Flu vaccines 2025 to 2026: JCVI advice

The Joint Committee on Vaccination and Immunisation (JCVI) reviewed the latest UK influenza surveillance vaccine effectiveness data for the 2023 to 2024 season at the 5 June 2024 JCVI meeting. Vaccine effectiveness against hospitalisation is important for determining vaccines for use in the programme. 

The 2023 to 2024 influenza season was the second season since:

• the COVID-19 pandemic with widespread transmission
• the introduction of the requirement that laboratories report negative influenza results

This improvement in UK hospital surveillance has supported informative comparison between vaccine types. As seen in the 2022 to 2023 season, 2023 to 2024 preliminary data in older adults in England showed a higher central estimate of vaccine effectiveness against hospitalisation for the inactivated recombinant influenza vaccine (IIVr), compared with other first or second line vaccines. There was also a negative central estimate of vaccine effectiveness for the inactivated influenza egg-culture vaccine (IIVe). It was noted that confidence intervals for IIVr overlapped with the point estimates for adjuvanted inactivated influenza vaccine (aIIV) and inactivated influenza cell-culture vaccine (IIVc). In a meta-analysis of the last 2 seasons’ data there was less overlap of confidence intervals, strengthening the evidence of a higher vaccine effectiveness with IIVr compared with aIIV. The low IIVe vaccine effectiveness estimate reinforces the current JCVI advice not to use this vaccine for older adults (65 years of age and over).

JCVI would like to see more use of IIVr in the programme to improve estimates of vaccine effectiveness and have data over multiple seasons on the performance of this vaccine, especially in older adults where there is strengthening evidence of additional benefit relative to other products. In those groups where the use of IIVe remains an option, this should only be in circumstances where the preferred first line influenza vaccines are not available and efforts should be made to use the best available influenza vaccines, particularly in at-risk groups.