Firstly, flu vaccines will now be trivalent because as far as we can tell B/Yamagata is gone (RIP Yam). These are the strains to be included in the next season. Also safety monitoring on 158 million doses of flu vaccine showed no new issues.
Next is an update on flu vaccines for solid organ transplant (SOT) recipients. SOT involves substantial immunosuppression (the details depend on the organ), putting patients at higher risk of a number of infectious diseases. SOT patients can get a non-live flu vaccine.
However, because of the immunosuppression, this meeting asks whether or not it's worth recommending they get high dose or adjuvanted vaccines, given the immunosuppression. The work group discussed the use of such vaccines.
The balance of benefits and harms here is... challenging. There are 9 studies that inform the question but most are small, and they focus on immunogenicity instead of clinical outcomes. There is no consideration of recombinant vaccines.
