Key Facts About Seasonal Flu Vaccine
On June 30, 2022, CDC announced that Director Rochelle P. Walensky adopted the Decision memo approving the ACIP vote for a preferential recommendation for the use of higher dose (including high dose and recombinant) or adjuvanted flu vaccines over standard-dose unadjuvanted flu vaccines for adults 65 years and older. CDC’s full recommendations for the use of flu vaccines during 2022-2023 will appear in a forthcoming Morbidity and Mortality Weekly Report. Edits to this page are also forthcoming. More information can be found online: CDC Director Adopts Preference for Specific Flu Vaccines for Seniors
Why should people get vaccinated against flu?
Influenza (flu) is a potentially serious disease that can lead to hospitalization and sometimes even death. Every flu season is different, and flu can affect people differently, but millions of people get flu every year, hundreds of thousands of people are hospitalized and thousands to tens of thousands of people die from flu-related causes every year. Flu can mean a few days of feeling bad and missing work or it can result in more serious illness. Complications of flu can include bacterial pneumonia, ear infections, sinus infections and worsening of chronic medical conditions, such as congestive heart failure, asthma, or diabetes. An annual seasonal flu vaccine is the best way to help protect against flu. Vaccination has been shown to have many benefits including reducing the risk of flu illnesses, hospitalizations and even the risk of flu-related death in children. While some people who get a flu vaccine may still get sick, flu vaccination has been shown in several studies to reduce severity of illness.
How do flu vaccines work?
Flu vaccines cause antibodies to develop in the body about two weeks after vaccination. These antibodies provide protection against infection with circulating influenza viruses.
Seasonal flu vaccines are designed to protect against the influenza viruses that research indicates will be most common during the upcoming season. All flu vaccines in the United States are “quadrivalent” vaccines, which means they protect against four different flu viruses: an influenza A(H1N1) virus, an influenza A(H3N2) virus, and two influenza B viruses.
CDC recommends use of any licensed, age-appropriate influenza vaccine during the 2021-2022 influenza season. Available influenza vaccines include quadrivalent inactivated influenza vaccine [IIV4], recombinant influenza vaccine [RIV4], or live attenuated influenza vaccine (LAIV4). No preference is expressed for any influenza vaccine over another.
Quadrivalent flu vaccines include:
- Standard-dose quadrivalent influenza shots that are manufactured using virus grown in eggs. These include Afluria Quadrivalent, Fluarix Quadrivalent, FluLaval Quadrivalent, and Fluzone Quadrivalent. Different influenza shots are licensed for different age groups. These four vaccines are approved for people 6 months of age and older. Most influenza shots are given in an arm muscle with a needle. One quadrivalent influenza shot (Afluria Quadrivalent) can be given either with a needle (for people aged 6 months and older) or with a jet injector (for people aged 18 through 64 years only).
- A quadrivalent cell-based influenza shot (Flucelvax Quadrivalent) containing virus grown in cell culture, which is licensed for people 6 months and older. This vaccine is egg-free.
- Recombinant quadrivalent influenza shot (Flublok Quadrivalent), an egg-free vaccine, approved for people 18 years and older.
- A quadrivalent flu shot using an adjuvant (an ingredient that helps create a stronger immune response), Fluad Quadrivalent, approved for people 65 years of age and older.
- A quadrivalent high-dose influenza vaccine Fluzone High-Dose, which contains a higher dose of antigen to help create a stronger immune response, licensed for people 65 years and older.
- A live attenuated influenza vaccine (FluMist Quadrivalent), which is given intranasally. This vaccine is approved for people 2 through 49 years of age. Live attenuated influenza vaccine should not be given to people who are pregnant, immunocompromised persons, and some other groups.
- There are many flu vaccine options to choose from, but the most important thing is for all people 6 months and older to get a flu vaccine every year. If you have questions about which vaccine is best for you, talk to your doctor or other health care professional. More information on approved flu vaccines for the 2021-2022 flu season, and age indications for each vaccine are available in CDC’s Table: U.S. Influenza Vaccine Products for the 2021-2022 Season.
Are any of the available flu vaccines recommended over others?
For the 2021-2022 flu season, the Advisory Committee on Immunization Practices (ACIP) recommends annual influenza (flu) vaccination for everyone 6 months and older with any licensed, influenza vaccine that is appropriate for the recipient’s age and health status, including inactivated influenza vaccine (IIV4), recombinant influenza vaccine (RIV4), or live attenuated nasal spray influenza vaccine (LAIV4) with no preference expressed for any one vaccine over another.
There are many vaccine options to choose from, but the most important thing is for all people 6 months and older to get a flu vaccine every year. If you have questions about which vaccine is best for you, talk to your doctor or other health care professional.
Who Should Vaccinate?
Everyone 6 months of age and older should get an influenza (flu) vaccine every season with rare exception. CDC’s Advisory Committee on Immunization Practices has made this recommendation since the 2010-2011 influenza season.
Vaccination to prevent flu and its potentially serious complications is particularly important for people who are at higher risk of developing serious flu complications. See People at Higher Risk of Developing Flu-Related Complications for a full list of age and health factors that confer increased risk.
More information is available at Who Needs a Flu Vaccine.
Who Should Not Be Vaccinated?
Different influenza (flu) vaccines are approved for use in people in different age groups. In addition, some vaccines are not recommended for certain groups of people. Factors that can determine a person’s suitability for vaccination, or vaccination with a particular vaccine, include a person’s age, health (current and past) and any allergies to flu vaccine or its components. For more information, visit Who Should and Who Should NOT get a Flu Vaccine.
It’s best to be vaccinated before flu begins spreading in your community. September and October are generally good times to be vaccinated against flu. Ideally, everyone should be vaccinated by the end of October. However, even if you are not able to get vaccinated until November or later, vaccination is still recommended because flu most commonly peaks in February and significant activity can continue into May.
Additional considerations concerning the timing of vaccination for certain groups include:
- Adults, especially those 65 years and older, should generally not get vaccinated early (in July or August) because protection may decrease over time, but early vaccination can be considered for any person who is unable to return at a later time to be vaccinated.
- Children can get vaccinated as soon as vaccine becomes available, even if this is in July or August. Some children need two doses of flu vaccine. For those children it is recommended to get the first dose as soon as vaccine is available, because the second dose needs to be given at least 4 weeks after the first.
- Early vaccination can also be considered for people who are in the third trimester of pregnancy, because this can help protect their infants during the first months of life (when they are too young to be vaccinated).
Where can I get a flu vaccine?
Flu vaccines are offered in many doctor’s offices and clinics. Even if you don’t have a regular doctor or nurse, you can get a flu vaccine somewhere else like a health department, pharmacy, urgent care clinic, college health center, and even in some schools and workplaces.
Why do I need a flu vaccine every year?
A flu vaccine is needed every year for two reasons. First, a person’s immune protection from vaccination declines over time, so an annual flu vaccine is needed for optimal protection. Second, because flu viruses are constantly changing, the composition of flu vaccines is reviewed annually, and vaccines are updated to protect against the viruses that research indicates will be most common during the upcoming flu season. For the best protection, everyone 6 months and older should get vaccinated annually.
Does flu vaccine work right away?
No. It takes about two weeks after vaccination for antibodies to develop in the body and provide protection against influenza virus infection. That’s why it’s best to get vaccinated before influenza viruses start to spread in your community.
Influenza (flu) vaccine effectiveness (VE) can vary. The protection provided by a flu vaccine varies from season to season and depends in part on the age and health status of the person getting the vaccine and the similarity or “match” between the viruses in the vaccine and those in circulation. During years when the flu vaccine match is good, it is possible to measure substantial benefits from flu vaccination in terms of preventing flu illness and complications. However, the benefits of flu vaccination will still vary, depending on characteristics of the person being vaccinated (for example, their health and age), what influenza viruses are circulating that season and, potentially, which type of flu vaccine was used. For more information, see Vaccine Effectiveness – How well does the Flu Vaccine Work. For information specific to this season, visit About the Current Flu Season.
Can I get seasonal flu even though I got a flu vaccine this year?
Yes. It’s possible to get sick with flu even if you have been vaccinated (although you won’t know for sure unless you get a flu test). This is possible for the following reasons:
- You may be exposed to a flu virus shortly before getting vaccinated or during the period that it takes the body to gain protection after getting vaccinated. This exposure may result in you becoming ill with flu before the vaccine begins to protect you. (Antibodies that provide protection develop in the body about 2 weeks after vaccination.)
- You may be exposed to a flu virus that is not included in the seasonal flu vaccine. There are many different flu viruses that circulate every year. A flu vaccine is made to protect against the three or four flu viruses that research suggests will be most common.
- Unfortunately, some people can become infected with a flu virus a flu vaccine is designed to protect against, despite getting vaccinated. Protection provided by flu vaccination can vary widely, based in part on health and age factors of the person getting vaccinated. In general, a flu vaccine works best among healthy younger adults and older children. Some older people and people with certain chronic illnesses may develop less immunity after vaccination. Flu vaccination is not a perfect tool, but it is the best way to protect against flu infection.
What protection does a flu vaccine provide if I do get sick with flu?
Some people who get vaccinated may still get sick with flu. However, flu vaccination has been shown in some studies to reduce severity of illness in people who get vaccinated but still get sick. A 2021 study showed that among adults, flu vaccination was associated with a 26% lower risk of ICU admission and a 31% lower risk of death from flu compared with those who were unvaccinated. A 2017 study showed that flu vaccination reduced deaths, intensive care unit (ICU) admissions, ICU length of stay, and overall duration of hospitalization among hospitalized adults with flu.
What are the benefits of flu vaccination?
There are many reasons to get an influenza (flu) vaccine each year. Flu vaccination is the best way to protect yourself and your loved ones against flu and its potentially serious complications.
Below is a summary of the benefits of flu vaccination and selected scientific studies that support these benefits.
- Flu vaccination can keep you from getting sick with flu.
- Flu vaccination prevents millions of illnesses and flu-related doctor’s visits each year. For example, during 2019-2020 flu vaccination prevented an estimated 7.5 million influenza illnesses, 3.7 million influenza-associated medical visits, 105,000 influenza-associated hospitalizations, and 6,300 influenza-associated deaths.
- During seasons when flu vaccine viruses are similar to circulating flu viruses, flu vaccine has been shown to reduce the risk of having to go to the doctor with flu by 40 percent to 60 percent.
- Flu vaccination has been shown in several studies to reduce severity of illness in people who get vaccinated but still get sick.
- A 2021 study showed that among adults, flu vaccination was associated with a 26% lower risk of ICU admission and a 31% lower risk of death from flu compared to those who were unvaccinated.
- A 2018 study showed that among adults hospitalized with flu, vaccinated patients were 59 percent less likely to be admitted to the ICU than those who had not been vaccinated. Among adults in the ICU with flu, vaccinated patients on average spent 4 fewer days in the hospital than those who were not vaccinated.
- Flu vaccination can reduce the risk of flu-associated hospitalization.
- Flu vaccination prevents tens of thousands of hospitalizations each year. For example, during 2019-2020 flu vaccination prevented an estimated 105,000 flu-related hospitalizations.
- A 2014 study showed that flu vaccination reduced children’s risk of flu-related pediatric intensive care unit (PICU) admission by 74 percent during flu seasons from 2010-2012. A 2017 study found that during 2009-2016, flu vaccines reduced the risk of flu-associated hospitalization among older adults by about 40 percent on average.
- A 2018 study showed that from 2012 to 2015, flu vaccination among adults reduced the risk of being admitted to an intensive care unit (ICU) with flu by 82 percent.
- Flu vaccination is an important preventive tool for people with certain chronic health conditions.
- Flu vaccination has been associated with lower rates of some cardiac events among people with heart disease, especially among those who have had a cardiac event in the past year.
- Flu vaccination can reduce the risk of a flu-related worsening of chronic lung disease (for example, chronic obstructive pulmonary disease (COPD) requiring hospitalization.
- Among people with diabetes and chronic lung disease, flu vaccination also has been shown in separate studies to be associated with reduced hospitalizations from a worsening of their chronic condition.
- Flu vaccination helps protect pregnant people during and after pregnancy.
- Vaccination reduces the risk of flu-associated acute respiratory infection in pregnant people by about one-half.
- A 2018 study showed that getting a flu shot reduced a pregnant person’s risk of being hospitalized with flu by an average of 40 percent from 2010-2016.
- A number of studies have shown that in addition to helping to protect pregnant people from flu, a flu vaccine given during pregnancy helps protect the baby from flu for several months after birth, when he or she is too young to be vaccinated.
- Flu vaccine can be lifesaving in children.
- A 2017 study was the first of its kind to show that flu vaccination can significantly reduce a child’s risk of dying from flu.
- Getting vaccinated yourself may also protect people around you, including those who are more vulnerable to serious flu illness, like babies and young children, older people, and people with certain chronic health conditions.
Despite the many benefits offered by flu vaccination, only about half of Americans get an annual flu vaccine and flu continues to cause millions of illnesses, hundreds of thousands of hospitalizations and tens of thousands of deaths. Many more people could be protected from flu if more people got vaccinated.
What is meant by a “good match” between viruses in the vaccine and circulating influenza viruses?
A “good match” is said to occur when the flu vaccine viruses used to produce flu vaccine and the viruses circulating among people during a given flu season are “like” one another such that the antibodies produced by vaccination protect against infection with circulating viruses.
What if circulating viruses and the vaccine viruses are different?
During seasons when one or more of the circulating viruses are different or “drifted” from the vaccine viruses, vaccine effectiveness against the drifted viruses can be reduced. It’s important to remember that flu vaccine protects against four different flu viruses and multiple different viruses usually circulate during any one season. Even if the effectiveness of the vaccine is reduced against one virus vaccination can still be effective at preventing flu illness caused by the other circulating viruses. For these reasons, CDC continues to recommend flu vaccination for everyone 6 months and older even if vaccine effectiveness against one or more viruses is reduced.
Why is there sometimes not a good match between a vaccine virus and circulating viruses?
Flu viruses are constantly changing (called “antigenic drift”) – they can change from one season to the next or they can even change within the course of one flu season. Experts must pick which viruses to include in the vaccine many months in advance in order for vaccine to be produced and delivered on time. (For more information about the vaccine virus selection process visit Selecting the Viruses in the Influenza (Flu) Vaccine.) Because of these factors, there is always the possibility of a less than optimal match between circulating viruses and the viruses used to produce vaccine.
The production process for some seasonal vaccines also may impact how well vaccine works against certain viruses, especially influenza A(H3N2) viruses. Growth in eggs is part of the production process for many seasonal flu vaccines. While all influenza viruses undergo changes when they are grown in eggs, changes in influenza A(H3N2) viruses are more likely to result in antigenic changes compared with changes in other influenza viruses. These so-called “egg-adapted changes” are present in most of the vaccine viruses recommended for use in egg-based vaccine production and may reduce their effectiveness against circulating influenza viruses. Advances in vaccine production technologies (for example, cell-based and recombinant technology) and advanced molecular techniques are being explored as ways to improve flu vaccine effectiveness. Learn more by visiting, Advancements in Influenza Vaccines.
Will this season’s vaccine be a good match for circulating viruses?
It’s not possible to predict with certainty if a flu vaccine will be like circulating flu viruses because flu viruses are constantly changing. A flu vaccine is made to protect against the flu viruses that research and surveillance indicate will likely be most common during the season. Over the course of flu season, CDC studies samples of circulating flu viruses to evaluate how close a match there is between viruses used to make the flu vaccine and circulating flu viruses. More information about the 2021-2022 flu season and recommended vaccines is available.
No, a flu vaccine cannot cause flu illness. Flu vaccines that are given with a needle (flu shots) are currently made in two ways: the vaccine is made either with a) flu vaccine viruses that have been killed (inactivated) and are therefore not infectious, or b) with proteins from a flu virus (which is the case for recombinant influenza vaccine). Nasal spray vaccine is made with weakened (attenuated) live flu viruses, and also cannot cause flu illness. The weakened viruses are cold-adapted, which means they are designed to only reproduce at the cooler temperatures found within the nose. The viruses cannot reproduce in the lungs or other areas where warmer temperatures exist.
What side effects can occur after getting a flu vaccine?
While a flu vaccine cannot give you flu illness, there are different side effects that may be associated with getting a flu shot or a nasal spray flu vaccine. These side effects are usually mild and short-lasting, especially when compared to symptoms of flu.
A flu shot: The viruses in a flu shot are killed (inactivated), so you cannot get flu from a flu shot. Some minor side effects that may occur are:
- Soreness, redness, and/or swelling where the shot was given
- Headache (low grade)
- Muscle aches
The nasal spray: The viruses in the nasal spray vaccine are weakened and do not cause severe symptoms often associated with influenza illness. In children, side effects from the nasal spray may include:
- Runny nose
- Muscle aches
- Fever (low grade)
In adults, side effects from the nasal spray vaccine may include:
- Runny nose
- Sore throat
If these problems occur, they begin soon after vaccination and usually are mild and short-lived. A flu shot, like other injections, can occasionally cause fainting. Tell your provider if you feel dizzy or have vision changes or ringing in the ears. As with any medicine, there is a very remote chance of a vaccine causing a severe allergic reaction, other serious injury, or death. People who think that they have been injured by a flu vaccine can file a claim for compensation from the National Vaccine Injury Compensation Program (VICP).
More information about the safety of flu vaccines is available at Influenza (Flu) Vaccine Safety.
How much influenza vaccine is projected to be available for the 2021-2022 influenza season?
Flu vaccine is produced by private manufacturers, so supply depends on manufacturers. Vaccine manufacturers have projected that they will supply the United States with as many as 188 million to 200 million doses of influenza vaccine for the 2021-2022 season. These projections may change as the season progresses. All flu vaccines for the 2021-2022 season will be quadrivalent (four component). Most will be thimerosal-free or thimerosal-reduced vaccine (87%) and about 18% of flu vaccines will be egg-free.
Where can I find information about vaccine supply?
Information about vaccine supply is available on CDC’s Vaccine Supply & Distribution.
Special Consideration Regarding Egg Allergy
People with egg allergies can receive any licensed, recommended age-appropriate influenza vaccine (IIV4, RIV4, or LAIV4) that is otherwise appropriate. People who have a history of severe egg allergy (those who have had any symptom other than hives after exposure to egg) should be vaccinated in a medical setting, supervised by a health care provider who is able to recognize and manage severe allergic reactions. Two completely egg-free (ovalbumin-free) flu vaccine options are available: quadrivalent recombinant vaccine and quadrivalent cell-based vaccine.