Do European and Japanese health guidelines recommend annual influenza (flu) and Covid-19 vaccinations, including boosters, for adults?

Annual Influenza and COVID-19 Vaccination Recommendations in Europe and Japan for Adults

Both Europe and Japan recommend annual influenza vaccination for adults, while COVID-19 vaccination recommendations have evolved to include periodic boosters, though specific schedules vary by country and risk group. 1

Influenza Vaccination Recommendations

• Annual influenza vaccination is recommended for all adults in the United States, Europe, and Japan, with particular emphasis on those aged ≥65 years and those with high-risk conditions 1
• In the United States, the Advisory Committee on Immunization Practices (ACIP) specifically recommends that adults aged ≥65 years should preferentially receive one of the following: quadrivalent high-dose inactivated influenza vaccine, quadrivalent recombinant influenza vaccine, or quadrivalent adjuvanted inactivated influenza vaccine 1
• Influenza vaccination coverage remains suboptimal globally, with only about 45.4% of adults aged 18-64 years with high-risk conditions receiving the vaccine, despite higher risk of complications 2
• Annual influenza vaccination is particularly important during the ongoing COVID-19 pandemic to reduce the potential strain on healthcare systems 3

COVID-19 Vaccination Recommendations

• COVID-19 vaccination is now routinely recommended for all adults in the United States, Europe, and Japan 1
• The 2023 ACIP recommendations include a primary series (2-3 doses) plus boosters for all adults, with specific guidance for immunocompromised individuals 1
• For the general adult population, the primary COVID-19 vaccination series consists of 2 doses, while those who are moderately or severely immunocompromised may require 3 doses 1
• Booster recommendations continue to evolve based on emerging variants and evidence of waning immunity 1
• The National Comprehensive Cancer Network (NCCN) specifically recommends that all persons with cancer or who have been previously treated for cancer should receive COVID-19 vaccination 1

Special Considerations for High-Risk Groups

• Adults with chronic medical conditions (heart disease, lung disease, diabetes, etc.) are at higher risk for complications from both influenza and COVID-19 and should prioritize annual vaccination 1, 2
• For immunocompromised individuals, including cancer patients, specific COVID-19 vaccination schedules may differ, often requiring additional doses 1
• The American Society of Clinical Oncology (ASCO) recommends that adults with cancer receive annual influenza vaccination and follow the latest CDC schedule for COVID-19 vaccination for immunocompromised individuals 1
• Healthcare personnel are specifically recommended to receive both annual influenza vaccination and COVID-19 vaccination/boosters to protect both themselves and vulnerable patients 1

Implementation Challenges and Considerations

• Despite recommendations, vaccination coverage remains suboptimal, with only about 34.7% of adults receiving influenza vaccines and 17.9% receiving COVID-19 vaccines during the 2024-25 respiratory virus season in the United States 4
• There are ongoing debates about the evidence base for annual vaccination strategies, particularly regarding the need for better clinical outcome data rather than relying primarily on antibody levels 5
• COVID-19 has demonstrated significantly greater severity of illness compared to influenza, highlighting the importance of vaccination against both viruses 6
• Vaccine hesitancy remains a challenge, though surveys indicate approximately 35-41% of adults report they definitely or probably will receive or are considering receiving influenza and COVID-19 vaccines 4

Practical Guidance for Healthcare Providers

• Healthcare providers should assess vaccination status during fall and winter visits and strongly recommend vaccination to people with high-risk conditions 2
• Co-administration of influenza and COVID-19 vaccines is acceptable per CDC guidelines when given on separate days with no recommended waiting period 1
• For adults aged ≥65 years, specific high-dose or adjuvanted influenza vaccines are preferred to provide enhanced protection 1
• Healthcare systems should implement strategies to identify undervaccinated populations and expand outreach activities to increase coverage before peak respiratory virus season 4