Free flu vaccine in 2026: who is eligible and when is the best time to get immunised

As the cold season approaches, doctors are drawing attention to the optimal timing for flu vaccination and the categories of people who can receive the vaccine free of charge or at a subsidised rate. Dr Sandra Alexiu, President of the București-Ilfov Family Doctors Association, has provided Digi24.ro with details about this season's vaccine composition, the recommended time for immunisation, and the reimbursement conditions.

What this year's vaccine contains

The composition of the flu vaccine is determined annually, based on the strains that circulated most widely during the previous season. Whilst a tetravalent vaccine containing four strains has been used in recent years, from the 2025–2026 season onwards the vaccine has become trivalent, as one of the strains is no longer in circulation. The new formula contains three strains: two of type A and one of type B, including the modified strain from the previous year.

For the 2026–2027 season, both the World Health Organization and the European Medicines Agency have recommended the same trivalent formula, containing strains A/H1N1, A/H3N2, and B/Victoria lineage.

When is the best time to get vaccinated

According to the doctor, the first flu cases typically appear as temperatures drop, and for this season the illness is expected to emerge from November onwards, with a gradual increase in the number of cases. The peak of the epidemic usually occurs around January, meaning that case numbers begin to rise significantly from December.

Since the body requires approximately two weeks after vaccination to develop antibodies, doctors recommend starting immunisation as early as 1 October.

Who should get vaccinated

Vaccination is recommended for everyone, regardless of age, as flu can cause severe illness even in people with no known underlying conditions. However, the WHO also identifies groups at increased risk of complications, including death: children under 5, the elderly, and people with respiratory, cardiac, or autoimmune conditions, or cancer.

Flu vaccination is available from the age of 6 months. Children under 9 who are being vaccinated for the first time must receive two doses for full protection, which is why it is important to begin immunisation early enough so that the second dose can also be administered before case numbers start to rise.

Who receives the vaccine free of charge

According to Dr Sandra Alexiu, Romania offers one of the most generous flu vaccine subsidy schemes in the European Union. All risk groups identified by the WHO are entitled to the vaccine free of charge, whilst individuals who do not fall into a risk category but are within a certain age range can receive the vaccine at 50% subsidy.

Under Order No. 3,120, the following are entitled to the vaccine free of charge (100% reimbursement):

• children aged between 6 months and under 19 years;
• pregnant women;
• people aged between 19 and 65 who have: chronic cardiovascular disease, chronic respiratory disease, chronic kidney disease, chronic liver disease, chronic neurological disease, metabolic conditions, oncological conditions, autoimmune conditions, congenital malformations, obesity, asplenia or who are being prepared for splenectomy, HIV/AIDS infection, immunosuppressive therapy, transplantation, or congenital immunosuppression;
• people aged over 65;
• medical, healthcare, and specialist auxiliary staff.

People aged between 45 and 65 without chronic conditions who wish to be vaccinated receive the vaccine with 50% state subsidy.

For people aged over 60, a vaccine containing four times the standard antigen dose, known as High-Dose (HD), is administered, also free of charge. The doctor explains that at older ages, a phenomenon known as immunosenescence occurs — an ageing process that also affects the immune system, causing the body to respond less effectively to illness, and a higher antigen dose helps to provide better protection.

Where to get vaccinated

The flu vaccine can be prescribed by any doctor in Romania who holds a contract with the National Health Insurance House, regardless of their speciality. However, administering the vaccine itself is only permitted for doctors whose specialist training includes vaccination methodology — these include family doctors, paediatricians, infectious disease specialists, and epidemiologists. Doctors from other specialities may also administer the vaccine if they have obtained vaccinology competencies through specialist courses.