This memo is to inform North Carolina Immunization Program (NCIP) providers of the availability of influenza vaccine and the ordering process for the 2025-2026 respiratory season. Please take time to carefully review this memo in full.
Flu vaccine supplied by the NCIP is available only for children 6 months through 18 years of age who are Vaccines for Children (VFC) eligible and served by a VFC provider location. Certain adult populations may be eligible for flu vaccines as outlined in the NCIP Coverage Criteria (to be updated with the 2025-2026 recommendations). More information about the seasonal flu vaccines is available from the CDC.
Receiving a seasonal flu vaccine each year remains the best way to protect against potentially severe effects of influenza. This year, increasing flu vaccination coverage is critical. While flu vaccines may not prevent influenza disease, they will reduce the burden of flu illnesses, hospitalizations, and deaths. More information is available from the CDC.
Updated 2025-2026 Flu Vaccine Recommendations
The 2025-2026 CDC Flu Vaccination Recommendations were updated and adopted on June 22, 2025. CDC recommends everyone 6 months of age and older, with rare exceptions, receive an updated 2025-2026 flu vaccine to reduce the risk of influenza and its potentially serious complications this fall and winter. CDC encourages providers to begin their influenza vaccination planning efforts now. The “Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2025-26 Influenza Season” has not yet been published but is forthcoming on CDC’s Influenza ACIP Vaccine Recommendations website.
Note: Due to recent ACIP recommendations, multi-dose vial flu products will not be available this season through the VFC Program.
Administration Best Practices
September and October are the best times for most people to receive a flu vaccine. Flu vaccination in July and August is not typically recommended, but there are several considerations regarding vaccination in July and August for specific groups of people, especially children and pregnant women in their third trimester.
Available Vaccines and Anticipated Shipping Timeline
- During the 2025-2026 flu season, the NCIP will supply several brands of flu vaccine in various presentations, all of which will be trivalent and will protect against H1N1, H3N2 and one influenza type B virus.
- For 2025-2026, providers may receive shipments that include both flu and non-flu vaccines.
- CDC’s centralized distribution process involves several steps not included in the delivery of private-ordered flu vaccine, which often results in privately ordered vaccine arriving before state vaccine.
- CDC is allowing one-directional vaccine borrowing for flu vaccine this season. This means private vaccine may be used to vaccinate VFC eligible patients and later replaced with VFC vaccine once available. This one-directional borrowing is unique to seasonal influenza vaccine and can be used as a mitigating strategy if private flu stock is received earlier than your VFC doses. A Vaccine Borrowing Report (PDF) must be completed when a privately purchased vaccine is administered to a VFC-eligible child.
How to Order Flu Vaccine
Ordering for flu vaccines for the 2025-2026 season will begin on Monday, August 11th. Providers should ensure orders are sufficient to meet the needs of VFC patients and ensure their ability to store the vaccines safely. Consider a vaccine ordering plan that allows for the use of smaller amounts in combination with different products and presentations early in the season until more vaccine becomes available.
- Place vaccine orders directly through the North Carolina Immunization Registry (NCIR).
- Order throughout the flu season to replenish supply, as needed.
- Order adequate private stock vaccine for your patients who are not eligible for state-supplied/VFC doses whom you intend to vaccinate.
- Train provider staff to immediately notify the vaccine coordinator or back-up coordinator when deliveries arrive.
- Check and store vaccines properly upon arrival. Maintaining cold chain is the first step in vaccine inventory management.
Flu Vaccines Available for 2025-2026 Season
┼ Any uninsured pregnant persons, 19 years and older, being served by a Local Health Department (LHD), Rural Health Center (RHC), or Federally Qualified Health Centers (FQHC) in any capacity and persons of any age enrolled in the “Family Planning Medicaid Program” receiving services at LHDs, RHCs, or FQHCs are eligible to receive state-supplied flu vaccine. The vaccine brands that may be used for these populations are bold and marked with an * in the table above.
** Available as an acceptable option for 18-year-old VFC eligible solid organ transplant recipients who are receiving immunosuppressive medication regimens.
Click here to download the 2025-2026 Flu Vaccine Product Availability and Ordering Information Memo
How to Contact Us
For assistance, please contact the NCIR Help Desk by phone: 1.877.USE.NCIR (1-877-873-6247) or by email.
Thank you for your ongoing partnership and dedication to improving immunization outcomes in North Carolina.