Independent report

JCVI statement on influenza vaccines for 2027 to 2028

Published 16 July 2026

Introduction

The Joint Committee on Vaccination and Immunisation (JCVI) reviewed the latest UK influenza immunisation programme data - including uptake, epidemiology and vaccine effectiveness - for the 2025 to 2026 season at the JCVI meeting on 4 June 2026. This followed a JCVI influenza sub-committee meeting on 30 May 2026, where new products currently under or nearing regulatory review were considered.

The 2025 to 2026 influenza season was characterised by an unusually early onset of activity starting in the second half of October 2025 in children and young adults with rising influenza A(H3N2) activity. Influenza activity peaked around the second week of December 2025 and declined thereafter, returning early to baseline activity levels. The 2025 to 2026 season was dominated by a drifted influenza A(H3N2) strain (subclade K (J.2.4.1)) compared with the World Health Organization (WHO) designated vaccine strain.

The schools’ vaccine programme, which started in September 2025, had its strongest start on record which helped to reduce influenza transmission to the wider population including adults (Sinnathamby, 2023; Kassianos, 2020; and Pebody 2015). The move to start the adult vaccine programme (except for pregnant women) in October 2025 (JCVI advice 2023), concentrated protection around the early peak of the infection wave. Vaccine coverage in adults and children was overall similar to the 2024 to 2025 season.

Despite the circulation of the drifted A(H3N2) sub clade K, the vaccines used in the programme retained meaningful effectiveness across age groups and offered protection in both primary and secondary care settings. Vaccine effectiveness was higher in children compared with that in adults where the impact of the drifted strain on vaccine effectiveness was greater. Overall burden, including mortality, was lower in 2025 to 2026 than in recent seasons. For comparison, the estimated number of influenza-attributable excess deaths was:

• 3,798 in 2025 to 2026
• 9,740 in 2024 to 2025
• 4,431 in 2023 to 2024
• 14,378 in 2022 to 2023

New vaccine products

In May 2026, the influenza sub-committee reviewed 2 new products currently under or nearing regulatory review, and considered whether, subject to licensure, these products could be incorporated into the UK influenza programme:

• a trivalent, adjuvanted inactivated cell-cultured influenza vaccine (aIIVc) from CSL Seqirus
• a quadrivalent mRNA influenza vaccine from Moderna (mRNA-1010)

The sub-committee advised JCVI that, pending licensure, the aIIVc vaccine was suitable for use in the UK programme. The Medicines and Healthcare products Regulatory Agency (MHRA) granted a marketing authorisation for aIIVc (Aujemflu) on 4 June 2026 to protect adults aged 50 and over against influenza.

JCVI agreed that the aIIVc vaccine should be included in advice for the 2027 to 2028 season. This would provide an opportunity for comparative evaluation in the UK programme.

JCVI noted that the availability of the mRNA-1010 vaccine was unlikely to be an option for procurement in the 2027 to 2028 season and would be considered in advice for future seasons, subject to market authorisation and availability.

The advice below represents JCVI’s scientific view on the use of influenza vaccines in the UK for the 2027 to 2028 influenza season.

Summary of influenza vaccines for 2027 to 2028

Age or risk group	Vaccine preference	If the preferred vaccine is unavailable
Aged 65 years and over	aIIV, aIIVc, IIVc, IIV-HD or IIVr	Not applicable
Aged 18 to 64 years in a clinical risk group (including pregnant women)	IIVc, IIVr or aIIV, aIIVc or IIV-HD in those aged 50 to 64 years	IIVe
Aged 2 to under 18 years	LAIV	IIVc
Aged 2 to under 18 years but unable to have LAIV	IIVc	IIVe
Aged 6 months to under 2 years in a clinical risk group	IIVc	IIVe

Note 1: IIV-HD is licensed from the age of 60 years but can be given off-label in those aged 50 to 59 years.

Note 2: LAIV is the vaccine of choice for children aged 2 to 17 years.

Advice on influenza vaccination in 2027 to 2028

Adults aged 65 years and over

For vaccination of those aged 65 years and over, JCVI advises the use of the following vaccines as preferred in this age group:

• adjuvanted inactivated cell-cultured influenza vaccine (aIIVc)
• adjuvanted inactivated influenza vaccine (aIIV)
• inactivated influenza cell-cultured vaccine (IIVc)
• high-dose inactivated influenza vaccine (IIV-HD)
• recombinant inactivated influenza vaccine (IIVr)

The inactivated influenza egg-cultured vaccine (IIVe) is not advised for use in this age group.

Considerations

The available evidence indicates additional benefit from the use of aIIV, IIVc, IIV-HD and IIVr in those aged 65 years and over, compared with standard dose IIVe.

Relevant comparative data on aIIV, IIVc, IIV-HD and IIVr is limited. The level of uncertainty in the available evidence, including lack of head-to-head studies, is considered too great to allow for a preferential recommendation between these 4 vaccines at the current time.

Based on immunogenicity data, JCVI advises that aIIVc should be included in the advice for 2027 to 2028.

JCVI strongly advises against the use of IIVe in adults over 65 years of age.

At-risk adults aged 18 to 64 years (including pregnant women)

For vaccination of adults aged 18 to 64 years in a clinical risk group, JCVI advises the use of the following influenza vaccines as preferred in this age group:

• inactivated influenza cell-cultured vaccine (IIVc)
• inactivated recombinant influenza vaccine (IIVr)
• adjuvanted inactivated influenza vaccine (aIIV) and adjuvanted inactivated cell-cultured influenza vaccine (aIIVc) are both licensed from the age of 50 years and can also be considered for use in those aged 50 to 64 years alongside the above
• high-dose inactivated influenza vaccine (IIV-HD) is licensed from the age of 60 years but can be given off-label in those aged 50 to 59 years following JCVI advice in October 2025, to harmonise the age thresholds for available vaccines (aIIV, aIIVc and IIV-HD). Therefore, IIV-HD can also be considered for use in those aged 50 to 64 years alongside the above

Inactivated influenza egg-cultured vaccine (IIVe) can be considered for use in this age group if all other options are unavailable.

Considerations

There is a potential advantage to using influenza vaccines which do not use eggs in the manufacturing process (cell-cultured or recombinant) compared with egg-cultured influenza vaccines, due to the possible impact of ‘egg adaptation’ on the effectiveness of influenza vaccines, particularly against A(H3N2) strains. The evidence on additional benefit is available for only a few seasons but the issue of egg adaptation remains a real concern for the A(H3N2) virus, which is a more virulent influenza subtype in terms of morbidity and mortality.

There is growing evidence from the UK programme that IIVr is more effective than IIVe in adults under 65 years age.  Based on the available evidence, JCVI supports a clear preference for IIVc and IIVr, over IIVe, and these are the vaccines of choice for this vulnerable group. aIIVc, aIIV and IIV-HD can also be considered for use as a preferred option alongside IIVc and IIVr in those aged 50 to 64 years.

If all other options are unavailable, IIVe can be considered for use in this group, recognising that any impact from egg adaptation will likely be more prominent in influenza seasons dominated by A(H3N2) strains.

Children aged 2 to less than 18 years of age

For vaccination of children aged 2 to less than 18 years of age, JCVI advises the use of the following influenza vaccine as preferred: 

• live attenuated influenza vaccine (LAIV)

Inactivated influenza cell-cultured vaccine (IIVc) is preferred for use when LAIV is medically contraindicated or otherwise unsuitable.

Inactivated influenza egg-cultured vaccine (IIVe) can be considered for use in this age group if all other options are unavailable.

Considerations

LAIV was first advised for use in the children’s programme in 2012 and remains the vaccine of choice given its acceptability and ease of administration, good safety profile and evidence of effectiveness, particularly against influenza A(H3N2) and influenza B.

Studies on the use of LAIV have indicated that vaccination of primary school children is associated with both protection in the children receiving the vaccine and in older adults who are indirectly protected through reductions in influenza transmission (Sinnathamby, 2023; Kassianos, 2020; and Pebody 2015).

Based on UK Health Security Agency (UKHSA) data on the last 4 influenza seasons, LAIV was noted to have a higher effectiveness against hospitalisation in A(H3N2) dominant seasons but lower effectiveness in A(H1N1)pdm09 dominant seasons. IIVc performed relatively better in A(H1N1)pdmo9 seasons compared with LAIV in previous years but not significantly so. Point estimates for LAIV vaccine effectiveness against A(H3N2) were frequently higher compared with IIVc. In the 2025 to 2026 influenza season, vaccine effectiveness against hospitalisation associated with the drifted A(H3N2) strain was significantly higher for LAIV compared with IIVc.  

The committee notes that, while the lower effectiveness of LAIV in A(H1N1)pdm09 seasons remains under investigation, LAIV should be retained in the programme as an effective vaccine that is preventing hospitalisations in children.

At-risk children less than 2 years of age

For vaccination of children less than 2 years of age in a clinical risk group, JCVI advises the use of the inactivated influenza cell-cultured vaccine (IIVc).

The inactivated influenza egg-cultured vaccine (IIVe) can also be considered for use in this age group, if all other options are unavailable.

LAIV is not licensed for use in children less than 24 months of age.

Generating real-world evidence in the UK

Further comparative data is required, preferably from the same country over multiple seasons and with laboratory-confirmed influenza endpoints, to support consideration of the relative effectiveness of the influenza vaccines available in the UK across the different age and risk groups in which they are licensed. JCVI would like to see high-quality comparative data generated in the UK. Most of this data can potentially be generated from the monitoring and surveillance of vaccine effectiveness in primary and secondary care for those influenza vaccines delivered through the influenza vaccination programme.

Improvements in data systems have enabled better vaccine effectiveness estimates with hospitalisation as a clinical endpoint in the UK. It is also important to maximise influenza A subtyping to support vaccine effectiveness evaluations. This data is important to inform future JCVI decisions which will benefit public health in the longer term and should form part of the longer-term planning for a first-class influenza programme as a whole.

Other research initiatives could also contribute to improving the evaluation of influenza vaccines in the UK. JCVI supports initiatives involving close working of industry, regulators, government and public-funded research in this regard.

JCVI would like to see all the available vaccines, which it has advised in preference to standard egg-based vaccines, used in the UK so they can be rigorously evaluated through the programme but understands that this is subject to NHS negotiations.

Operational considerations

JCVI is mindful that factors other than purely scientific and clinical advice need to be considered from an operational perspective including supply availability and affordability. These factors will contribute to the decisions on which vaccines are purchased for the 2027 to 2028 season.

The aim of JCVI’s advice on the preferred vaccines for the influenza programme is to provide a framework from which NHS England, the devolved governments and UKHSA can:

• plan the ordering of vaccines and delivery of the influenza programme in 2027 to 2028
• communicate this clearly to providers and the public

A well planned and orchestrated programme that results in the timely delivery of vaccination is important to ensure the eligible population is protected as early as possible before influenza activity starts to increase in the winter months.

Background to the current vaccines in the programme

An influenza programme for children was advised by JCVI in 2012, with LAIV as the preferred vaccine. From the start of the 2023 season, IIVc became the preferred vaccine for children less than 2 years of age, following JCVI advice in October 2022.

Adjuvanted influenza vaccines were first advised for use in the UK programme in October 2017 and subsequently available in the 2018 to 2019 season.

In June and October 2018, JCVI discussed IIV-HD and IIVc, respectively. Both vaccines were advised for use in adults over 65 years of age in the 2019 to 2020 season. IIVc was also advised for use in adults aged under 65 years who are in clinical risk groups and children who could not receive LAIV.

In October 2020, IIVr was considered by JCVI to be an acceptable alternative to aIIV and IIV-HD, alongside IIVc in adults aged 65 years and over. It was also considered suitable for use in adults aged under 65 years who are in clinical risk groups.

In September 2021, JCVI revised the use of IIVr and advised that it could be considered equivalent to aIIV and IIV-HD in those aged 65 years and over.

In June 2025, JCVI advised that IIVc could be considered equivalent to aIIV, IIV-HD and IIVr in those aged 65 years and older.

In June 2026, JCVI advised that aIIVc can be included in the advice for the 2027 to 2028 season.

References

JCVI. Minutes of JCVI meetings available on the JCVI page.

Kassianos G and others. Implementation of the United Kingdom’s childhood influenza national vaccination programme: a review of clinical impact and lessons learned over six influenza seasons Vaccine 2020: volume 38, issue 36, pages 5,747 to 5,758.

Pebody RG and others. Uptake and impact of vaccinating school age children against influenza during a season with circulation of drifted influenza A and B strains, England, 2014/15 Euro Surveillance 2015, volume 20, issue 39.

Sinnathamby MA and others. An intercountry comparison of the impact of the paediatric live attenuated influenza vaccine (LAIV) programme across the UK and the Republic of Ireland (ROI), 2010 to 2017 Influenza and Other Respiratory Viruses 2023, volume 17, issue 2: e13099.

UKHSA. Influenza in the UK, annual epidemiological report: winter 2025 to 2026