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. 2019 Aug 23;68(3):1–21. doi: 10.15585/mmwr.rr6803a1

TABLE 1. Influenza vaccines — United States, 2019–20 influenza season*.

Trade name (Manufacturer) Presentation Age indication HA (IIVs and RIV4) or virus count (LAIV4) for each vaccine virus (per dose) Route Mercury (from thimerosal) (μg/0.5mL)
IIV4—Standard Dose—Egg based

Afluria Quadrivalent (Seqirus)
0.25-mL PFS§
6 through 35 mos
7.5 μg/0.25 mL§
15 μg/0.5 mL§
IM

0.5-mL PFS§
≥3 yrs

5.0-mL MDV§
≥6 mos (needle/syringe)
18 through 64 yrs (jet injector)
24.5
Fluarix Quadrivalent (GlaxoSmithKline)
0.5-mL PFS
≥6 mos
15 μg/0.5 mL
IM

FluLaval Quadrivalent (GlaxoSmithKline)
0.5-mL PFS
≥6 mos
15 μg/0.5 mL
IM

5.0-mL MDV
≥6 mos
<25
Fluzone Quadrivalent (Sanofi Pasteur)
0.25-mL PFS**
6 through 35 mos
7.5 μg/0.25 mL**
15 μg/0.5 mL**
IM

0.5-mL PFS**
≥6 mos

0.5-mL SDV**
≥6 mos

5.0-mL MDV**
≥6 mos
25
IIV4—Standard Dose—Cell culture based (ccIIV4)

Flucelvax Quadrivalent (Seqirus)
0.5-mL PFS
≥4 yrs
15 μg/0.5 mL
IM

5.0-mL MDV
≥4 yrs
25
IIV3—High Dose—Egg based (HD-IIV3)

Fluzone High-Dose (Sanofi Pasteur)
0.5-mL PFS
≥65 yrs
60 μg/0.5 mL
IM

IIV3—Standard Dose—Egg based with MF59 adjuvant (aIIV3)

Fluad (Seqirus)
0.5-mL PFS
≥65 yrs
15 μg/0.5 mL
IM

RIV4—Recombinant HA

Flublok Quadrivalent (Sanofi Pasteur)
0.5-mL PFS
≥18 yrs
45 μg/0.5 mL
IM

LAIV4—Egg based

FluMist Quadrivalent (AstraZeneca) 0.2-mL prefilled single-use intranasal sprayer 2 through 49 yrs 106.5–7.5 fluorescent focus units/0.2 mL NAS

Abbreviations: ACIP = Advisory Committee on Immunization Practices; FDA = Food and Drug Administration; HA = hemagglutinin; IIV3 = inactivated influenza vaccine, trivalent; IIV4 = inactivated influenza vaccine, quadrivalent, IM = intramuscular; LAIV4 = live attenuated influenza vaccine, quadrivalent; MDV = multidose vial; NAS = intranasal; PFS = prefilled syringe; RIV4 = recombinant influenza vaccine, quadrivalent; SDV = single-dose vial.

*Vaccination providers should consult FDA-approved prescribing information for 2019–20 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 https://www.fda.gov/vaccines-blood-biologics/approved-products/vaccines-licensed-use-united-states. Availability of specific products and presentations might change and differ from what is described in this table and in the text of this report.

Persons with a history of egg allergy may receive any licensed, recommended influenza vaccine that is otherwise appropriate for their age and health status. Those who report having had reactions to egg involving symptoms other than urticaria (e.g., angioedema or swelling, respiratory distress, lightheadedness, or recurrent emesis) or who required epinephrine or another emergency medical intervention should be vaccinated in an inpatient or outpatient medical setting (including, but not necessarily limited to, hospitals, clinics, health departments, and physician offices). Vaccine administration should be supervised by a health care provider who is able to recognize and manage severe allergic reactions.

§ The dose volume for Afluria Quadrivalent is 0.25 mL for children aged 6 through 35 months and 0.5 mL for persons aged ≥3 years.

Intramuscularly-administered influenza vaccines should be given by needle and syringe only, with the exception of the MDV presentation of Afluria Quadrivalent, which may alternatively be given by the PharmaJet Stratis jet injector for persons aged 18 through 64 years only. For adults and older children, the recommended site for IM influenza vaccination is the deltoid muscle. The preferred site for infants and young children is the anterolateral aspect of the thigh. Additional guidance regarding site selection and needle length for intramuscular administration is available in the ACIP General Best Practice Guidelines for Immunization (https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/downloads/general-recs.pdf).

** Fluzone Quadrivalent may be given to children aged 6 through 35 months as either 0.25 mL per dose or 0.5 mL per dose. No preference is expressed for one or the other dose volume for this age group. Persons aged ≥3 years should receive the 0.5-mL dose volume.