccine effectiveness networks, United States, October 2024-February 2025. MMWR Morb Mortal Wkly Rep 2025; 74:83. doi:10.15585/mmwr. mm7406a2
- A Hsiao et al. Recombinant or standard-dose influenza vaccine in adults under 65 years of age. N Engl J Med 2023; 389:2245. doi:10.1056/nejmoa2302099
- B Young et al. Do antibody responses to the influenza vaccine persist year-round in the elderly? A systematic review and meta-analysis. Vaccine 2017; 35:212. doi:10.1016/j.vaccine.2016.11.013
- Y Pang et al. Effectiveness of influenza vaccination on in-hospital death and recurrent hospitalization in older adults with cardiovascular diseases. Int J Infect Dis 2022; 122:162. doi:10.1016/j.ijid.2022.05.059
- Z-Y Peng et al. Reduced risks of influenza-associated hospitalization and complications following vaccination among over 2 million older individuals: a nationwide study using target trial emulation framework. BMC Med 2025; 23:157. doi:10.1186/s12916-025-03955-w
- CA DiazGranados et al. Efficacy of high-dose versus standard-dose influenza vaccine in older adults. N Engl J Med 2014; 371:635. doi:10.1056/nejmoa1315727
- S Gravenstein et al. Comparative effectiveness of high-dose versus standard-dose influenza vaccination on numbers of US nursing home residents admitted to hospital: a cluster-randomised trial. Lancet Respir Med 2017; 5:738. doi:10.1016/s2213-2600(17)30235-7
- DK Shay et al. Comparative effectiveness of high-dose versus standard-dose influenza vaccines among US Medicare beneficiaries in preventing postinfluenza deaths during 2012-2013 and 2013-2014. J Infect Dis 2017; 215:510. doi:10.1093/infdis/jiw641
- KG Skaarup et al. The relative vaccine effectiveness of high-dose vs standard-dose influenza vaccines in preventing hospitalization and mortality: a meta-analysis of evidence from randomized trials. J Infect 2024; 89:106187. doi:10.1016/j.jinf.2024.106187
- JKH Lee et al. Efficacy and effectiveness of high-dose influenza vaccine in older adults by circulating strain and antigenic match: an updated systematic review and meta-analysis. Vaccine 2021; 39(Suppl 1):A24. doi:10.1016/j.vaccine.2020.09.004
- Y Young-Xu et al. High-dose influenza vaccination and mortality among predominantly male, white, senior veterans, United States, 2012/13 to 2014/15. Euro Surveill 2020; 25:1900401. doi:10.2807/1560-7917.es.2020.25.19.1900401
- ND Johansen et al. A pragmatic randomized feasibility trial of influenza vaccines. NEJM Evid 2023; 2:EVIDoa2200206. doi:10.1056/evidoa2200206
- J Pardo-Seco et al. High-dose influenza vaccine to reduce hospitalizations. N Engl J Med 2025 August 30 (epub). doi:10.1056/nejmoa2509834
- ND Johansen et al. High-dose influenza vaccine effectiveness against hospitalization in older adults. N Engl J Med 2025 August 30 (epub). doi:10.1056/nejmoa2509907
- ND Johansen et al. High-dose vs standard-dose influenza vaccine and cardiovascular outcomes in older adults: a prespecified secondary analysis of the DANFLU-2 randomized clinical trial. JAMA Cardiol 2025 August 30 (epub). doi:10.1001/jamacardio.2025.3460
- O Vardeny et al. Effect of high-dose trivalent vs standard-dose quadrivalent influenza vaccine on mortality or cardiopulmonary hospitalization in patients with high-risk cardiovascular disease: a randomized clinical trial. JAMA 2021; 325:39. doi:10.1001/jama.2020.23649
- A Peikert et al. Influenza vaccine immune response in patients with high-risk cardiovascular disease: a secondary analysis of the INVESTED randomized clinical trial. JAMA Cardiol 2024; 9:574. doi:10.1001/jamacardio.2024.0468
- SE Frey et al. Comparison of the safety and immunogenicity of an MF59-adjuvanted with a non-adjuvanted seasonal influenza vaccine in elderly subjects. Vaccine 2014; 32:5027. doi:10.1016/j.vaccine.2014.07.013
- PG Van Buynder et al. The comparative effectiveness of adjuvanted and unadjuvanted trivalent inactivated influenza vaccine (TIV) in the elderly. Vaccine 2013; 31:6122. doi:10.1016/j.vaccine.2013.07.059
- F Lapi et al. Adjuvanted versus nonadjuvanted influenza vaccines and risk of hospitalizations for pneumonia and cerebro/cardiovascular events in the elderly. Expert Rev Vaccines 2019; 18:663. doi:10.1080/14760584.2019.1622418
- KW McConeghy et al. Cluster-randomized trial of adjuvanted versus nonadjuvanted trivalent influenza vaccine in 823 US nursing homes. Clin Infect Dis 2021; 73:e4237. doi:10.1093/cid/ciaa1233
- HS Izurieta et al. Comparative effectiveness of influenza vaccines among US Medicare beneficiaries ages 65 years and older during the 2019-2020 season. Clin Infect Dis 2021; 73:e4251. doi:10.1093/cid/ciaa1727
- JH Ku et al. Comparative effectiveness of licensed influenza vaccines in preventing influenza-related medical encounters and hospitalizations in the 2022-2023 influenza season among adults ≥65 years of age. Clin Infect Dis 2024; 79:1283. doi:10.1093/cid/ciae375
- LC Sahni et al. Maternal vaccine effectiveness against influenza-associated hospitalizations and emergency department visits in infants. JAMA Pediatr 2024; 178:176. doi:10.1001/jamapediatrics.2023.5639
- A Mehrabadi et al. Association of maternal influenza vaccination during pregnancy with early childhood health outcomes. JAMA 2021; 325:2285. doi:10.1001/jama.2021.6778
- AK Regan et al. Risk of miscarriage in relation to seasonal influenza vaccination before or during pregnancy. Obstet Gynecol 2023; 142:625. doi:10.1097/aog.0000000000005279
- CDC. Influenza vaccine safety considerations during pregnancy or while breastfeeding. January 16, 2025. Available at: https://bit.ly/46b12Am. Accessed September 11, 2025.
- ACOG. Influenza in pregnancy: prevention and treatment. ACOG Committee Statement No. 7. Obstet Gynecol 2024; 143:e24. doi:10.1097/aog.0000000000005479
- M Greenhawt et al. Administration of influenza vaccines to egg allergic recipients: a practice parameter update 2017. Ann Allergy Asthma Immunol 2018; 120:49. doi:10.1016/j.anai.2017.10.020
- American Academy of Allergy Asthma & Immunology. Egg allergy and the flu vaccine. August 13, 2025. Available at: https://bit.ly/3JS9v45. Accessed September 11, 2025.
- Y Natori et al. A double-blind, randomized trial of high-dose vs standard-dose influenza vaccine in adult solid-organ transplant recipients. Clin Infect Dis 2018; 66:1698. doi:10.1093/cid/cix1082
- AG L’huillier et al. Cell-mediated immune responses after influenza vaccination of solid organ transplant recipients: secondary outcomes analyses of a randomized controlled trial. J Infect Dis 2020; 221:53. doi:10.1093/infdis/jiz471
- M Melgar et al. Use of respiratory syncytial virus vaccines in older adults: recommendations of the Advisory Committee on Immunization Practices – United States, 2023. MMWR Morb Mortal Wkly Rep 2023; 72:793. doi:10.15585/mmwr.mm7229a4
- A Babazadeh et al. Influenza vaccination and Guillain-Barré syndrome: reality or fear. J Transl Int Med 2019; 7:137. doi:10.2478/jtim-2019-0028
- AL Hulsizer et al. Hyperglycemia post-influenza vaccine in patients with diabetes. Ann Pharmacother 2023; 57:51. doi:10.1177/10600280221098101
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