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Influenza vaccines – United States, 2022-23 influenza season*

Influenza vaccines – United States, 2022-23 influenza season*
Trade name
(manufacturer)
Presentations Age indication mcg HA (IIV4s and RIV4) or
virus count (LAIV4) for each
vaccine virus (per dose)
Route
IIV4s: Inactivated influenza vaccines
Standard-dose, egg-based vaccines
Afluria Quadrivalent
(Seqirus)
0.5-mL PFSΔ ≥3 yearsΔ 15 mcg/0.5 mL IM
5.0-mL MDVΔ

≥6 monthsΔ (needle/syringe)

18 through 64 years (jet injector)

7.5 mcg/0.25 mL

15 mcg/0.5 mL
IM
Fluarix Quadrivalent
(GlaxoSmithKline)
0.5-mL PFS ≥6 months 15 mcg/0.5 mL IM
FluLaval Quadrivalent
(GlaxoSmithKline)
0.5-mL PFS ≥6 months 15 mcg/0.5 mL IM
Fluzone Quadrivalent
(Sanofi Pasteur)
0.5-mL PFS§ ≥6 months§ 15 mcg/0.5 mL IM
0.5-mL SDV§ ≥6 months§ 15 mcg/0.5 mL IM
5.0-mL MDV§ ≥6 months§

7.5 mcg/0.25 mL

15 mcg/0.5 mL
IM
Standard-dose, cell culture-based vaccine (ccIIV4)
Flucelvax Quadrivalent
(Seqirus)
0.5-mL PFS ≥6 months 15 mcg/0.5 mL IM
5.0-mL MDV ≥6 months 15 mcg/0.5 mL IM
High-dose, egg-based vaccine (HD-IIV4)
Fluzone High-Dose Quadrivalent
(Sanofi Pasteur)
0.7-mL PFS ≥65 years 60 mcg/0.7 mL IM
Standard-dose, egg-based vaccine with MF59 adjuvant (aIIV4)
Fluad Quadrivalent
(Seqirus)
0.5-mL PFS ≥65 years 15 mcg/0.5 mL IM
RIV4 (recombinant HA vaccine)
Flublok Quadrivalent
(Sanofi Pasteur)
0.5-mL PFS ≥18 years 45 mcg/0.5 mL IM
LAIV4 (live attenuated egg-based vaccine)
FluMist Quadrivalent
(AstraZeneca)
0.2-mL prefilled single-use intranasal sprayer 2 through 49 years 106.5-7.5 fluorescent focus units/0.2 mL NAS

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

* Vaccination providers should consult FDA-approved prescribing information for 2022-23 influenza vaccines for the most complete and updated information, including (but not limited to) indications, contraindications, warnings, and precautions. Package inserts for United States-licensed vaccines are available at https://www.fda.gov/vaccines-blood-biologics/approved-products/vaccines-licensed-use-united-states. Availability and characteristics of specific products and presentations might change or differ from what is described in this table.

¶ Although a history of severe allergic reaction (eg, anaphylaxis) to egg is a labeled contraindication to the use of egg-based IIV4s and LAIV4, the ACIP recommends that 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 (eg, 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) supervised by a health care provider who is able to recognize and manage severe allergic reactions, if a vaccine other than ccIIV4 or RIV4 is used.

Δ The approved 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. However, 0.25-mL prefilled syringes are not expected to be available for the 2022-23 season. For children aged 6 through 35 months, a 0.25-mL dose must be obtained from a multidose vial.

◊ IM-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 specific guidance regarding site selection and needle length for IM administration is available in the ACIP General Best Practice Guidelines for Immunization, available at https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/index.html.

§ Fluzone Quadrivalent is currently approved for ages 6 through 35 months at either 0.25 mL or 0.5 mL per dose; however, 0.25-mL prefilled syringes are not expected to be available for the 2022-23 influenza season. If a prefilled syringe of Fluzone Quadrivalent is used for a child in this age group, the dose volume will be 0.5 mL per dose.
Adapted from: Grohskopf LA, Blanton LH, Ferdinands JM, et al. Prevention and control of seasonal influenza with vaccines: Recommendations of the Advisory Committee on Immunization Practices - United States, 2022-23 influenza season. MMWR Recomm Rep 2022; 71:1.
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