Table 2. Choice of influenza vaccine for selected age and risk groups (for persons without a contraindication to the vaccine)1.
| Recipient by age group | Vaccine types available for use | Comments |
|---|---|---|
| Children 6–23 months of age | • TIV • QIV • ATIV |
TIV, QIV and ATIV are authorized for this age group. NACI recommends that, given the burden of influenza B disease, QIV should be used. If QIV is not available, either unadjuvanted or adjuvanted TIV should be used. |
| Children 2–17 years of age | • TIV • QIV • Quadrivalent LAIV |
In children without contraindications to the vaccine, any of the following vaccines can be used: LAIV, QIV or TIV. The current evidence does not support a recommendation for the preferential use of LAIV in children and adolescents 2–17 years of age. Given the burden of influenza B disease in children and the potential for lineage mismatch between the predominant circulating strain of influenza B and the strain in a trivalent vaccine, NACI continues to recommend that a quadrivalent formulation of influenza vaccine be used in children and adolescents 2–17 years of age. If a quadrivalent vaccine is not available, TIV should be used. LAIV is not recommended for children with immune compromising conditions. LAIV, TIV or QIV can be used in children with chronic health conditions and without contraindications (see full statement for more details) (4). |
| Adults 18–59 years of age | • TIV • QIV • Quadrivalent LAIV |
TIV and QIV are the recommended products for adults with chronic health conditions. TIV and QIV, instead of LAIV, are recommended for health care workers. LAIV is not recommended for adults with immune compromising conditions. |
| Adults 60–64 years of age | • TIV • QIV |
TIV and QIV are authorized for use in this age group. |
| Adults 65 years of age and older | • TIV • QIV • ATIV • High-dose TIV |
Given the burden of Influenza A(H3N2) disease and evidence of better efficacy in this age group, it is expected that high-dose TIV should provide superior protection compared with the standard-dose intramuscular vaccine for older adults. |
| Pregnant women | • TIV • QIV |
LAIV is not recommended because of the theoretical risk to the fetus from administering a live virus vaccine. |
Abbreviations: ATIV, adjuvanted trivalent inactivated influenza vaccine; LAIV, live attenuated influenza vaccine (quadrivalent formulation); QIV, quadrivalent inactivated influenza vaccine; TIV, trivalent inactivated influenza vaccine 1 Updated recommendations noted in bold