ACP encourages all adults to receive the 2025–2026 influenza vaccine

The American College of Physicians (ACP) issued new influenza vaccine practice points that say everyone ages 18 to 64 years who are not pregnant or immunocompromised should receive either a standard-dose trivalent or a standard-dose quadrivalent (cell-based, egg-based, MF59-adjuvanted, or recombinant) influenza vaccine for the 2025-2026 influenza season.

Those aged 65 years or older who are not immunocompromised should receive either a high-dose trivalent or a high-dose quadrivalent egg-based influenza vaccine. ACP did not examine evidence or make recommendations for pregnant women or immunocompromised adults.

The practice points are published in the Annals of Internal Medicine.

Influenza A and B drive seasonal epidemics because they are highly infectious, rapidly mutate, and cause a respiratory infection known as the flu. Incidence and severity of influenza vary by year and season, but are greatest in the fall and winter. Adults aged ≥ 65 years and adults with comorbidities, such as diabetes, asthma, or chronic obstructive pulmonary disease (COPD), are at greater risk for morbidity and mortality.

To develop its practice points, ACP explored new evidence and analyzed the comparative effectiveness and harms of influenza vaccines in adults aged ≥ 18 years who are not pregnant or immunocompromised. Influenza vaccines help prevent morbidity and mortality.

ACP's Practice Points are based on a rapid review of the best available evidence of the benefits and harms of trivalent (three different influenza viruses or viral proteins) and quadrivalent (four different influenza viruses or viral proteins) influenza vaccines in nonpregnant and nonimmunocompromised adults aged ≥ 18 years.

The ACP Center for Evidence Reviews (ACP CER) team evaluated 42 studies, which had two comparators. The most common comparator was the standard dose trivalent or quadrivalent egg-based influenza vaccine. The other comparator was the high-dose trivalent or quadrivalent egg-based influenza vaccine.

The ACP considered evidence on benefits (influenza-associated pneumonia/lower respiratory tract disease, influenza-related mortality, influenza-related hospitalization, and laboratory-confirmed influenza) and harms (fever, idiopathic thrombocytopenic purpura, and serious adverse events) of the influenza vaccines to develop the Practice Points.

More information:
Influenza Vaccines for 2025-2026 in Adults Who are Not Pregnant or Immunocompromised: Rapid Practice Points From the American College of Physicians, Annals of Internal Medicine (2025). DOI: 10.7326/ANNALS-25-04056

Provided by American College of Physicians