Yes. It is especially important to vaccinate during pregnancy because of the increased risk for influenza-related complications during pregnancy and the baby’s increased risk of influenza-related illness and hospitalizations during the first 6 months of life.
Influenza vaccination during pregnancy reduces mothers’ risk of influenza illness, preterm labor, and their infants’ risk of influenza and influenza-related hospitalization in the first 6 months of life.
Vaccination can occur in any trimester, including the first. Only inactivated or recombinant influenza vaccines may be given during pregnancy. FluMist (LAIV), a live vaccine, should not be given during pregnancy.
In addition to the long-standing recommendation from ACIP, the American College of Obstetricians and Gynecologists (ACOG) strongly recommends influenza vaccination during pregnancy (www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2025/08/influenza-in-pregnancy-prevention-and-treatment). The American Academy of Pediatrics (AAP) recommends influenza vaccination of all children, including pregnant teens. See the AAP policy statement on influenza vaccination for the 2025–26 season here: https://publications.aap.org/pediatrics/article/doi/10.1542/peds.2025-073620/202845/Recommendations-for-Prevention-and-Control-of.
Last reviewed:
September 3, 2025
Last reviewed:
September 3, 2025
ACIP has recommended vaccinating during pregnancy with inactivated influenza vaccine since 1997. Studies have shown that pregnant people are at increased risk for complications, hospitalization, and even death from influenza because of the increased physiologic strain of pregnancy on their heart, lungs, and immune system. Vaccination can occur in any trimester, including the first.
Infants younger than 6 months old are at high risk of influenza-related complications, but influenza vaccine is not recommended for them because the immune response to influenza vaccination is limited before 6 months of age. Vaccinating during pregnancy provides maternal antibodies to the fetus which helps protect infants against influenza during the first 6 months of life until they can get vaccinated at age 6 months. Vaccinating pregnant people protects them, their unborn babies, and their babies after birth.
Last reviewed:
September 3, 2025
Pregnant patients may receive any age-appropriate inactivated or recombinant influenza vaccine. The ACIP recommends use of influenza vaccines in single-dose vials or manufacturer-filled syringes. FluMist (LAIV) should not be given during pregnancy because it is a live virus vaccine.
In June 2025, ACIP voted to no longer recommend the use of influenza vaccines from multidose vials containing thimerosal as a preservative for any person. There is no evidence that the low doses of thimerosal contained in vaccines cause harm, unless the recipient has a rare severe allergy to thimerosal.
The American College of Obstetricians and Gynecologists (ACOG) strongly recommends vaccination with an inactivated or recombinant influenza vaccine during pregnancy, and makes no specific comment on thimerosal. The American Academy of Pediatrics (AAP) recommends seasonal vaccination of all children, beginning at age 6 months, including pregnant teens. AAP states, “Any licensed influenza vaccine appropriate for age and health status can be administered, as soon as possible in the season, without preference for one product or formulation.” See the AAP policy statement on influenza vaccination for the 2025–26 season.
Last reviewed:
September 3, 2025
The ACIP in June 2025 voted to no longer recommend the use of influenza vaccine from thimerosal-containing multidose vials for any recipient. In addition, a few states have legislation restricting its use in pregnancy. There is no scientific evidence that thimerosal in vaccines is a cause of adverse events unless the patient has a systemic allergy to thimerosal. More than 95% of influenza vaccine doses administered in the 2024–25 season came from single dose products without preservatives, so the new ACIP recommendation should have limited impact on access to influenza vaccination in the 2025–26 season.
Last reviewed:
September 3, 2025
No. CDC’s Advisory Committee on Immunization Practices (ACIP) does not recommend more than one dose of influenza vaccine per season, except for certain children being vaccinated for the first time.
Last reviewed:
September 3, 2025
A CDC-funded study found that people who had been vaccinated early in pregnancy with an influenza vaccine containing the pandemic H1N1 (H1N1pdm09) component and who also had been vaccinated the prior season with an H1N1pdm09-containing influenza vaccine had an increased risk of spontaneous abortion (miscarriage) in the 28 days after vaccination. This study did not quantify the risk of miscarriage and did not prove that influenza vaccine was the cause of the miscarriage. Earlier studies have not found a link between influenza vaccination and miscarriage. A larger follow-up study also funded by CDC which included 3 more years of data found no association between early miscarriage and influenza vaccination regardless of previous influenza season vaccination. These results are reassuring regarding the safety of influenza vaccination during pregnancy.
CDC, ACIP, and the American College of Obstetricians and Gynecologists (ACOG) all recommend influenza vaccination during any trimester of pregnancy. Influenza poses a danger during pregnancy and the vaccine can prevent influenza in pregnant people and their infants.
Last reviewed:
September 3, 2025
From the time influenza vaccines were first recommended for children until 2025, CDC, ACIP, and the American Academy of Pediatrics (AAP) expressed no preference for preservative-free vaccine for infants or any other group of vaccine recipients. In June 2025, a newly constituted group of 7 ACIP members voted to no longer recommend the use of preservative-containing formulations of influenza vaccine for any recipient. AAP continues to express no preference for preservative-containing or preservative-free products among available age-appropriate products in its guidance. See AAP 2025–26 influenza vaccination recommendations for children here: https://doi.org/10.1542/peds.2025-073620.
No scientific evidence exists that thimerosal in vaccines is a cause of adverse events unless the patient has a systemic allergy to thimerosal. However, some states have enacted legislation that restricts the use of thimerosal-containing vaccines. Check with your state immunization program to see if your state is one of them (www.immunize.org/official-guidance/state-policies/state-resources/).
Last reviewed:
September 3, 2025
People with a metabolic disease, including diabetes, should receive annual influenza vaccination with an age-appropriate inactivated or recombinant influenza vaccine.
Last reviewed:
September 3, 2025
Yes. People with multiple sclerosis should be vaccinated against influenza. Multiple sclerosis is not a contraindication to any vaccine, including influenza vaccines.
Last reviewed:
September 3, 2025
Although some studies have demonstrated a transient increase in replication of HIV following inactivated influenza vaccine, other studies have not found this. This temporary increase in HIV titer has not been associated with deterioration in either T-lymphocyte counts or clinical condition. Annual influenza vaccination with an age-appropriate injectable influenza vaccine benefits HIV-infected people.
Last reviewed:
September 3, 2025
In November 2015, FDA licensed Fluad (aIIV, CSL Seqirus), an MF59-adjuvanted inactivated influenza vaccine, for people age 65 years and older. Fluad is the first adjuvanted influenza vaccine marketed in the U.S. An adjuvant is a substance added to a vaccine to increase the immune response to vaccination. The MF59 adjuvant is based on squalene, an oil that occurs naturally in many plants and animals. Fluad has been used in Europe since 1997 and is approved in many other countries. In contrast to Fluzone High-Dose (HD-IIV, Sanofi), Fluad is a standard-dose vaccine, containing 15 mcg of hemagglutinin per virus per dose.
Last reviewed:
September 3, 2025
Yes. Aging decreases the body’s ability to develop a good immune response after getting influenza vaccine, which places older people at greater risk of severe illness from influenza.
After years of review and deliberation, ACIP voted in June 2022 to recommend that all adults age 65 and older should preferentially receive one of the three different vaccine products that evidence suggests are likely to perform better than standard dose, unadjuvanted vaccines: Flublok recombinant influenza vaccine (RIV, Sanofi), Fluad adjuvanted vaccine (aIIV, CSL Seqirus), or Fluzone High-Dose vaccine (HD-IIV, Sanofi). However, if none of these three vaccines is available at the time of vaccination, any age-appropriate influenza vaccine may be administered.
For a thorough review of the evidence for this recommendation, see the 2022 ACIP recommendations for influenza vaccination: www.cdc.gov/mmwr/volumes/71/rr/pdfs/rr7101a1-H.pdf.
Last reviewed:
September 3, 2025
Although Fluzone High-Dose (HD-IIV) and Fluad (aIIV) are FDA-licensed for people 65 years and older, in June 2024, ACIP recommended that HD-IIV or aIIV are options for administration to people age 18 through 64 years old who have had a solid organ transplant (SOT) and are on immunosuppressive medication regimens. ACIP expressed no preference for HD-IIV or aIIV over any other age-appropriate IIV or RIV vaccines for SOT recipients.
Last reviewed:
September 3, 2025
Last reviewed:
September 3, 2025
No, and this is not recommended.
Last reviewed:
September 3, 2025
People with cancer need to be protected from influenza. All cancer patients should receive an age-appropriate inactivated or recombinant influenza vaccine. They should not be given the live virus vaccine, FluMist (LAIV). Cancer patients and survivors are at higher risk for complications from influenza, including hospitalization and death.
Last reviewed:
September 3, 2025
Inactivated influenza vaccine or recombinant influenza vaccine should be administered beginning at least 6 months after bone marrow transplant and annually thereafter for the life of the patient. A dose of vaccine can be given as early as 4 months after transplant, but a second dose should be considered in this situation. A second dose is recommended routinely for all children younger than 9 years receiving influenza vaccine for the first time.
Last reviewed:
September 3, 2025
