Vaccine Guideline

CDC Issues Interim Influenza Vaccine Guidance for 2026–2027

Edited by:
Anthony Calabro, MA

Key Highlights

  • The seasonal influenza vaccination recommendations in the July 2025 immunization schedule remain in effect for the 2026–2027 season.
  • Most people who require 1 dose should be vaccinated during September or October, although vaccination should continue throughout the influenza season.
  • Adults aged ≥65 years should preferentially receive high-dose inactivated, recombinant, or adjuvanted inactivated influenza vaccine.
  • People with egg allergy may receive any age- and health-appropriate influenza vaccine without additional safety measures beyond those recommended for all vaccine recipients.

The CDC has issued interim clinical considerations for seasonal influenza vaccination during the 2026–2027 season. Because of legal uncertainties and related inquiries, the agency stated that the seasonal influenza vaccination recommendations included in the July 2025 immunization schedule remain in effect.¹

Seasonal influenza vaccines available in the United States are trivalent and contain influenza A(H1N1)pdm09, influenza A(H3N2), and influenza B/Victoria components. Available vaccine types include inactivated influenza vaccine, trivalent (IIV3); recombinant influenza vaccine, trivalent (RIV3); and live attenuated influenza vaccine, trivalent (LAIV3).

Vaccine Selection

People should receive an FDA-licensed influenza vaccine appropriate for their age and health status. No vaccine is preferred when multiple licensed and recommended products are available, with 2 principal exceptions:

  • Adults aged ≥65 years should preferentially receive high-dose IIV3, RIV3, or adjuvanted IIV3. If none of these products is available when vaccination is offered, clinicians should administer any other age-appropriate influenza vaccine.
  • Solid organ transplant recipients aged 18 through 64 years who are receiving immunosuppressive medication regimens may receive high-dose or adjuvanted IIV3. These products are acceptable options but are not preferred over other age-appropriate IIV3 or RIV3 formulations.

Timing and Dosing

For most people who require 1 dose, vaccination should ideally occur during September or October. Vaccination during July or August is generally not recommended for most adults, particularly those aged ≥65 years, because vaccine-induced immunity may decline over the course of the influenza season.

Earlier vaccination may be considered for children and people who might not have another opportunity to be vaccinated. Vaccination during July or August also may be considered for women who are in their third trimester during those months because maternal vaccination may help protect infants during their first months of life.

Vaccination should preferably be completed by the end of October but should continue after October and throughout the influenza season while influenza viruses are circulating and unexpired vaccine remains available. People who have been fully vaccinated for the season should not receive an additional or booster dose, regardless of when they received the seasonal vaccine.

People aged ≥9 years should receive 1 dose. Children aged 6 months through 8 years who have not previously received ≥2 influenza vaccine doses administered ≥4 weeks apart before July 1 preceding the influenza season—or whose vaccination history is unknown—require 2 doses separated by ≥4 weeks. These children should receive their first dose as soon as possible so the second dose can ideally be administered by the end of October.

Considerations for Specific Populations

Pregnant women should receive IIV3 or RIV3 and may be vaccinated during any trimester. LAIV3 should not be administered during pregnancy but may be used postpartum.

Immunocompromised patients should receive IIV3 or RIV3 rather than LAIV3. Immune responses may be reduced in people with certain immunodeficiencies or those receiving cancer chemotherapy, posttransplant regimens, or immunosuppressive medications. The timing of vaccination in relation to an immunocompromising intervention may warrant consideration.

People aged ≥6 months with egg allergy may receive any influenza vaccine, including an egg-based vaccine, that is otherwise appropriate for their age and health status. Egg allergy alone does not require additional safety measures beyond those recommended for any vaccine recipient.

A history of Guillain-Barré syndrome within 6 weeks after a previous influenza vaccination is considered a precaution for all influenza vaccines. People who are not at increased risk for severe influenza complications and experienced Guillain-Barré syndrome within this period typically should not be vaccinated. For patients at increased risk for severe influenza complications, however, the potential benefits of vaccination may outweigh the risks. Influenza antiviral chemoprophylaxis may be considered as an alternative.

Live Attenuated Vaccine Considerations

LAIV3 is approved for people aged 2 through 49 years but should not be used in several populations. These include pregnant or immunocompromised patients; children aged 2 through 4 years with asthma or wheezing during the preceding 12 months; children and adolescents receiving aspirin- or salicylate-containing medications; and close contacts or caregivers of severely immunocompromised people who require a protected environment.

FluMist is approved for self-administration by eligible adults aged 18 through 49 years or administration by a caregiver aged ≥18 years to eligible children and adolescents aged 2 through 17 years. The same recommendations, contraindications, and precautions apply whether the vaccine is administered at home or by a health care professional.

Influenza antiviral medications may interfere with LAIV3. Potential interference periods extend from 48 hours before through 2 weeks after vaccination for oseltamivir and zanamivir, 5 days before through 2 weeks after vaccination for peramivir, and 17 days before through 2 weeks after vaccination for baloxavir. Patients who receive an antiviral during the applicable interval should be revaccinated with an age-appropriate IIV3 or RIV3.

Coadministration With Other Vaccines

IIV3 and RIV3 may be administered simultaneously or sequentially with other inactivated or live vaccines. Injectable vaccines administered during the same visit should be given at separate anatomic sites. Vaccines more likely to cause local injection-site reactions should be administered in different limbs when possible.

LAIV3 may be administered simultaneously with another live or inactivated vaccine. If LAIV3 and another live vaccine are not administered on the same day, clinicians should allow an interval of ≥4 weeks between them. Influenza vaccination should not be delayed solely because a particular vaccine formulation is unavailable.

Reference

  1. Centers for Disease Control and Prevention. Interim clinical considerations for the use of seasonal influenza vaccines in the United States. Updated September 1, 2026. Accessed September 14, 2026. https://www.cdc.gov/flu/hcp/vax-summary/seasonal-influenza-vaccines.html