Frequently Asked Influenza (Flu) Questions: 2022-2023 Season

What’s New for 2022-2023

A few things are different for the 2022-2023 influenza (flu) season, including:

  • The composition of flu vaccines has been updated.
  • For the 2022-2023 flu season, 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.
  • The recommended timing of vaccination is similar to last season. For most people who need only one dose for the season, September and October are generally good times to get vaccinated. Vaccination in July and August is not recommended for most adults but can be considered for some groups. While ideally it’s recommended to get vaccinated by the end of October, it’s important to know that vaccination after October can still provide protection during the peak of flu season.
  • The age indication for the cell culture-based inactivated flu vaccine, Flucelvax Quadrivalent (ccIIV4), changed from 2 years and older to 6 months and older.
  • Pre-filled Afluria Quadrivalent flu shots for children are not expected to be available this season. However, children can receive this vaccine from a multidose vial at the recommended dose.

Flu Vaccine

Annual flu vaccination is recommended for everyone 6 months and older, with few exceptions as has been the case since 2010. New this season, however, is a preferential recommendation for the use of higher dose and adjuvanted flu vaccines in people 65 and older over standard dose, unadjuvanted flu vaccines. More information on this new recommendation can be found here.

There are many different flu viruses, and they are constantly changing. The composition of U.S. flu vaccines is reviewed annually and updated as needed. The recommendations for the 2022-2023 season include two updates compared with the recommended composition of last season’s U.S. flu vaccines. Both the influenza A(H3N2) and the influenza B(Victoria lineage) vaccine virus components were updated.

The recommendations for egg-based and cell-based and recombinant flu vaccines are listed below:

Egg-based vaccine composition recommendations:

  • an A/Victoria/2570/2019 (H1N1) pdm09-like virus;
  • an A/Darwin/9/2021 (H3N2)-like virus (updated);
  • a B/Austria/1359417/2021-like virus (B/Victoria lineage) (updated);
  • a B/Phuket/3073/2013-like virus (B/Yamagata lineage)

 Cell- or recombinant-based vaccine composition recommendations:

  • an A/Wisconsin/588/2019 (H1N1) pdm09-like virus;
  • an A/Darwin/6/2021 (H3N2)-like virus (updated);
  • a B/Austria/1359417/2021-like virus (B/Victoria lineage) (updated);
  • a B/Phuket/3073/2013-like virus (B/Yamagata lineage).

This recommendation is the same as the Southern Hemisphere flu vaccine recommendation. For more information, visit Influenza Vaccine for the 2022-2023 Season | FDA

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 173.5 million to 183.5 million doses of influenza vaccines for the 2022-2023 season. These projections may change as the season progresses. All flu vaccines for the 2022-2023 season will be quadrivalent (four component). Most will be thimerosal-free or thimerosal-reduced vaccine (93%), and about 20% of flu vaccines will be egg-free.

Yes, for some people. For the 2022-2023 flu season, 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. There is not a preferential recommendation for one of these three higher dose or adjuvanted flu vaccines over the others.

On June 22, 2022, CDC’s Advisory Committee on Immunization Practices (ACIP) voted unanimously to preferentially recommend these vaccines over standard-dose unadjuvanted flu vaccines. 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.

If one of the three preferentially recommended flu vaccines for people 65 and older is not available at the time of administration, people in this age group should get a standard-dose flu vaccine instead.

CDC has annual educational campaigns to increase awareness about the importance of seasonal flu vaccination. For the 2022-2023 season, CDC will continue to emphasize the importance of flu vaccination beginning in September and for the entire flu season. The agency will conduct targeted communication outreach to specific groups of people who are at higher risk for developing serious complications from flu. Communication strategies for providers and the public will include:

  • Educational outreach activities by CDC, including social media, press conferences, web page spotlights, radio media tours, op-eds, and other publications.
  • Special educational efforts and a digital campaign to inform the general population, people with underlying health conditions, children, pregnant people, and African American and Hispanic audiences about the importance of flu vaccination.

In addition, as part of its new Partnering for Vaccine Equity program, CDC has provided more than $150 million in funding to support national, state, local, and community-level partners working to increase confidence in COVID-19 and flu vaccines among adults in racial and ethnic minority groups.

If you don’t have a health care provider you regularly see, you can find flu vaccines at many places, including health departments and pharmacies.

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.
  • 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. 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).

Flu Vaccine and COVID-19 Vaccine Coadministration

Yes, you can get a COVID-19 vaccine and a flu vaccine at the same time if you are eligible and the timing coincides.

Even though both vaccines can be given at the same visit, people should follow the recommended schedule for either vaccine: If you haven’t gotten your currently recommended doses of COVID-19 vaccine, get a COVID-19 vaccine as soon as you can, and ideally get a flu vaccine by the end of October.

Studies conducted throughout the COVID-19 pandemic indicate that it is safe to get both a COVID-19 vaccine and a flu vaccine at the same visit. A recent CDC study published in JAMA suggests people who received a flu vaccine and an mRNA COVID-19 booster vaccine at the same time were slightly more likely (8% to 11%) to report systemic reactions including fatigue, headache, and muscle ache than people who only received a COVID-19 mRNA booster vaccine, but these reactions were mostly mild and resolved quickly. The findings of this study are consistent with safety data from clinical trials that did not identify any serious safety concerns with coadministration.

If you have concerns about getting both vaccines at the same time, you should speak with a health care provider.

Yes, you can get a flu vaccine at the same time you get a COVID-19 vaccine, including a COVID-19 booster shot.

Yes, children who are eligible for COVID-19 vaccination can get a COVID-19 vaccine and a flu vaccine at the same visit.

If your child is eligible, get them up to date on their recommended COVID-19 vaccine and annual flu vaccine as soon as possible. You can get both vaccines at the same time, but don’t delay either vaccination in order to get them both at the same visit. Both vaccines are recommended, and your child should get the recommended doses for each vaccine.

All children 6 months and older should get a flu vaccine. Most children will only need one dose of flu vaccine. Your child’s healthcare provider can tell you if your child needs two doses of flu vaccine.

Flu Activity

Flu viruses are constantly changing so it’s not unusual for new flu viruses to appear each year. More information is available at how flu viruses change.

The timing of flu is difficult to predict and can vary in different parts of the country and from season to season.

Flu Vaccine Coverage

CDC’s Weekly Flu Vaccination Dashboard will again provide preliminary, within-season, weekly influenza vaccination data which will be updated during the season as more data become available. The first posting of vaccine coverage data for the season is expected in early October. Visit the National Flu Vaccination Dashboard for more information.

Flu vaccination coverage among children is assessed through the National Immunization Survey-Flu (NIS-Flu), which provides weekly flu vaccination coverage estimates for children 6 months–17 years old. NIS-Flu is a national random-digit-dialed cellular telephone survey of households conducted during the flu season (October-June). Additional information about NIS-Flu methods and estimates from 2021-2022 season are available at FluVaxView. Visit CDC’s Weekly Flu Vaccination Dashboard for more information.

Flu vaccination coverage estimates among pregnant people are available via CDC’s Weekly Flu Vaccination Dashboard. These estimates are based on electronic health record (EHR) data from the Vaccine Safety Datalink (VSD), a collaboration between CDC’s Immunization Safety Office and nine integrated health care organizations. Of note, because these estimates are based on data from nine integrated health care systems, they may not be representative of all pregnant people in the United States.

CDC tracks the number of flu vaccines administered at pharmacies and doctor’s offices by utilizing new sources of vaccination data, including IQVIA data for vaccinations administered in retail pharmacies (e.g., pharmacy chains, mass merchandise, food stores, and independent pharmacies) and doctors’ offices. Visit CDC’s Weekly Flu Vaccination Dashboard for more information.

CDC’s Weekly Flu Vaccination Dashboard provides preliminary, within-season, weekly flu vaccination data which will be updated during the season as more data become available. The first posting of vaccine coverage data for the season is expected in early October. Visit the National Flu Vaccination Dashboard for more information.

Click here for vaccination coverage estimates from past flu seasons. CDC will continue to provide end-of-season estimates of flu vaccination coverage from these data sources.