Table 3. Recommended dose and route of administration, by age, for influenza vaccine types authorized for the 2021–2022 influenza season.
| Age group | Influenza vaccine type (route of administration) | Number of doses required | |||||
|---|---|---|---|---|---|---|---|
| IIV3-SDa or IIV4-SDb (IM) | IIV4-ccc (IM) |
IIV3-Adjd (IM) |
IIV3-HDe (IM) |
IIV4-HDf (IM) |
LAIV4g (intranasal) |
||
| 6–23 months | 0.5 mLh | – | 0.25 mL | – | – | – | 1 or 2i |
| 2–8 years | 0.5 mL | – | – | – | – | 0.2 mL (0.1 mL per nostril) |
1 or 2i |
| 9–17 years | 0.5 mL | 0.5 mL | – | – | – | 0.2 mL (0.1 mL per nostril) |
1 |
| 18–59 years | 0.5 mL | 0.5 mL | – | – | – | 0.2 mL (0.1 mL per nostril) |
1 |
| 60–64 years | 0.5 mL | 0.5 mL | – | – | – | – | 1 |
| 65 years and older |
0.5 mL | 0.5 mL | 0.5 mL | 0.5 mL | 0.7 mL | – | 1 |
Abbreviations: IIV3-Adj, adjuvanted trivalent inactivated influenza vaccine; IIV3-HD, high-dose trivalent; IIV4-cc, quadrivalent mammalian cell-culture based inactivated influenza vaccine; IIV4-HD, high-dose quadrivalent inactivated influenza vaccine; IIV3-SD, standard-dose trivalent inactivated influenza vaccine; IIV4-SD, standard-dose quadrivalent inactivated influenza vaccine; IM, intramuscular; LAIV4, quadrivalent live attenuated influenza vaccine; –, not applicable
a IIV3-SD formulations (Agriflu® [six months and older], Fluviral® [six months and older] and Influvac® [three years and older]) are authorized but will not be available for use in Canada during the 2021–2022 influenza season
b Afluria® Tetra (five years and older), Flulaval® Tetra (six months and older), Fluzone® Quadrivalent (six months and older), Influvac® Tetra (three years and older)
c Flucelvax® Quad (nine years and older)
d Fluad Pediatric® (6–23 months) or Fluad® (65 years and older)
e Fluzone® High-Dose (65 years and older) was previously authorized, but marketing of the vaccine has been discontinued as of February 2021
f Fluzone® High-Dose Quadrivalent (65 years and older)
g FluMist® Quadrivalent (2–59 years)
h Evidence suggests 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 (25,26). 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 (27)
i Children six months to less than nine years of age receiving seasonal influenza vaccine for the first time in their life should be given two doses of influenza vaccine, with a minimum interval of four weeks between doses. Children six months to younger than nine years of age who have been properly vaccinated with one or more doses of seasonal influenza vaccine in the past should receive one dose of influenza vaccine per season thereafter
Source: Table reproduced from NACI Seasonal Influenza Vaccine Statement for 2021–2022 (5)