What Nurses Should Know About Flu Season 2025

During the 2024-2025 flu season there was an estimated 47-82 million flu illnesses with a 27,000 to 130,000 flu related deaths according to the CDC. With the flu season underway, healthcare professionals and organizations are advising the public to get the flu vaccine. The flu season generally starts on October 1st so there is still plenty of time!

“The flu vaccine is one of our best defenses to prevent transmission of influenza this fall,” said ANA President Ernest J. Grant, Ph.D., RN, FAAN. “Getting the flu vaccine is especially critical for people with compromised immune systems, as the flu can lead to hospitalization and even death.

2025-2026 Available Flu Vaccines

There are numerous flu vaccines available to the general public, all of which are covered by private and public insurance. Those without insurance can often get a low-cost or even no-cost flu vaccine at major pharmacies. The availability of specific types will vary based on location and population needs. The CDC recommends that all individuals over 6 months of age receive their annual flu vaccine by the end of October. 

The four most common flu shots this year are:

• Standard dose flu shots. An inactivated influenza vaccine is given via intramuscular injection.
• High-dose shots for people 65 years and older.
• Shots that are made with the flu virus grown in cell culture. No eggs are involved in the production of this vaccine.
• Live attenuated influenza vaccine. A vaccine made with an attenuated live virus that is given by a nasal spray vaccine.

The CDC has a complete breakdown of all the flu vaccinations available in the United States for the 2025-2026 flu season.

According to the Food and Drug Administration (FDA), the trivalent formula for the egg-based influenza vaccine contains the following:

• an A/Victoria/4897/2022 (H1N1)pdm09-like virus
• an A/Croatia/10136RV/2023 (H3N2)-like virus
• a B/Austria/1359417/2021 (B/Victoria lineage)-like virus

According to the FDA, the trivalent formula for the cell or recombinant-based influenza vaccine contains the following:  

• an A/Wisconsin/67/2022 (H1N1)pdm09-like virus
• an A/District of Columbia/27/2023 (H3N2)-like virus
• a B/Austria/1359417/2021 (B/Victoria lineage)-like virus

Trivalent flu vaccines are formulated to protect against three main types of seasonal flu, including, 

• A(H1N1) virus
• A(H3N2) virus
• B/Victoria lineage virus

There are very few contraindications for the standard dose flu vaccine, but it is important to speak to your doctor if you have any questions.

The live attenuated nasal spray vaccine is contraindicated in the following populations according to the CDC:

• Adults age 50 or older
• Children 2 years through 17 years of age who are receiving aspirin- or salicylate-containing medications.
• Children 2 years through 4 years who have asthma or who have had a history of wheezing in the past 12 months.
• Children younger than 2
• People who are immunocompromised (ex. Cancer patients or individuals living with HIV/AIDS)
• People who care for severely immunocompromised persons who require a protected environment
• People who have taken influenza antiviral drugs within the previous 48 hours, such as Tamiflu.
• Pregnant women

The high-dose flu vaccine is specifically designed for people 65 years and older, as it is intended to give older individuals a better immune response, which will give better protection against the flu. The vaccine contains four times the antigen of a standard-dose flu vaccine.

Switch from Quadrivalent to Trivalent

A major difference that some might notice is the move from the quadrivalent vaccine to the trivalent. This change occurred during the 2024-2025 flu season and was in part due to historical research of flu infections, but also projected data for the upcoming season. To provide context, the U.S. transitioned to the quadrivalent flu vaccine during the 2013-2014 flu season to incorporate a second Flu B virus because, at the time, both Flu B viruses were seen, and the research showed that there was little cross-protection between the two lineages. 

The two B virus lineages found in the quadrivalent were, 

• B/Yamagata lineage
• B/Victoria lineage

The World Health Organization (WHO) and FDA's Vaccines and Related Biological Products Advisory Committee (VRBPAC) found that influenza B/Yamagata lineage had not been seen in patients after March 2020, and the recommendation was made to remove this lineage from all future flu vaccines. 

FluMist Self Administration

Another exciting change for the 2025-2026 flu season is at-home administration of FluMist nasal spray. The FluMist Home Program allows for eligible individuals to self-administer or administer to another individual (with training) the vaccine. The plan was proposed last flu season, but didn't take effect until this year. 

While relatively new, the program is available in 34 states, with plans to add more in the coming years. Adults must order the vaccine via the FluMist website after answering a medical screening questionnaire and paying for shipping. The order is reviewed by a pharmacist, and if approved, the vaccine is delivered to your door. 

FluMist is still available at doctors' offices or retail pharmacies for those who do not qualify for the program or do not want to self-administer. 

🤔Nurses, share your thoughts in the discussion forum below!