Know What’s Changed With Flu Immunization for 2022-2023

You’ll need to know what’s new with flu vaccines for 2022-2023.

All influenza vaccines will be quadrivalent again this season...with 1 updated A strain and 1 updated B strain.

Which flu vaccine is “best”? For patients age 65 and up, use a higher-dose or adjuvanted vaccine...Fluzone High-Dose, Flublok, or Fluad. It’s the first time CDC recommends these over standard-dose.

Mounting evidence suggests these vaccines are more effective than standard-dose for seniors...especially to reduce flu hospitalizations.

Use any of these vaccines you have in stock. Fluzone High-Dose has the most evidence, but the data often reflect just 1 or 2 seasons.

If these vaccines aren’t available, use standard-dose...don’t wait.

Be aware, some specialist groups now suggest a high-dose or adjuvanted flu vaccine for immunocompromised adults under 65. But there’s not yet evidence that these vaccines prevent more flu in these patients.

Continue to use ANY age-appropriate injectable flu vaccine for most patients under age 65. Or consider intranasal FluMist as an option for healthy, NONpregnant patients 2 through 49.

When is the right time to vaccinate? CDC recommends to start vaccinating most patients in September...not July or August, due to potential waning immunity before flu season ends.

But don’t give a flu “booster”...regardless of when patients get this year’s vaccine.

How effective are flu vaccines? Acknowledge that last year’s vaccines reduced flu cases by about 35%. Plus the season was mild.

But remind hesitant patients that each season is different.

Emphasize that even when a flu vaccine isn’t well matched to circulating strains, it still reduces risk of flu...and its severity.

Will there be a combo COVID-19/flu vaccine? Explain that studies are ongoing...but a combo won’t be available this fall.

Reinforce getting BOTH vaccines, if needed. And continue to give all other needed vaccines (pneumococcal, Tdap, etc) at the same visit.

Use our resource, Flu Vaccines for 2022-23, to find immunization guidance for kids, pregnant patients, and people with an egg allergy.

Key References

  • MMWR Morb Mortal Wkly Rep. 2022 Jul 22;71(29):913-919
  • https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2022-06-22-23/03-influenza-grohskopf-508.pdf (8-25-22)
  • https://www.cdc.gov/vaccines/acip/meetings/downloads/slides-2022-06-22-23/04-influenza-grohskopf-508.pdf (8-25-22)
Prescriber's Letter. September 2022, No. 380913



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