Annual vaccination in the US against influenza A and B viruses is recommended for everyone ≥6 months old without a contraindication. Influenza vaccines available in the US for the 2024-2025 season are listed in Table 2.

The US Food and Drug Administration (FDA) recently approved HibTITER (Lederle-Praxis) and PedvaxHIB (Merck), two new Haemophilus influenzae type b conjugate vaccines, for use in infants as part of their primary immunization schedule.

FluMist (MedImmune), the first live-attenuated and first intranasally administered influenza vaccine, has been approved by the FDA to prevent influenza in healthy people 5-49 years old. Given as a nasal spray, it stimulates immunity by viral replication in the upper respiratory tract. This vaccine apparently will be advertised directly to the public as a "needle-free" alternative to intramuscular influenza vaccine.

FluMist (AstraZeneca), the live-attenuated intranasal influenza vaccine that has been available for years for administration by a healthcare provider in nonpregnant persons 2-49 years old, has now been approved by the FDA for self- or caregiver-administration. It is expected to be available for such use during the 2025-2026 influenza season. FluMist is only available through a healthcare provider this season. It will continue to be available for administration by a healthcare provider in the future

Two new trivalent influenza vaccines, Flucelvax (Novartis) and Flublok (Protein Sciences), will soon be available for prevention of seasonal influenza in adults ≥18 years old (Flucelvax) and 18-49 years old (Flublok). Unlike other available influenza vaccines, neither vaccine is produced in eggs, removing any concern regarding use in egg-allergic patients. Avoiding the use of eggs should allow for faster production of these 2 new vaccines, which could be especially beneficial during a pandemic.Flucelvax is prepared in a similar manner to other influenza vaccines, but the influenza virus is...

Addendum: FluMist Storage: The storage requirements for FluMist, the intranasal live-attenuated influenza vaccine (Medical Letter 2003; 45:65) have changed. New data have shown that frost-free freezers are appropriate for storage for at least 3 months, without need for a freezer-box insert.

The FDA has approved Fluad (Seqirus), an adjuvanted trivalent seasonal influenza vaccine, for immunization of adults ≥65 years old. It will become available later this year for use during the 2016-2017 influenza season. Fluad is the second influenza vaccine to be approved in the US specifically for older adults; Fluzone High-Dose was the first. Fluad has been available in other countries for many years.

The FDA has licensed 4 new monovalent vaccines for prevention of respiratory illness caused by a new influenza A H1N1 virus that appears to be derived from a swine strain. The 5th vaccine should be licensed soon. All of these vaccines are expected to become available in October. An intranasal formulation is expected in the first week of October.

Live-attenuated vaccines are generally contraindicated during pregnancy; inactivated vaccines can be given if indicated. A more detailed review of routine immunizations for adults will be available in the December issue of Treatment Guidelines from The Medical Letter.

A new Haemophilus influenzae type b capsular polysaccharide vaccine conjugated with diphtheria toxoid (ProHIBiT - Connaught) was recently marketed in the USA. It is being promoted as a replacement for older, unconjugated H. influenzae vaccines (b- Capsa I; Hibimune; HibVAX) previously reviewed in The Medical Letter (Volume 27, page 61, 1985).