- Article
- Source: Campus Sanofi
- 24 Apr 2026
International Recommendations
Leading international health authorities and their affiliated medical associations now recommend age-appropriate influenza vaccination, reflecting a global consensus shaped by robust clinical evidence.
The better protection of HD over conventional SD influenza vaccines is acknowledged by more and more scientific societies
Adult Immunizations as Part of Cardiovascular Care: 2026 ACC Concise Clinical Guidance
The current recommendations for influenza vaccination of adults are as follows6:
- High-dose vaccine for adults aged ≥65 years. (Alternatives include recombinant or adjuvanted formulations.)
- Standard-dose vaccine for all adults aged 18 to 64 years.
An analysis of 2 large, randomized trials in adults aged >65 years found that high-dose influenza vaccine was associated with lower hospitalizations for respiratory disease, CVD, and HF compared with standard-dose vaccine. The relative risk reduction was similar among individuals with and without CVD; however, given the substantially higher baseline risk in those with CVD, the absolute benefit was greater in this group. In a trial reporting outcome by cardiac condition, individuals with HF had a number needed to treat of only 105 with high-dose vs standard-dose influenza vaccine to prevent a hospitalization.
France1,2
- Geriatrics scientific society (SFGG): recommends to use HD preferentially in ≥65 years given the « superior clinical efficacy demonstrated »
- 24 scientific societies qualified HD as “more efficacious to prevent influenza and its complications” in a press release calling for vaccination
Since
Feb 2021
Feb 2021
November
2023
2023
Spain3,4
-
Pneumologists association
(Neumo Experto en Prevención, NEP) - 8 scientific societies (AEV; AEP; SEMERGEN; SEMG; SEMPSPH; SPAR; SEC; SEGG)
June
2021
2021
October
2021
2021
Italy5,6
- Oncologists association (AIOM)
- Geriatrics scientific society (SIGG)
May
2023
2023
February
2024
2024
Czech Republic7
- Vaccinology Society
June
2023
2023
Portugal8,9
- 6 Medical Scientific Societies (Portuguese [PT] Society of Pulmonology, PT Society of Diabetology, PT Society of Cardiology, PT Society Geriatrics and Gerontology, Study Group of Geriatrics of the PT Society of Internal Medicine and PT Society of Infectious Diseases and Clinical Microbiology) published a position paper
- 3 Portuguese Public Health Societies (PT Public Health Society, National Association of Public Health Physicians and Portuguese Association for Public Health Promotion)
December
2023
2023
October
2024
2024
Poland10
- Scientific societies of Family Medicine, Cardiology, Gerontology, Vaccinology, and Diabetes
January
2024
2024
Romania11
- Romanian Society of Gerontology and Geriatrics: “HD influenza vaccine (60 mg hemagglutinin per strain) is preferentially recommended as the first-choice vaccine for all people ≥65 years of age”
June
2024
2024
Germany12
- Joint statement by the German Society of Cardiology – Cardiovascular Research and the German Diabetes Society: "annual vaccination of 60+ should be done with HD, or if unavailable with MF-59 adjuvanted vaccine"
September
2024
2024
Cut of date: May 2025
HD: high-dose; SD: standard-dose; SEGG: Spanish Society of Geriatrics and Gerontology; SFGG: Société Française de Gériatrie et Gérontologie. AIOM: Italian Association of Medical Oncology. References in slide notes.
- SFGG. Available at: https://sfgg.org/espace-presse/communiques-de-presse/grippe-la-communaute-geriatrique-appelle-a-vacciner-de-toute-urgence-les-personnes-agees-de-plus-de-65-ans/ (Accessed May 2025)
- COMMUNIQUÉ INTER STRUCTURES - Vaccinons maintenant contre la grippe et la COVID-19 ! - Société Française de Microbiologie (sfm-microbiologie.org) (Accessed May 2025)
- NEP. Available at: https://neumoexpertosdotorg.files.wordpress.com/2021/06/slidekit-neumoexpertos.pdf (Accessed May 2025)
- SEGG. Available at: https://www.segg.es/media/descargas/Libro_vacunas_antigripales.pdf (Accessed May 2025)
- AIOM. Available at https://www.aiom.it/2023-raccomandazioni-vaccinazione-anti-influenzale-anti-pneumococcica-e-anti-sars-cov-2-nei-pazienti-con-neoplasia-solida/ (Accessed May 2025)
- SIGG. Monography of the Italian Society of Geriatrics and Gerontology. Available at Il vaccino antinfluenzale.pdf (sigg.it) Il vaccino antinfluenzale.pdf (sigg.it)(Accessed May 2025)
- NH 2022-2023: https://www.vakcinace.eu/doporuceni-a-stanoviska/doporuceni-ceske-vakcinologicke-spolecnosti-cls-jep-k-ockovani-proti-chripce-3 (Accessed June 2025)
- Portugal. https://www.sciencedirect.com/science/article/pii/S2531043723002015 (Accessed May 2025)
- Portugal https://spsp.pt/noticias/declaracao-conjunta/ (Accessed May 2025)
- Poland reco: https://doi.org/10.5114/fmpcr.2024.134715 (Accessed May 2025)
- Romania: Rada GI, Băjenaru OL, Chelu GC, et al. J Med Life. 2024;17(7):746-754. doi: 10.25122/jml-2024-0274 (Accessed May 2025)
- Germany. https://www.ddg.info/politik/stellungnahmen/gemeinsame-stellungnahme-der-deutschen-gesellschaft-fuer-kardiologie-herz-und-kreislaufforschung-dgk-und-der-ddg-zur-mitteilung-der-staendigen-impfkommission-beim-robert-koch-institut-vom-27-september-2024 (Accessed June 2025)
Canada1
- Quebec Society of Geriatrics: strongly recommends that the CIQ (Quebec Immunization Committee) endorse the free use of the HD influenza vaccine for people aged ≥75 years
October
2022
2022
US2
- American College of Cardiology (ACC): "Not all flu vaccines are the same for people 65 and older. HD vaccines are better”
October
2024
2024
Argentina3,4
- Argentine Association of Respiratory Medicine (AAMR)
- Society of Infectious Disease (SADI)
December
2023
2023
April
2024
2024
Brazil5-9
- Immunization scientific society (SBIM), Cardiology society (DEIC), Society of Pulmonology and Tisiology (SBPT), Society of Clinical Oncology (SBOC): recommend to use HD as the vaccine of choice for older adults aged ≥60 years
- Society of Geriatry & Gerontology (SBGG): recommend to use HD as the vaccine of choice for most vulnerable population
March-
June 2023
June 2023
June
2024
2024
Malaysia10,11
- Malaysian Society of Infectious Diseases and Chemotherapy, and Malaysian Society of Geriatric Medicine: HD influenza vaccine is preferentially recommended for older persons
December
2022
2022
South Korea12
- Society of Infectious Disease (KSID)
August
2023
2023
Thailand13
- Collaboration between 7 medical associations and 1 royal college
March
2025
2025
Algeria14
- Algerian societies of Pneumology, Infectiology, Immunology and Clinical Microbiology: recommend HD over SD vaccine, as a better protection for the elderly population of 65 years of and older
April
2025
2025
Cut of date:
May 2025 AAMR: Argentine Association of Respiratory Medicine; ACC, American College of Cardiology; CIQ: Quebec Immunization Committee; HD: high-dose; KSID: Korean Society of Infectious Diseases; SBIM: Sociedade Brasileira de Imunizações; SD: standard-dose References in slide notes.
- Canada: https://www.sqgeriatrie.org/dl2.php?file=2022-11_immunisation_adulte_chez_la_personne_agee.pdf (Accessed May 2025)
- US: https://www.cardiosmart.org/assets/infographic/flu-vaccines-for-patients-over-65 (Accessed June 2025)
- AAMR. Luna CM, Pulido L, Rizzo O, et al. Medicina (B Aires). 2024;84(1):108-124. https://pubmed.ncbi.nlm.nih.gov/38271938/ (Accessed June 2025)
- SADI : https://sadi.org.ar/publicaciones/1760-recomendaciones-de-vacunacion-antigripal-en-adultos-y-ninos-actualizacion-2024 (Accessed June 2025)
- SBIM. https://sbim.org.br/calendarios-de-vacinacao (Accessed May 2025).
- SBPT. https://sbpt.org.br/portal/vacina-high-dose-influenza/ (Accessed May 2025)
- DEIC. Available at: https://www.deic.cardiol.br/post/vacina%C3%A7%C3%A3o-contra-a-gripe (Accessed Sept 2024)
- SBOC. Available at: https://app.sboc.org.br/wp-content/uploads/2022/09/Guia-de-Vacinao-no-Paciente-Oncolgico.pdf (Accessed June 2025)
- SBGG. Available at: https://sbgg.org.br/para-evitar-complicacoes-publico-idoso-deve-aderir-a-vacinacao-contra-a-influenza/ (Accessed June 2025)
- Malaysia: Tan MP, Sekawi Z, Abdul Manap R, et al. BMC Infect Dis. 2022;22(1):943.https://bmcinfectdis.biomedcentral.com/articles/10.1186/s12879-022-07920-3 (Accessed May 2025)
- Malaysia:https://storage.unitedwebnetwork.com/files/183/392a5baac7fb975ca8c179782cc44bbc.pdf (Accessed May 2025)
- KSID. https://www.ksid.or.kr/content/info/vaccine_rule.php (Accessed May 2025)
- Thailand: https://idthai.org/Contents/Views/?d=!17!9!!1046 (Accessed May 2025)
- Algeria: Avaialable at: https://sai-immuno.org/organization/sai-d6e71af74fe8fdeaa40184097391bc26/articles/optimisation-de-la-vaccination-antigrippale-chez-les-sujets-ages-apport-du-vaccin-haute-dose-face-aux-defis-de-limmunosenescence-1d3c138f86/show (Accessed May 2025)
MAT-KW-2600467/V1/Oct 2026