Expert Q&A: Pharmacist Outlines Influenza Vaccine Selection and Timing Considerations for 2026-2027

In an interview with Pharmacy Times, Adam James, PharmD, a pharmacist who manages clinical immunization and travel health programs, discussed key considerations for influenza vaccine selection and timing for the 2026-2027 season. James explained that while most flu vaccine products are equally effective for the general population, age is the primary factor guiding selection, with adjuvanted and high-dose options available for adults 65 and older and nasal formulations available for younger patients who prefer to avoid a needle. He noted that September and October remain the ideal vaccination window, with earlier vaccination reserved for patients facing transportation barriers, children beginning a 2-dose series, or pregnant individuals in their third trimester. James emphasized that vaccination remains just as effective later in the season, which can extend into April, and urged patients to get protected given the severity of influenza illness.

Pharmacy Times: Can you please introduce yourself?

Adam James, PharmD: My name is Adam James. I am a pharmacist by trade, but more recently, I manage clinical programs, specifically immunization and travel health programs, to support our preventative medicine and communities with those.

Pharmacy Times: What patient-specific factors should guide pharmacists in selecting the right influenza vaccine for the 2026-2027 season?

James: The number one factor that pharmacists should consider is age. For the most part, our flu shot selection is going to be arbitrary. You could pick any of our products that are going to be equally effective for most patients. But for those individuals 65 and older, those who are immunocompromised, or those that don't prefer a needle, there are ages that restrict those. [For] 65 and older, we do have the adjuvanted and high-dose options, and for those who don't prefer a needle, we have nasal formulations, but only for ages 2 to 50. So, those considerations need to be made for age.

Pharmacy Times: What should pharmacists know about optimal timing for influenza vaccination this season?

James: The optimal timing is now. In general, we tell individuals, and this correlates with everything from our trusted professional organizations, the CDC and AAP, that we want [vaccination] between September and October. In general, we want to avoid earlier vaccination unless there's a transportation barrier where the patient may have trouble getting back, it's a child who's starting a two-dose series, or it's a pregnant person who may need to get their vaccine in the third trimester, and that would pass by the time September or October occurred.

Now, the one thing I do like to call out is that although we say ideal timing is September or October, that doesn't mean that past those times it becomes less effective. It's still just as effective. Flu season continues the whole way through, normally to February or March, even into April in some seasons. So, even if you miss that September-October timeline, you should still get one later in the season.

Pharmacy Times: Is there anything you would like to add?

James: I think it's just important to get protected and prevent illness. You think, "Oh, I've been sick before," but the flu is a whole different type of illness. I know I thought I had the flu a few times, and then you get the flu, and you realize how severe it can be. It knocks you off your feet. You don't get out of bed. So, that time away from family, work, and all those types of things—just avoid it and get protected.