ACIP recommends annual influenza vaccination for all children age 6 months and older who do not have a contraindication to the vaccine.
All six 2025–26 season influenza vaccines approved for children are trivalent, containing two influenza A strains and one influenza B strain.
There are six injectable inactivated influenza vaccine (IIV) options for children. Four egg-based IIVs, one cell culture-based (ccIIV), and one recombinant (RIV), all given as intramuscular (IM) injections, are approved for children age 6 months and older:
One egg-based live attenuated nasal spray vaccine, FluMist (LAIV, AstraZeneca), is an option for healthy, non-pregnant people age 2 years and older: 0.2 mL (intranasal, 0.1 mL in each nostril).
Children age 6 months through 8 years should receive a second influenza vaccine dose 4 weeks or more after the first dose if they meet one of the following three criteria: 1) they are receiving influenza vaccine for the first time, or 2) they have not received a total of at least two doses of any seasonal influenza vaccine before July 1 of the current year, or 3) their vaccination history is unknown. The two previous doses need not have been received during the same season or consecutive seasons.
A child who is 8 years old and is recommended to receive two doses during the current season and turns 9 during the current season before receiving dose 2, should still receive dose 2.
Immunize.org’s handout titled “Guide for Determining the Number of Doses of Influenza Vaccine to Give to Children Age 6 Months Through 8 Years” provides additional guidance on this issue; it is available at www.immunize.org/catg.d/p3093.pdf.
Yes. Doses of FluMist administered in past seasons can be counted.
The two doses may be the same or different products.
The child should always receive the dose appropriate for his or her age at the time of the clinic visit; at age 37 months that would be a 0.5 mL dose of Afluria.
Multidose vials of inactivated influenza vaccine contain a small amount of thimerosal to prevent bacterial and fungal growth in the vial.
Thimerosal-containing vaccines from multidose vials are safe to use in children. No scientific evidence indicates that the small amount of thimerosal in vaccines causes adverse events unless the patient has a severe allergy to thimerosal. In June 2025, CDC’s ACIP voted to no longer recommend use of influenza vaccines in MDVs containing thimerosal as a preservative. In addition, a few states have enacted legislation that restricts the use of thimerosal-containing vaccines in children. To find out if your state has such restrictions, check with your state immunization program (see www.immunize.org/official-guidance/state-policies/state-resources/ for program contact information).
The American Academy of Pediatrics (AAP) continues to recommend annual influenza vaccination of all children, beginning at age 6 months, using any available age-appropriate presentation, including MDVs containing thimerosal as a preservative.
Yes, but only if the 9-year-old meets all of the criteria below:
A CDC study showed a small increased risk for febrile seizures during the 24 hours after a child receives the inactivated influenza vaccine at the same time as the PCV13 vaccine or DTaP vaccine. However, the risk of febrile seizure with any combination of these vaccines is small and ACIP recommends giving these vaccines at the same visit if indicated. The risk for febrile seizures in children who received the currently-recommended PCV15 or PCV20 vaccines at the same time as an influenza vaccine has not been studied.
See www.cdc.gov/vaccine-safety/about/febrile-seizures.html for more information about febrile seizures after vaccination.