Influenza Vaccines for 2025–2026 in Adults Who Are Not Pregnant or Immunocompromised: Rapid Practice Points From the American College of Physicians

Description: The American College of Physicians (ACP) developed these rapid practice points addressing the comparative effectiveness and harms of trivalent (3 different influenza viruses or viral proteins) and quadrivalent (4 different influenza viruses or viral proteins) influenza vaccines in adults aged 18 years or older who are not pregnant or immunocompromised. These practice points do not address adults aged 18 years or older who are pregnant or immunocompromised. Methods: The ACP Population Health and Medical Science Committee (PHMSC) developed the rapid practice points on the basis of a rapid review by the ACP Center for Evidence Reviews at Cochrane Austria. The rapid review was a focused update of the 2024 comprehensive, high-quality systematic review and meta-analysis conducted by the European Centre for Disease Prevention and Control. The ACP PHMSC focused on the comparative effectiveness of influenza vaccines compared with each other because of the established efficacy and safety of the standard influenza vaccines. Practice Point 1: Adults aged 18 to 64 years who are not pregnant or immunocompromised should receive either a standard-dose trivalent or a standard-dose quadrivalent (cell-based, egg-based, MF59-adjuvanted, or recombinant) influenza vaccine for the 2025–2026 influenza season. Practice Point 2: Adults aged 65 years or older who are not immunocompromised should receive either a high-dose trivalent or a high-dose quadrivalent egg-based influenza vaccine for the 2025–2026 influenza season.