Trevor James
Influenza, or flu, is a contagious respiratory illness caused by influenza viruses that affect the nose, throat, and lungs. Flu vaccines are designed to protect against infection with these viruses. In the US, the Centers for Disease Control and Prevention (CDC) recommends annual influenza vaccinations for everyone aged 6 months and older. However, the availability and type of flu vaccines may vary across different regions and states. For instance, during the 2023-24 flu season, vaccination coverage among children aged 6 months to 17 years ranged from 35.4% in Mississippi to 75.1% in Massachusetts. Additionally, the coverage of some Pacific Island jurisdictions may differ due to vaccination programs aligned with regional virus circulation patterns.
| Characteristics | Values |
|---|---|
| Vaccination coverage for the 2023-24 flu season among children aged 6 months to 17 years | 55.4% |
| Vaccination coverage for the 2023-24 flu season by state among children aged 6 months to 17 years | 35.4% (Mississippi) to 75.1% (Massachusetts) |
| Vaccination coverage for the 2023-24 flu season among children living in a metropolitan statistical area (MSA) principal city | 60.8% |
| Vaccination coverage for the 2023-24 flu season among children living in a MSA non-principal city | 55.4% |
| Vaccination coverage for the 2023-24 flu season among children living in a non-MSA | 41.0% |
| Number of doses of flu vaccine distributed in the United States for the 2024-25 season as of March 8, 2025 | 147.6 million |
| Number of doses of flu vaccine administered in retail pharmacies for the 2024-25 season as of April 12, 2025 | 37.6 million |
| Number of doses of flu vaccine administered in physicians' medical offices for the 2024-25 season as of April 12, 2025 | 21.5 million |
| Type of vaccine used for the 2024-25 influenza season | Trivalent flu vaccines |
| Type of vaccine used for the 2025-26 influenza season | Trivalent seasonal influenza vaccines |
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What You'll Learn
Flu vaccination coverage varies across the USA
Flu vaccination coverage does vary across the USA. While there is no indication that different influenza vaccines are used in different regions of the USA, there are several types of vaccines available, and these can vary in their formulation and method of administration.
The CDC recommends that everyone aged 6 months and older should receive a flu vaccine every season, with rare exceptions. Vaccination is particularly important for those at high risk of serious complications from influenza. The flu vaccine can be administered at the same time as the COVID-19 vaccine.
The types of flu vaccines available include:
- Trivalent flu vaccines: These protect against three different main groups of influenza Type A and B viruses. All influenza vaccines available in the US for the 2024-25 influenza season were trivalent.
- High dose vaccines: These contain four times the antigen of a regular flu shot and are approved for people aged 65 and older.
- Cell-based vaccines: These are grown in mammal cell culture instead of hens' eggs.
- Recombinant flu vaccines: These are produced without an egg-grown vaccine virus and contain three times the antigen of a standard-dose vaccine.
- Jet injector vaccines: These are approved for people aged 18-64 and can be administered without a needle.
- Live attenuated influenza vaccines: These are given as a nasal spray and are approved for people aged 2-49. They are not recommended for pregnant women or immunocompromised people.
- Adjuvanted flu vaccines: These contain an additional ingredient to create a stronger immune response and are licensed for people aged 65 and older.
The CDC's Weekly Influenza (Flu) Vaccination Dashboard provides preliminary weekly in-season flu vaccination information, including coverage estimates. According to the dashboard, as of April 26, 2025, 49.2% of children and 46.7% of adults had received a flu vaccination. There is wide variability in vaccination coverage across states, ranging from 37.8% in Wyoming to 77.7% in Massachusetts for children, and from 37.8% in Mississippi to 64.4% in Rhode Island for adults.
County-level predictions for flu vaccination coverage from 2018 to 2021 show that vaccination rates were highest in the Midwest/West and Northeast. Southern and southeastern regions typically have lower vaccination rates and are often the most vulnerable to the flu from a public health standpoint.
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Different types of flu vaccines available
Flu vaccines are designed to protect against infection with influenza viruses. Seasonal flu vaccines, in particular, protect against the influenza viruses that research suggests will be most common during the upcoming season. These include three different main groups of influenza Type A and B viruses.
For the 2024-2025 flu season, all influenza vaccines available in the United States were trivalent, meaning they protected against three different influenza viruses. These included two influenza A subtype viruses (H1N1 and H3N2) and one influenza B virus. The trivalent vaccines did not include the influenza B/Yamagata lineage vaccine virus or viral protein component, as the B/Yamagata viruses have not been detected since March 2020.
For the 2025-2026 flu season, the FDA has made recommendations to vaccine manufacturers for the virus strains to be included in the vaccines, and they anticipate that there will be an adequate and diverse supply of approved trivalent seasonal influenza vaccines.
There are several different types of flu vaccines available in the USA, including:
- Flu shots, which are vaccines given with a needle, usually in the arm.
- Live Attenuated Influenza Vaccine (LAIV) or FluMist, which is given as a nasal spray. This vaccine is made with attenuated (weakened) live influenza viruses and is approved for use in people aged 2 to 49 years. It is not recommended for pregnant women, immunocompromised people, or those with certain medical conditions.
- Adjuvanted flu vaccine or Fluad vaccine, which contains an adjuvant that helps create a stronger immune response. It is licensed for people 65 years and older.
- High-dose vaccine or Fluzone High-Dose, which contains four times the amount of antigen as a regular inactivated flu shot, helping to create a stronger immune response. It is approved for people 65 years and older.
- Cell-based vaccines or Flucelvax, which are grown in mammal cell culture instead of hens' eggs. This vaccine is completely egg-free and is approved for people 6 months and older.
- Recombinant flu vaccine or Flublok, which is produced without the need for an egg-grown vaccine virus. This vaccine contains three times the antigen than other standard-dose inactivated flu vaccines.
- Flu vaccination via jet injector or Afluria, which is approved for people 18 to 64 years old. This vaccine can be administered either with a jet injector or a needle.
Everyone 6 months and older should get a flu vaccine every season, with rare exceptions.
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Vaccination recommendations for the 2025-26 season
The CDC recommends that everyone aged six months and older, with rare exceptions, should receive a flu vaccine every season. Vaccination is of particular importance for individuals at higher risk of serious complications from influenza. For the 2025-26 flu season, the CDC specifically recommends seasonal flu vaccination with single-dose formulations that are free of thimerosal as a preservative for children, pregnant women, and adults.
In terms of vaccine types, individuals have several options. The traditional flu shot is administered with a needle, usually in the arm. For those aged 18 through 64, the option of a jet injector is also available. People under 18 years old and over 64 years old can only receive the vaccine via needle. Additionally, the Live Attenuated Influenza Vaccine (LAIV), also known as FluMist, is given as a nasal spray and is approved for individuals aged 2 through 49 years. It is important to note that FluMist is not recommended for pregnant women, immunocompromised individuals, or those with certain medical conditions.
For individuals aged 65 years and older, two specific vaccine options are available. The Fluzone High-Dose vaccine contains four times the amount of antigen compared to a regular inactivated flu shot, helping to create a stronger immune response. The other option is the adjuvanted flu vaccine, Fluad, which contains an ingredient that enhances immune response.
Finally, Flublok, a recombinant influenza vaccine, has been approved for individuals aged 9 years and older. This vaccine is produced without the need for an egg-grown vaccine virus and contains three times the antigen compared to standard-dose inactivated flu vaccines.
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Flu vaccines for children and adults
Influenza, or the flu, is a contagious respiratory illness caused by influenza viruses that infect the nose, throat, and lungs. Flu vaccines cause antibodies to develop in the body about two weeks after vaccination, providing protection against infection with the influenza viruses that are used to make the vaccine. The seasonal flu vaccine protects against the influenza viruses that research suggests will be most common during the upcoming season.
The flu vaccine is recommended for everyone 6 months of age and older. It helps keep kids and parents from getting sick and protects those around them as well. Children younger than 5 years old, especially those younger than 2, and children of any age with certain chronic health conditions, like asthma and diabetes, are at higher risk of developing potentially serious flu-related complications. In children, annual flu vaccination has been shown to reduce flu illnesses, doctors' visits, missed school days, and the risk of flu-related hospitalization and death. Flu vaccination is particularly important for people who are at higher risk of serious complications from influenza.
Flu vaccines are given either as a shot or a nasal spray. Flu shots are vaccines given with a needle, usually in the arm or thigh, depending on the person's age. The high dose vaccine (Fluzone High-Dose) is approved for use in people 65 years and older and contains four times the amount of antigen as a regular inactivated flu shot. Adjuvanted flu vaccines (Fluad) are also licensed specifically for people 65 years and older. Flu shots can cause soreness, redness, or swelling at the injection site and may rarely cause a low fever or body aches.
The nasal spray flu vaccine, or Live Attenuated Influenza Vaccine (LAIV), is approved for people 2 through 49 years old. It is made with attenuated (weakened) live influenza viruses. The nasal spray vaccine should not be given to pregnant women, immunocompromised people, or people with certain medical conditions. It may cause mild cold-like symptoms, such as a runny nose, sore throat, or tiredness, and rarely, a low fever or body aches. However, the weakened virus isn't strong enough to grow in the lungs, so it will not cause serious illness.
There are also recombinant flu vaccines (Flublok) that are produced without using an egg-grown vaccine virus. This type of vaccine contains three times the antigen of a standard-dose inactivated flu vaccine. Cell-based vaccines (Flucelvax) are grown in mammal cell culture instead of hens' eggs.
For the 2024-25 influenza season, all influenza vaccines available in the United States were trivalent, protecting against three different main groups of influenza Type A and B viruses. The FDA has made recommendations for the virus strains to be used in influenza vaccines for the 2025-2026 flu season, and an adequate and diverse supply of approved trivalent seasonal influenza vaccines is anticipated.
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Flu vaccines for at-risk groups
Flu vaccines are recommended for everyone aged 6 months and older, with rare exceptions. However, vaccination is particularly crucial for individuals facing a higher risk of severe flu complications. This includes people with specific chronic health conditions, such as chronic lung disease, neurologic and neurodevelopmental conditions, blood disorders, endocrine disorders, and heart disease. During recent flu seasons, 9 in 10 hospitalised patients with the flu had at least one underlying health issue.
For adults aged 65 and above, three flu vaccines are preferentially recommended: Fluzone High-Dose (inactivated flu vaccine), Flublok (recombinant flu vaccine), and Fluad (adjuvanted inactivated flu vaccine). These vaccines are anticipated to be more effective for this age group than standard-dose unadjuvanted flu vaccines. The Fluzone High-Dose vaccine, for instance, contains four times the antigen amount of a regular flu shot, while the Fluad vaccine is specifically licensed for individuals aged 65 and older.
The nasal spray flu vaccine, or Live Attenuated Influenza Vaccine (LAIV), is an option for individuals aged 2 to 49. However, it is not advised for pregnant women, immunocompromised individuals, or those with specific medical conditions. For those aged 18 to 64 who are solid organ transplant recipients and on immunosuppressive medication, the high-dose inactivated flu vaccine or adjuvanted flu vaccine is recommended.
It is important to note that flu vaccines can help prevent severe, life-threatening complications in children. Studies have shown that flu vaccination can reduce the risk of flu-associated death and flu-related paediatric intensive care unit (PICU) admissions. Additionally, flu vaccines can reduce the risk of flu-related worsening of chronic conditions and prevent flu-associated hospitalisation.
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Frequently asked questions
No, there are no region-specific influenza vaccines in the USA. However, the vaccination coverage differs across states. For instance, in the 2023-24 flu season, vaccination coverage ranged from 35.4% in Mississippi to 75.1% in Massachusetts.
There are several types of influenza vaccines available in the USA, including:
- Trivalent flu vaccines
- High-dose vaccines
- Cell-based vaccines
- Recombinant flu vaccines
- Adjuvanted flu vaccines
- Live attenuated influenza vaccines (LAIV)
It is recommended to get a flu vaccine every season, especially for those at higher risk of serious complications from influenza.
Flu vaccines are typically administered in retail pharmacies and physicians' medical offices.
