Ask the Experts: Influenza Vaccines

Please summarize what's new in the 2021–22 influenza vaccine recommendations?
Yearly influenza vaccination continues to be recommended for everyone age 6 months and older. All available influenza vaccines in the United States are now quadrivalent (containing two influenza A and two influenza B strains). The 2021–22 vaccines have been updated to include new influenza A (H3N2) and influenza A (H1N1) virus vaccine antigens. One vaccine product, Flucelvax Quadrivalent (ccIIV4, Seqirus) is now FDA-approved for children age 2 years and older (formerly approved for children age 4 years and older).
In addition, the 2021–22 recommendations discuss considerations for co-administration of influenza vaccine with a COVID-19 vaccine. Influenza vaccines and other vaccines may be administered at the same time as a COVID-19 vaccine. Guidance on COVID-19 vaccination, including coadministration with other vaccines, is available here: http://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html. If administered simultaneously, COVID-19 vaccines and influenza vaccines that might be more likely to cause a local reaction [e.g., adjuvanted inactivated influenza vaccine (aIIV4, Fluad Quadrivalent, Seqirus) or high-dose inactivated vaccine (HD-IIV4 Fluzone High-Dose Quadrivalent (Sanofi Pasteur)] should be administered in different limbs, if possible].
CDC also now recommends that providers consider influenza vaccination of pregnant people in their third trimester as soon as vaccine is available. CDC continues to recommend that children not previously vaccinated who need two doses of influenza receive their first dose as soon as possible so that they can get their second dose before the end of October. The two doses should be separated by at least 4 weeks. For non-pregnant adults, CDC continues to recommend avoiding influenza vaccination in July and August unless there is a concern that later vaccination may not be possible.
Lastly, CDC revised guidance for the contraindications and precautions for the use of Flucelvax Quadrivalent (ccIIV4) and Flublok Quadrivalent (RIV4, Sanofi Pasteur) among people with a history of a severe allergic reaction to an influenza vaccine. For ccIIV4, a history of a severe allergic reaction to a prior dose of any egg-based IIV, live attenuated vaccine (LAIV), or RIV is a precaution. For RIV4, a history of a severe allergic reaction to IIV, LAIV, or ccIIV4 is a precaution. People with precautions for receiving ccIIV4 and RIV4 should be vaccinated in a medical setting under supervision of a provider who can recognize and manage severe allergic reactions. RIV4 continues to be contraindicated for people with a prior allergic reaction to any RIV vaccine components. Similarly, ccIIV4 is contraindicated for people with a prior allergic reaction to any ccIIV components.