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Influenza vaccines — United States, 2016–17 influenza season*

Note: For the 2016-2017 season, CDC recommends use of the flu shot (inactivated influenza vaccine or IIV) and the recombinant influenza vaccine (RIV). The nasal spray flu vaccine (live attenuated influenza vaccine or LAIV) should not be used during 2016-2017. The 2016-2017 influenza vaccination recommendations are now available.

TABLE 1. Influenza vaccines — United States, 2016–17 influenza season

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Trade name

Manufacturer

Presentation

Age indication

Mercury (from thimerosal)
µg/0.5 mL

Latex

Route

Inactivated influenza vaccine, quadrivalent (IIV4), standard dose

Fluarix Quadrivalent

GlaxoSmithKline

0.5 mL single-dose prefilled syringe

≥3 yrs

NR

No

IM§

Flulaval Quadrivalent ID Biomedical Corp. of Quebec (distributed by GlaxoSmithKline) 0.5 mL single-dose prefilled syringe ≥3 yrs NR No IM

 

 

5.0 mL multi-dose vial

≥3 yrs

<25

No

IM

Fluzone Quadrivalent

Sanofi Pasteur

0.25 mL single-dose prefilled syringe

6–35 mos

NR

No

IM

0.5 mL single-dose prefilled syringe

≥36 mos

NR

No

IM

0.5 mL single-dose vial

≥36 mos

NR

No

IM

5.0 mL multidose vial

≥6 mos

25

No

IM

Fluzone Intradermal
Quadrivalent

Sanofi Pasteur

0.1 mL single-dose prefilled microinjection system

18 through 64 yrs

NR

No

ID**

Inactivated influenza vaccine, quadrivalent, cell culture-based (ccIIV4), standard dose
Flucelvax Quadrivalent Seqirus 0.5 mL single-dose prefilled syringe ≥4 yrs NR No IM
Inactivated Influenza Vaccine, trivalent (IIV3), standard dose

Afluria

Seqirus

0.5 mL single-dose prefilled syringe

≥9 yrs††

NR

No

IM

5.0 mL multi-dose vial

≥9 yrs††
(needle and syringe)
18 through 64 years
(jet injector)

24.5

No

IM

Fluvirin

Seqirus

0.5 mL single-dose prefilled syringe

≥4 yrs

≤1

Yes§§

IM

5.0 mL multi-dose vial

≥4 yrs

25

No

IM

Adjuvanted Inactivated Influenza Vaccine, trivalent (aIIV3), standard dose

Fluad

Seqirus

0.5 mL single-dose prefilled syringe

≥65 yrs

NR

Yes§§

IM

Inactivated Influenza Vaccine, trivalent (IIV3), High Dose¶¶

Fluzone High-Dose

Sanofi Pasteur

0.5 mL single-dose prefilled syringe

≥65 yrs

NR

No

IM

Recombinant Influenza Vaccine, trivalent (RIV3)***

FluBlok

Protein Sciences

0.5 mL single-dose vial

≥18 yrs

NR

No

IM

Live Attenuated Influenza Vaccine, quadrivalent (LAIV4)†††

FluMist Quadrivalent

MedImmune

0.2 mL single-dose prefilled
intranasal sprayer

2 through 49 yrs

NR

No

NAS

Abbreviations: ACIP = Advisory Committee on Immunization Practices; ID = intradermal; IM = intramuscular; NAS = intranasal; NR = not relevant (does not contain thimerosal).
*Immunization providers should check Food and Drug Administration–approved prescribing information for 2016–17 influenza vaccines for the most complete and updated information, including (but not limited to) indications, contraindications, warnings, and precautions. Package inserts for U.S.-licensed vaccines are available at http://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm093833.htm . Availability of specific products and presentations might change and differ from what is described in this table.
Standard dose intramuscular IIVs contain 15 µg of each vaccine HA antigen (45 µg total for trivalents and 60 µg total for quadrivalents) per 0.5mL dose.
§For adults and older children, the recommended site for intramuscular influenza vaccination is the deltoid muscle. The preferred site for infants and young children is the anterolateral aspect of the thigh. Specific guidance regarding site and needle length for intramuscular administration may be found in the ACIP General Recommendations on Immunization, available at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6002a1.htm.
Quadrivalent inactivated influenza vaccine, intradermal: a 0.1-mL dose contains 9 µg of each vaccine HA antigen (36μg total).
**The preferred injection site is over the deltoid muscle. Fluzone Intradermal Quadrivalent is administered using the delivery system included with the vaccine.
††Age indication per package insert is ≥5 years; however, ACIP recommends that Afluria not be used in children aged 6 months through 8 years because of increased risk for febrile reactions noted in this age group with Seqirus’ 2010 Southern Hemisphere IIV3. If no other age-appropriate, licensed inactivated seasonal influenza vaccine is available for a child aged 5 through 8 years who has a medical condition that increases the child's risk for influenza complications, Afluria can be used; however, providers should discuss with the parents or caregivers the benefits and risks of influenza vaccination with Afluria before administering this vaccine. Afluria may be used in persons aged ≥9 years. Afluria is licensed for administration by jet injector for persons aged 18 through 64 years only.
§§Syringe tip cap might contain natural rubber latex.
¶¶High-dose IIV3 contains 60 μg of each vaccine antigen (180 μg total) per 0.5mL dose.
***RIV3 contains 45 μg of each vaccine HA antigen (135 μg total) per 0.5mL dose.
†††ACIP recommends that Flumist (LAIV4) not be used during the 2016–17 season.

TABLE 2. Contraindications and precautions to the use of influenza vaccines — United States, 2016–17 influenza season*

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Vaccine

Contraindications

Precautions

IIV

History of severe allergic reaction to any component of the vaccine or after previous dose of any influenza vaccine

Moderate to severe illness with or without fever
History of Guillain-Barré syndrome within 6 weeks of receipt of influenza vaccine

RIV History of severe allergic reaction to any component of the vaccine Moderate to severe illness with or without fever
History of Guillain-Barré syndrome within 6 weeks of receipt of influenza vaccine

LAIV

For the 2016–17 season, ACIP recommends that LAIV not be used. Content below is provided for information.

  History of severe allergic reaction to any component of the vaccine† or after a previous dose of any influenza vaccine
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 have immunosuppression (including immunosuppression caused by medications or by HIV)
Close contacts and caregivers of severely immunosuppressed persons who require a protected environment
Pregnancy
Receipt of influenza antiviral medication within the previous 48 hours
Moderate to severe 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 after wild-type influenza infection (e.g., chronic pulmonary, cardiovascular [except isolated hypertension], renal, hepatic, neurologic, hematologic, or metabolic disorders (including diabetes mellitus)

Abbreviations: ACIP = Advisory Committee on Immunization Practices; IIV = Inactivated Influenza Vaccine; LAIV = Live-Attenuated Influenza Vaccine; RIV = Recombinant Influenza Vaccine.
* Immunization providers should check Food and Drug Administration–approved prescribing information for 2016–17 influenza vaccines for the most complete and updated information, including (but not limited to) indications, contraindications, and precautions. Package inserts for US-licensed vaccines are available at http://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm093833.htm .
History of severe allergic reaction (e.g., anaphylaxis) to egg is a labeled contraindication to the use of IIV and LAIV. However, ACIP recommends that any licensed, recommended, and appropriate IIV or RIV may be administered to persons with egg allergy of any severity (see Influenza Vaccination of Persons with a History of Egg Allergy).

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