Key Facts About Seasonal Flu Vaccine
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 during typical flu seasons, millions of people get flu, hundreds of thousands of people are hospitalized and thousands to tens of thousands of people die from flu-related causes. Flu can mean a few days of feeling bad and missing work, school, or family events, 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 reduce the risk of getting flu and any of its potentially serious complications. Vaccination has been shown to have many benefits including reducing the risk of flu illnesses, hospitalizations and even the risk of flu-related death. While some people who get a flu vaccine may still get sick with influenza, 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 flu illness.
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.
For people younger than 65 years, CDC does not preferentially recommend any licensed, age-appropriate influenza (flu) vaccine over another during the 2022-2023 flu season. Options for this age group include inactivated influenza vaccine [IIV], recombinant influenza vaccine [RIV], or live attenuated influenza vaccine (LAIV), with no preference for any flu vaccine over another.
New for this season: For people 65 years and older, there are three flu vaccines that are preferentially recommended over standard-dose, unadjuvanted flu vaccines. These are Fluzone High-Dose Quadrivalent vaccine, Flublok Quadrivalent recombinant flu vaccine and Fluad Quadrivalent adjuvanted flu vaccine. More information is available at Flu & People 65 Years and Older.
All flu vaccines for the 2022-2023 season are quadrivalent vaccines, designed to protect against four different flu viruses, including two influenza A viruses and two influenza B viruses. Different vaccines are licensed for use in different age groups, and some vaccines are not recommended for some groups of people.
Available flu vaccines include:
- Standard-dose flu shots that are manufactured using virus grown in eggs. Several different brands of standard dose flu shots are available, including Afluria Quadrivalent, Fluarix Quadrivalent, FluLaval Quadrivalent, and Fluzone Quadrivalent. These vaccines are approved for use in children as young as 6 months. Most flu shots are given in the arm (muscle) with a needle. Afluria Quadrivalent can be given either with a needle (for people 6 months and older) or with a jet injector (for people 18 through 64 years only).
- A cell-based flu shot (Flucelvax Quadrivalent) containing virus grown in cell culture, which is approved for people 6 months and older. This vaccine is completely egg-free.
- A recombinant flu shot (Flublok Quadrivalent) which is a completely egg-free flu shot that is made using recombinant technology and is approved for use in people 18 years and older. This shot is made without flu viruses and contains three times the antigen (the part of the vaccine that helps your body build up protection against flu viruses) than other standard-dose inactivated flu vaccines, to help create a stronger immune response.
- An egg-based high dose flu shot (Fluzone High-Dose Quadrivalent), which is approved for use in people 65 years and older. This vaccine contains four times the antigen (the part of the vaccine that helps your body build up protection against flu viruses) than other standard-dose inactivated flu vaccines, to help create a stronger immune response.
- An egg-based adjuvanted flu shot (Fluad Quadrivalent), which is approved for people 65 years and older. This vaccine is made with an adjuvant (an ingredient that helps create a stronger immune response).
- An egg-based live attenuated flu nasal spray vaccine (FluMist Quadrivalent) made with attenuated (weakened) live flu viruses, which is approved for use in people 2 years through 49 years. This vaccine is not recommended for use in pregnant people, immunocompromised people, or people with certain medical conditions.
Are any of the available flu vaccines recommended over others?
Yes, for some people. There are three flu vaccines that are preferentially recommended for people 65 years and older. These are Fluzone High-Dose Quadrivalent vaccine, Flublok Quadrivalent recombinant flu vaccine and Fluad Quadrivalent adjuvanted flu vaccine. This recommendation was based on a review of available studies which suggests that, in this age group, these vaccines are potentially more effective than standard dose unadjuvanted flu vaccines. There is no preferential recommendation for people younger than 65 years.
What if a preferentially recommended flu vaccine is not available?
If none of the three flu vaccines preferentially recommended for people 65 years and older is available at the time of administration, people in this age group should get any other age-appropriate flu vaccine instead.
Who Should Be Vaccinated?
Everyone 6 months and older in the United States should get an influenza (flu) vaccine every season with rare exception. CDC’s Advisory Committee on Immunization Practices has made this “universal” recommendation since the 2010-2011 flu 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. A full list of age and health factors that confer increased risk is available at People at Higher Risk of Developing Flu-Related Complications.
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. More information is available at Who Should and Who Should NOT get a Flu Vaccine.
For most people who need only one dose of flu vaccine for the season, September and October are generally good times to be vaccinated against flu. Ideally, everyone should be vaccinated by the end of October. Additional considerations concerning the timing of vaccination for certain groups of people include:
- Most adults, especially those 65 years and older, and pregnant people in the first or second trimester should generally not get vaccinated early (in July or August) because protection may decrease over time. However, early vaccination can be considered for any person who is unable to return at a later time to be vaccinated.
- 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 four weeks after the first. Vaccination during July and August also can be considered for children who need only one dose.
- Vaccination during July and August also can be considered for people who are in the third trimester of pregnancy during those months, because this can help protect their infants for the first few months after birth (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 flu viruses are circulating that season and, potentially, which type of flu vaccine was used. More information is available at Vaccine Effectiveness – How well does the Flu Vaccine Work.
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 four flu viruses that research suggests will be most common.
- Unfortunately, some people can become infected with a flu virus that the vaccine is designed to protect against, despite getting vaccinated. Protection provided by flu vaccination can vary widely, based in part on the age and health of the person getting vaccinated. In general, flu vaccines work best among healthy younger adults and older children. Some older people and some 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 virus 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 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.
There are many reasons to get an influenza (flu) vaccine each year.
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 vaccine prevents millions of illnesses and flu-related doctor’s visits each year. For example, during 2019-2020, the last flu season prior to the COVID-19 pandemic, flu vaccination prevented an estimated 36 million influenza illnesses, 16 million influenza-associated medical visits, 390,000 influenza-associated hospitalizations, and 25,000 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% to 60%.
- 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 hospitalized with flu, vaccinated patients had a 26% lower risk of intensive care unit (ICU) admission and a 31% lower risk of death from flu compared with those who were unvaccinated.
- A 2018 study showed that among adults hospitalized with flu, vaccinated patients were 59% 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 four fewer days in the hospital than those who were not vaccinated.
- Flu vaccination can reduce the risk of flu-associated hospitalization.
- Flu vaccine prevents tens of thousands of hospitalizations each year. For example, during 2019-2020 flu vaccination prevented an estimated 390,000 flu-related hospitalizations.
- A 2018 study showed that from 2012 to 2015, flu vaccination among adults reduced the risk of being admitted to an ICU with flu by 82%.
- A 2017 systematic review found that during 2010-2011 through 2014-2015, flu vaccines reduced the risk of flu-associated hospitalization among older adults by about 40% on average.
- A 2014 study showed that flu vaccination reduced children’s risk of flu-related pediatric intensive care unit (PICU) admission by 74% during flu seasons from 2010-2012.
- 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 has been shown in separate studies to be associated with reduced hospitalizations from a worsening of their chronic condition.
- Flu vaccination during pregnancy helps protect pregnant people from flu during and after pregnancy and helps protect their infants from flu in their first few months of life.
- A 2013 study showed that during the 2010–2011 and 2011–2012 flu seasons vaccination reduced 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% 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 babies are too young to be vaccinated.
- Flu vaccine can be lifesaving in children.
- A 2022 study showed that flu vaccination reduced children’s risk of severe life-threatening influenza by 75%.
- A 2020 study found that during the 2018-2019 flu season, flu vaccination reduced flu-related hospitalization by 41% and flu-related emergency department visits by half among children (aged 6 months to 17 years old).
- A 2017 study was the first of its kind to show that flu vaccination can significantly reduce children’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. During an average flu season, flu can 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.
*References for the studies listed above can be found at Publications on Influenza Vaccine Benefits.
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 induced by vaccination protect against infection caused by circulating viruses.
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.
What if circulating flu viruses are different from vaccine viruses?
During seasons when one or more of the circulating viruses are different or “drifted” from the vaccine viruses, vaccine effectiveness 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.
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 upcoming season. Over the course of the 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 2023-2024 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 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 report with the Vaccine Adverse Event Reporting System (VAERS).
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 2023-2024 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 156.2 million to 170 million doses of influenza vaccines for the 2023-2024 season. These projections may change as the season progresses. All flu vaccines for the 2023-2024 season will be quadrivalent (four component). Most will be thimerosal-free or thimerosal-reduced vaccine (91%), and about 21% 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.
Recommendations for Vaccination of People with Egg Allergy
People with egg allergy may get any vaccine (egg-based or non-egg-based) that is otherwise appropriate for their age and health status. Previously, it was recommended that people with severe allergy to egg (those who have had any symptom other than hives with egg exposure) be vaccinated in an inpatient or outpatient medical setting. Beginning with the 2023-2024 season, additional safety measures are no longer recommended for flu vaccination of people with an egg allergy beyond those recommended for receipt of any vaccine, regardless of the severity of previous reaction to egg. All vaccines should be given in settings where allergic reactions can be recognized and treated quickly.