Trade name (manufacturer) | Presentation | Age indication | mcg HA (IIV4s and RIV4) or virus count (LAIV4) for each vaccine virus (per dose) | Route | Mercury (from thimerosal, if present) mcg/0.5 mL |
IIV4 (standard-dose, egg-based vaccines¶) | |||||
Afluria Quadrivalent (Seqirus) | 0.5 mL PFSΔ | ≥3 yearsΔ | 15 mcg/0.5 mL | IM◊ | – |
5 mL MDVΔ | 6 to 35 monthsΔ (needle and syringe) | 7.5 mcg/0.25 mL | IM◊ | 24.5 | |
≥3 years (needle and syringe) | 15 mcg/0.5 mL | ||||
18 to 64 years (jet injector) | 15 mcg/0.5 mL | ||||
Fluarix Quadrivalent (GlaxoSmithKline) | 0.5 mL PFS | ≥6 months | 15 mcg/0.5 mL | IM◊ | – |
FluLaval Quadrivalent (GlaxoSmithKline) | 0.5 mL PFS | ≥6 months | 15 mcg/0.5 mL | IM◊ | – |
Fluzone Quadrivalent (Sanofi Pasteur) | 0.5 mL PFS§ | ≥6 months§ | 15 mcg/0.5 mL | IM◊ | – |
0.5 mL SDV§ | ≥6 months§ | 15 mcg/0.5 mL | IM◊ | – | |
5 mL MDV§ | 6 to 35 months§ | 7.5 mcg/0.25 mL or 15 mcg/0.5 mL | IM◊ | 25 | |
≥3 years | 15 mcg/0.5 mL | ||||
ccIIV4 (standard-dose, cell culture–based vaccine) | |||||
Flucelvax Quadrivalent (Seqirus) | 0.5 mL PFS | ≥6 months | 15 mcg/0.5 mL | IM◊ | – |
5 mL MDV | ≥6 months | 15 mcg/0.5 mL | IM◊ | 25 | |
HD-IIV4 (high-dose, egg-based vaccine¶) | |||||
Fluzone High-Dose Quadrivalent (Sanofi Pasteur) | 0.7 mL PFS | ≥65 years | 60 mcg/0.7 mL | IM◊ | – |
aIIV4 (standard-dose, egg-based vaccine¶ with MF59 adjuvant) | |||||
Fluad Quadrivalent (Seqirus) | 0.5 mL PFS | ≥65 years | 15 mcg/0.5 mL | IM◊ | – |
RIV4 (recombinant HA vaccine) | |||||
Flublok Quadrivalent (Sanofi Pasteur) | 0.5 mL PFS | ≥18 years | 45 mcg/0.5 mL | IM◊ | – |
LAIV4 (egg-based vaccine¶) | |||||
FluMist Quadrivalent (AstraZeneca) | 0.2 mL prefilled single-use intranasal sprayer | 2 to 49 years | 106.5 to 7.5 fluorescent focus units/0.2 mL | Intranasal | – |
ACIP: Advisory Committee on Immunization Practices; aIIV4: adjuvanted inactivated influenza vaccine, quadrivalent; ccIIV4: cell-culture based inactivated influenza vaccine, quadrivalent; HA: hemagglutinin; HD-IIV4: high-dose inactivated influenza vaccine, quadrivalent; IIV4: inactivated influenza vaccine, quadrivalent; IM: intramuscular; LAIV4: live attenuated influenza vaccine, quadrivalent; MDV: multidose vial; PFS: prefilled syringe; RIV4: recombinant influenza vaccine, quadrivalent; SDV: single-dose vial.
* Manufacturer package inserts and updated CDC and ACIP guidance should be consulted for additional information concerning, but not limited to, indications, contraindications, warnings, and precautions. Package inserts for US-licensed vaccines are available at https://www.fda.gov/vaccines-blood-biologics/vaccines/vaccines-licensed-use-united-states. Availability and characteristics of specific products and presentations might change or differ from what is described in this table.
¶ Although a history of severe allergic reaction (eg, anaphylaxis) to egg is a labeled contraindication to the use of egg-based IIV4s and LAIV4, ACIP recommends that all persons aged ≥6 months with egg allergy should receive influenza vaccine and that any influenza vaccine (egg-based or non-egg-based) that is otherwise appropriate for the recipient's age and health status can be used.
Δ The approved dose volume for Afluria Quadrivalent is 0.25 mL for children aged 6 to 35 months and 0.5 mL for persons aged ≥3 years. However, 0.25 mL prefilled syringes are no longer available. For children aged 6 to 35 months, a 0.25 mL dose must be obtained from a multidose vial.
◊ IM-administered influenza vaccines should be administered by needle and syringe only, with the exception of the MDV presentation of Afluria Quadrivalent, which may alternatively be given by the PharmaJet Stratis jet injector for persons aged 18 to 64 years only. For older children and adults, the recommended site for IM influenza vaccination is the deltoid muscle. The preferred site for infants and young children is the anterolateral aspect of the thigh. Additional specific guidance regarding site selection and needle length for IM administration is available in the General Best Practice Guidelines for Immunization available at https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/index.html.
§ Fluzone Quadrivalent is approved for children aged 6 to 35 months at either 0.25 mL or 0.5 mL per dose; however, 0.25 mL prefilled syringes are no longer available. If a prefilled syringe of Fluzone Quadrivalent is used for a child in this age group, the dose volume will be 0.5 mL per dose.Do you want to add Medilib to your home screen?