Health Care Expert Expresses Mixed Feelings About Recommendations for 2025-2026 Influenza Vaccination Policies

The COVID-19 recommendations have been changing—with conflicting reports coming from different official sources, such as the Department of Health and Human Services (HHS), CDC, and the CDC’s Advisory Committee for Immunization Practices (ACIP). This has sparked confusion among not only the medical community, but the general public as well. In addition, HSS Secretary Robert F. Kennedy Jr’s newly appointed vaccine panel members recommended against including the preservative thimerosal in 2025-2026 influenza vaccines. However, ACIP upheld past recommendations that everyone 6 months and older should receive an annual influenza vaccine.

Pharmacies play a significant role in influenza vaccination. | Image Credit: Aron M - Austria

“I’m so glad that this long-standing policy was reaffirmed by the CDC’s committee,” William Schaffner, MD, professor of medicine in the Division of Infectious Diseases at the Vanderbilt University School of Medicine, said in a phone interview.

This year’s ACIP meeting was held from June 25 to 27, 2025. The panel consisted entirely of 8 new members appointed by Kennedy after he fired all 17 former members of the panel in June due to concerns around members having conflicts of interest.¹

In recent years, the politicization of vaccines has made it more challenging to protect the public on a large scale. Many people view the influenza vaccine with increased suspicion after the COVID-19 pandemic.

“[The panel] recommended that everyone should receive an influenza vaccine that’s presented as a single dose, not from a multidose vial, because the multidose vial contains the preservative thimerosal,” Schaffner said. “They had concerns about potential adverse events associated with thimerosal, which is very much disputed by the scientific evidence.”

According to Schaffner, multidose vials account for about 5% of the world’s influenza vaccines. Whether this will significantly affect health organizations, manufacturers, and vaccine availability remains to be seen.

“By June, virtually all medical locations that give the flu vaccine have already ordered their vaccines: how much they want and how they want it for the upcoming season,” Schaffner said. “There will be some circumstances in which, if organizations are vaccinating a lot of people very rapidly, multidose vials are easier to administer and are less expensive; for example, in nursing homes.”

“So, in certain circumstances, people will have to look at their budgets again to make a change, if that’s what they intend to do. We’ll see what the impact of this is. I suspect the effect will be a little less immediate but more of an impact long-term,” he said.

At a March 2025 meeting earlier this year, the FDA recommended similar compositions for 2025-2026 trivalent influenza vaccines, with 1 change to one of the strains.²

“The flu vaccine this year for 2025-2026 is very similar to the influenza vaccine that was available for the 2024-2025 season,” Schaffner said. “They’ve made only 1 change in one of the viral strains, and that’s the H3N2 strain, but other than that, there are no major changes to the flu vaccine.”

“Because young people have stronger immune systems, the vaccine always protects younger people better than it protects older and frail people. Unfortunately, those are the people we would like to protect best, but that’s just the way the flu vaccine is,” Schaffner said. “That’s also why the CDC’s advisory committee recommends that older people receive one of the 3 types of enhanced flu vaccines: high dose, adjuvanted, or recombinant.”

“In people 65 [years] and older who receive an influenza vaccine, more than 70% of them are getting one of these enhanced vaccines, so the message is getting through to both practitioners and to patients,” Schaffner said.

Schaffner noted that it remains to be seen whether the ACIP will have the trust of the general medical community due to the sudden removal and lack of information regarding this switch.

“They’ve already made changes to vaccine recommendations that have not been endorsed by professional societies. One example I can give is the Secretary of Health and Human Services, a few weeks ago, sent out a notice on X [formerly Twitter] that pregnant women should not be routinely recommended to receive the COVID[-19] vaccine. That was a different recommendation than ACIP had, and furthermore, the American College of Obstetricians and Gynecologists and the midwives’ associations have actually spoken against that. They are continuing to recommend routine COVID[-19] vaccines for pregnant women.”

Schaffner said that there are myriad reasons for giving the COVID-19 vaccine to pregnant individuals, including protecting against COVID-19 infections in the latter half of pregnancy, which increase the risk of adverse events due to infection, including premature birth and miscarriage. In addition, babies have rates of hospitalization for COVID-19 that are equivalent to the rates of people aged 65 to 70 years.

“Who would have thought that very young babies have hospitalization rates of COVID[-19] that rival those of [older adults]?” Schaffner said. “But it happens to be true. So, protecting the baby during those first 6 months of life by vaccinating the parent, so the antibodies are transferred throughthe placenta to the baby is a really good idea.”

“We’re working to restore trust,” Schaffner said. “What we need to do is get more and more people to accept the flu vaccine. There’s no reason at the present moment to anticipate that the season is going to be any worse this year, but the flu season last year in 2024-2025 was the worst influenza season we have seen in a good 10 to 12 years, and that was unanticipated.”

If patients raise concerns about the safety of the flu vaccine itself, Schaffner offers advice for medical professionals on how to respond.

“Make [patients] feel acknowledged and make them feel comfortable. Say, ‘Thank you for bringing it up. I get questions like this all the time. What’s your concern?’ If the patient expresses a safety concern about the flu vaccine, I tell patients, ‘You cannot get the flu from the vaccine. That’s an old fairy tale. We give millions of doses of this vaccine every year, not only in the United States but around the world. It’s a remarkably well-studied vaccine,” Schaffner said.

What we need to do is get more and more people to accept the flu vaccine —William Schaffner, MD

Pharmacies play a significant role in influenza vaccination. Schaffner noted how much more convenient it can be for the public to get vaccinated at a pharmacy. “I’m a big advocate of pharmacists being part of the, as we call it, ‘immunization neighborhood.’ They play a terrific role.”

Schaffner noted that if he could tell the public one thing about flu vaccines, it would be to get vaccinated because the flu should not be underestimated.

“Even calling influenza ‘the flu’ can raise challenges. Familiarity breeds, if not contempt, then indifference. Many people kind of brush off the flu, but they should not. Influenza is a fierce virus. It can take even healthy people and put them in the emergency room in 24 to 48 hours. But vaccination will help prevent people who get infected with influenza from developing more severe disease,” Schaffner said. “I had a patient complain to me, ‘Doctor! You gave me the flu shot, and I still got the flu!’ And I smiled and told him, ‘I’m so glad you’re here to complain about it!’ And we had a laugh. The point is, even if a vaccinated patient gets the flu, the vaccine often prevents them from being hospitalized or even from death."

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REFERENCES

1. Glenza J. RFK Jr’s new vaccine panel votes against preservative in flu shots in shock move. The Guardian. June 26, 2025. Accessed July 7, 2025. https://www.theguardian.com/us-news/2025/jun/26/rfk-flu-shotvaccines-panel

2. Influenza vaccine composition for the 2025-2026 U.S. influenza season. FDA. March 13, 2025. AccessedJuly 7, 2025. https://www.fda.gov/vaccines-blood-biologics/influenza-vaccine-composition-2025-2026-usinfluenza-season