Inactivated Influenza Vaccines (IIVs)

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TRADE NAME [MANUFACTURER] PRESENTATION AGE INDICATION MERCURY,
µG/0.5ML 		LATEX ROUTE
IIV QUADRIVALENT, STANDARD-DOSE (SD-IIV4)
Afluria Quadrivalent [Seqirus] 0.5 mL prefilled syringe ≥18 yrs NR No IM
5.0 mL multi-dose vial ≥18 yrs (needle/syringe)

18 through 64 yrs (jet injector)

 24.5 No IM
Fluarix Quadrivalent [GlaxoSmithKline] 0.5 mL prefilled syringe ≥3 years NR No IM
FluLaval Quadrivalent
[ID Biomedical Corp. of Quebec]		 0.5 mL prefilled syringe ≥6 mos NR No IM
5.0 mL multi-dose vial ≥6 mos <25 No IM
Fluzone Quadrivalent [Sanofi Pasteur] 0.25 mL prefilled syringe 6 through 35 mos NR No IM
0.5 mL prefilled syringe ≥3 yrs NR No IM
0.5 mL single-dose vial ≥3 yrs NR No IM
5.0 mL multi-dose vial ≥6 mos 25 No IM
IIV QUADRIVALENT, STANDARD-DOSE, CELL CULTURE-BASED (ccIIV4)
Flucelvax Quadrivalent [Seqirus] 0.5 mL prefilled syringe ≥4 yrs NR No IM
5.0 mL multi-dose vial ≥4 yrs 25 No IM
IIV QUADRIVALENT, STANDARD-DOSE, INTRADERMAL (Intradermal IIV4)
Fluzone Intradermal Quadrivalent
[Sanofi Pasteur]		 0.1 mL single-dose prefilled micro-injection system 18 through 64 yrs NR No ID
IIV TRIVALENT, STANDARD-DOSE (SD-IIV3)
Afluria [Seqirus] 0.5 mL prefilled syringe ≥5 yrs NR No IM
5.0 mL multi-dose vial ≥5 yrs (needle/syringe)
18 through 64 yrs (jet injector)		 24.5 No IM
Fluvirin [Seqirus] 0.5 mL prefilled syringe ≥4 yrs ≤1 Yes* IM
5.0 mL multi-dose vial ≥4 yrs 25 No IM
ADJUVANTED IIV TRIVALENT, STANDARD-DOSE (aIIV3)
Fluad [Seqirus] 0.5 mL prefilled syringe ≥65 yrs NR Yes* IM
IIV TRIVALENT HIGH-DOSE (HD-IIV3)
Fluzone High-Dose [Sanofi Pasteur] 0.5 mL prefilled syringe ≥65 yrs NR No IM

Abbreviations: ID = intradermal; IM = intramuscular; NR = not relevant (does not contain thimerosal); mos = months; yrs = years.

*Syringe tip cap may contain natural rubber latex

IIV Hemagglutinin Content

  • Intramuscular SD-IIVs contain 15µg of HA per virus (45 µg total for SD-IIV3s and 60 µg total for SD-IIV4s) per 0.5 mL dose.
  • Fluzone High-Dose (HD-IIV3) contains 60µg of HA per virus (180µg total) per 0.5 mL dose.
  • Fluzone Intradermal Quadrivalent (intradermal IIV4) contains 9µg of each HA per virus (36µg total) per 0.1 mL dose.

IIV Administration

  • IIVs are administered intramuscularly (IM), with the exception of Fluzone Intradermal Quadrivalent. For IM vaccines:
    • Adults and older children: the deltoid is the preferred site;
    • Infants and younger children: 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) at ACIP Vaccine Recommendations and Guidelines.
  • Afluria and Afluria Quadrivalent are licensed for intramuscular administration via jet injector (the Pharmajet Stratis), for persons aged 18-64 years only.
  • Fluzone Intradermal Quadrivalent is administered intradermally, preferably over the deltoid muscle, using the included delivery system.

IIV 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)
    • Information about vaccine components is located in package inserts from each manufacturer.

Precautions:

  • Moderate to severe acute illness with or without fever.
  • Guillain–Barré syndrome within 6 weeks following a previous dose of influenza vaccine.
Vaccine Abbreviations
  • IIV = Inactivated Influenza Vaccine.
    • IIV3 = Trivalent Inactivated Influenza Vaccine;
    • IIV4 = Quadrivalent Inactivated Influenza Vaccine.
  • RIV = Recombinant Influenza Vaccine.
    • RIV3 = Trivalent Recombinant Influenza Vaccine;
    • RIV4 = Quadrivalent Recombinant Influenza Vaccine.
  • LAIV4 = Quadrivalent Live Attenuated Influenza Vaccine
  • IIV, RIV, and LAIV denote vaccine categories; numeric suffix denotes number of antigens in the vaccine,
  • When referring specifically to adjuvanted vaccine, the prefix “a” is used (e.g., aIIV3).
  • When referring specifically to cell culture-based vaccine, the prefix “cc” is used (e.g., ccIIV4).
  • When referring specifically to High-dose vs. Standard-dose vaccines, the prefixes “HD-” and “SD-” are used (e.g., HD-IIV3 vs. SD-IIV3 and SD-IIV4).
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