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Finding Optimism in Seasonal Influenza Vaccines

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Released: September 02, 2026

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Seasonal influenza vaccination rates have decreased over the past few years, but I think there is cause for optimism. Now more than ever, the range of available flu vaccines enables people to make individualized choices that help protect themselves and their loved ones.

Paul G. Auwaerter
Paul G. Auwaerter, MD, MBA
Optimism in Flu Vaccines

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What has influenced seasonal influenza vaccine uptake in recent years?
First, since this vaccine has been around for a long time, I think people have become somewhat complacent about staying current on their seasonal flu vaccine every year.

Second, I think this complacency increased after the COVID-19 pandemic. It is as if people think influenza isn’t as serious as COVID-19, and we survived a pandemic, so how important could the flu be?

Finally, I think the number of vaccines that are recommended, including yearly boosters of the COVID-19 vaccine, has led to a bit of vaccine fatigue. Many people have perhaps decided, enough of vaccines, and wish to take a breather.

All these and other factors have led to a notable decline in routine influenza immunization. Yet I think there is still an important source of optimism: people who don’t see themselves as at risk for severe influenza disease, but choose to get vaccinated to protect those who are.

Finding Sources of Optimism
The people who are most at risk of severe influenza are older adults, the very young, anyone with serious comorbidities, including anyone with cardiovascular, pulmonary, liver, and renal disease, and anyone who is immunosuppressed. These populations are not only at increased risk of severe disease, but they often don't respond as well to vaccines. I think it is crucial to teach patients that despite limitations, receiving their annual flu vaccine helps to protect their loved ones who are part of these high-risk populations, whether they are a part of the household or just visiting.

Individualizing Influenza Vaccine Choices
Another cause for optimism is the sheer number of influenza vaccine options currently available. Now more than ever, the range of seasonal flu vaccines enables people to make individualized choices that help protect themselves and their loved ones.

Beyond the standard dose vaccine, there are adjuvanted and high-dose influenza vaccines, which offer people older than 65 years of age a better chance build robust immune responses to combat influenza infection.

The standard dose, adjuvanted, and high-dose vaccines are egg based, but there are also the cell culture–based and recombinant flu vaccines that do not use egg-grown virus.

In addition, there is a recombinant influenza vaccine that uses no inactivated or attenuated influenza viruses, only viral proteins, and contains a higher amount of antigen compared to the standard dose vaccine, making it another good choice for older adults.

There is also a new mRNA influenza vaccine that was released this year. Although this vaccine is still in its early days, the initial data suggest that it promotes substantially elevated antibody titers against the influenza virus to prevent infection, and it may have the added benefit of moderately improved T-cell responses to fight an infection should one occur. [link to mod 4 slides when posted]

Finally, there is the live attenuated vaccine, which is available as a nasal spray and can be self-administered, potentially improving uptake by eliminating the need to schedule and attend a vaccination appointment.

Ultimately, I am optimistic that the pushback against vaccines will wane over time, especially in the face of increasing rates of vaccine-preventable diseases in the United States. For example, I hope that our unfortunate substantial set of measles outbreaks in many parts of the country, after having been nearly eradicated for many years, reminds people that we cannot become complacent about vaccines and the diseases that they can safely prevent. If you're not actively trying to protect yourself and your loved ones, a serious vaccine-preventable illness could easily affect you or your family.

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