Influenza vaccines — United States, 2018–19 influenza season*
U.S. Influenza Vaccine Products for the 2018-19 Season
Trade Name [Manufacturer] | Presentation | Age Indication | HA, µG/dose (each virus) | Egg-grown virus, Cell culture-grown virus, or Recombinant HA | Adjuvanted Yes/No | Latex Yes/No | Thimerosal Yes/No If yes, Mercury, μg/0.5mL |
---|---|---|---|---|---|---|---|
Quadrivalent IIVs (IIV4s) | |||||||
Afluria Quadrivalent* Seqirus | 0.5 mL prefilled syringe | ≥3 yrs | 15 | Egg | No | No | No |
5.0 mL multi-dose vial | ≥6 mos (needle/syringe)
18 through 64 yrs (jet injector) |
7.5/0.25* mL
15/0.5 mL |
Egg | No | No | Yes (24.5) | |
Fluarix Quadrivalent GlaxoSmithKline | 0.5 mL prefilled syringe | ≥6 months | 15 | Egg | No | No | No |
FluLaval Quadrivalent ID Biomedical Corp. of Quebec | 0.5 mL prefilled syringe | ≥6 months | 15 | Egg | No | No | No |
5.0 mL multi-dose vial | ≥6 months | 15 | Egg | No | No | Yes (<25) | |
Flucelvax Quadrivalent Seqirus (ccIIV4) | 0.5 mL prefilled syringe | ≥4 yrs | 15 | Cell | No | No | No |
5.0 mL multi-dose vial | ≥4 yrs | 15 | Cell | No | No | Yes (25) | |
Fluzone Quadrivalent* Sanofi Pasteur | 0.25 mL prefilled syringe | 6 through 35 months | 7.5/0.25 mL | Egg | No | No | No |
0.5 mL prefilled syringe | ≥3 yrs | 15/0.5 mL | Egg | No | No | No | |
0.5 mL single-dose vial | ≥3 yrs | 15/0.5 mL | Egg | No | No | No | |
5.0 mL multi-dose vial | ≥6 months | 7.5/0.25* mL
15/0.5 mL |
Egg | No | No | Yes (25) | |
Trivalent IIV (IIV3s) | |||||||
Afluria* Seqirus |
0.5 mL prefilled syringe | ≥3 yrs | 15 | Egg | No | No | No |
5.0 mL multi-dose vial | ≥6 mos (needle/syringe)
18 through 64 yrs (jet injector) |
7.5/0.25* mL
15/0.5 mL |
Egg | No | No | Yes (24.5) | |
Fluad Seqirus (aIIV3) |
0.5 mL prefilled syringe | ≥65 yrs | 15 | Egg | Yes | No | No |
Fluzone High-Dose Sanofi Pasteur (HD-IIV3) | 0.5 mL prefilled syringe | ≥65 yrs | 60 | Egg | No | No | No |
Quadrivalent RIV (RIV4) | |||||||
Flublok Quadrivalent Sanofi Pasteur | 0.5 mL prefilled syringe | ≥18 yrs | 45 | Recombinant | No | No | No |
Abbreviations: IIV=inactivated influenza vaccine; RIV=recombinant influenza vaccine; HA=hemagglutinin; mos=months; yrs=years.
* For Afluria, Afluria Quadrivalent, and Fluzone Quadrivalent, the dose volume for children aged 6 through 35 months is 0.25mL. For persons aged 36 months (three years) and older, the dose volume is 0.5 mL.
Administration of IIVs and RIV4
- IIVs and RIV4 are administered intramuscularly (IM):
- Adults and older children: the deltoid is the preferred site;
- Infants and younger children (IIVs only): the anterolateral thigh is the preferred site.
- Detailed guidance for administration sites and needle length is available in Best Practices Guidance of the Advisory Committee on Immunization Practices (ACIP)
- Afluria and Afluria Quadrivalent are licensed for intramuscular administration via jet injector (the Pharmajet Stratis), for persons aged 18-64 years only.
- RIV4 is licensed for persons aged ≥18 years
IIV and RIV4 Contraindications and Precautions
Contraindications:
- History of severe allergic reaction to the vaccine or any of its components
- ACIP recommends that persons with egg allergy of any severity receive influenza vaccine (see Persons with a History of Egg Allergy, above)
- Information about vaccine components is located in package inserts from each manufacturer.
Precautions:
- Moderate or severe acute illness with or without fever.
- Guillain–Barré syndrome within 6 weeks following a previous dose of influenza vaccine.
Abbreviations: LAIV=live attenuated influenza vaccine; mos=months; yrs=years.
LAIV4 Administration
- LAIV is administered intranasally using the supplied prefilled, single-use sprayer containing 0.2 mL of vaccine.
- Half of the total sprayer contents is sprayed into the first nostril while the recipient is in the upright position.
- The attached divider clip is removed and the second half of the dose administered into the other nostril.
- If the vaccine recipient sneezes immediately after administration, the dose should not be repeated.
- If nasal congestion impedes delivery of the vaccine to the nasopharyngeal mucosa, deferral should be considered, or another age appropriate vaccine should be administered.
LAIV4 Contraindications and Precautions
Contraindications:
- History of severe allergic reaction to any vaccine component or after previous dose of any influenza vaccine;
- ACIP recommends that persons with egg allergy of any severity receive influenza vaccine (see Persons with a History of Egg Allergy, above)
- Information about vaccine components is located in package inserts from the manufacturer.
- Concomitant aspirin or salicylate-containing therapy in children and adolescents;
- Children aged 2 through 4 years who have received a diagnosis of asthma or whose parents or caregivers report that a health care provider has told them during the preceding 12 months that their child had wheezing or asthma or whose medical record indicates a wheezing episode has occurred during the preceding 12 months;
- Children and adults who are immunocompromised due to any cause (including immunosuppression caused by medications or by HIV infection);
- Close contacts and caregivers of severely immunosuppressed persons who require a protected environment;
- Pregnancy;
- Receipt of influenza antiviral medication within previous 48 hours.
Precautions:
- Moderate or severe acute illness with or without fever;
- History of Guillain-Barré syndrome within 6 weeks of receipt of influenza vaccine;
- Asthma in persons aged ≥5 years;
- Other underlying medical conditions that might predispose to complications attributable to severe influenza (e.g., chronic pulmonary, cardiovascular [excluding isolated hypertension], renal, hepatic, neurologic, hematologic, or metabolic disorders (including diabetes mellitus)).
Vaccine Abbreviations
-
IIV = Inactivated Influenza Vaccine.
- IIV3 = Trivalent Inactivated Influenza Vaccine;
- IIV4 = Quadrivalent Inactivated Influenza Vaccine.
- RIV4 = Quadrivalent Recombinant Influenza Vaccine.
- LAIV4 = Quadrivalent Live Attenuated Influenza Vaccine
- aIIV3 refers specifically to adjuvanted IIV3
- ccIIV4 refers specifically to cell-culture based IIV4
- HD-IIV3 refers specifically to high-dose IIV3
- SD-IIV3 and SD-IIV4 refer specifically to standard-dose IIVs
- Page last reviewed: November 6, 2018
- Page last updated: November 6, 2018
- Content source:
- Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases (NCIRD)
- Page maintained by: Office of the Associate Director for Communication, Digital Media Branch, Division of Public Affairs