Table 3. Recommended influenza vaccine dosage and route, by age, for the 2018–2019 influenza season.
| Age group |
TIV without adjuvanta (Intramuscular) |
QIV without adjuvantb (Intramuscular) |
TIV without adjuvant, high dose (Fluzone® High-Dose) (Intramuscular) |
MF59-adjuvanted TIV (Fluad Pediatric® or Fluad®) (Intramuscular) |
LAIV (FluMist® Quadrivalent) (Intranasal) |
Number of doses required |
|---|---|---|---|---|---|---|
| 6–23 months | 0.5 mLc | 0.5 mLc | N/A | 0.25 mL | N/A | 1 or 2d |
| 2–8 years | 0.5 mL | 0.5 mL | N/A | N/A | 0.2 mL (0.1 mL per nostril) | 1 or 2d |
| 9–17 years | 0.5 mL | 0.5 mL | N/A | N/A | 0.2 mL (0.1 mL per nostril) | 1 |
| 18–59 years | 0.5 mL | 0.5 mL | N/A | N/A | 0.2 mL (0.1 mL per nostril) | 1 |
| 60–64 years | 0.5 mL | 0.5 mL | N/A | N/A | N/A | 1 |
| 65 years and older | 0.5 mL | 0.5 mL | 0.5 mL | 0.5 mL | N/A | 1 |
Abbreviations: LAIV, live attenuated influenza vaccine (quadrivalent formulation); N/A, not applicable; QIV, quadrivalent inactivated influenza vaccine; TIV, trivalent inactivated influenza vaccine
a Influvac® three years and older, Fluviral® six months and older, Agriflu® six months and older
b Flulaval® Tetra six months and older, Fluzone Quadrivalent six months and older
c This information may differ from the product monograph. Published and unpublished evidence suggest moderate improvement in antibody response in infants, without an increase in reactogenicity, with the use of full vaccine doses (0.5 mL) for unadjuvanted inactivated influenza vaccines (10) (11). This moderate improvement in antibody response without an increase in reactogenicity is the basis for the full dose recommendation for unadjuvanted inactivated vaccine for all ages. For more information, refer to Statement on Seasonal Influenza Vaccine for 2011–2012 (12)
d Children six months to less than nine years of age who have never received the seasonal influenza vaccine require two doses of influenza vaccine, with a minimum interval of four weeks between doses. Eligible children under nine years of age who have properly received one or more doses of seasonal influenza vaccine in the past should receive one dose per influenza vaccination season thereafter