Influenza Vaccine Comparisons

INFLUENZA VACCINE COMPARISONS (2022−2023 SEASON)
Storage and Handling

• Store refrigerated at 2–8°C (36–46°F)

• Do not freeze; discard if product has been frozen

• Protect from light

• Do not use influenza vaccine beyond the expiration
date printed on the label

• Once punctured for the 1st dose, multidose vials should be discarded after the Beyond Use Date (BUD) or the maximum number of doses contained per vial. If no BUD, use the expiration date.
Brand Indicated
Age		 Route Allergies1 Mercury 
content  
(mcg
Hg/0.5mL)		 How Supplied
INACTIVATED INFLUENZA VACCINE, QUADRIVALENT, ADJUVANTED (aIIV4)
Fluad Quadrivalent ≥65yrs IM egg protein, neomycin, kanamycin, hydrocortisone, formaldehyde, CTAB 0 0.5mL single-dose prefilled syringe
INACTIVATED INFLUENZA VACCINE, QUADRIVALENT, HIGH DOSE (HD-IIV4)
Fluzone High-Dose Quadrivalent ≥65yrs IM egg protein, formaldehyde 0 0.7mL single-dose prefilled syringe
INACTIVATED INFLUENZA VACCINE, QUADRIVALENT (IIV4), STANDARD DOSE
Afluria
Quadrivalent		 ≥6mos IM egg protein, neomycin, polymyxin, hydrocortisone 24.5 5mL multi-dose vial2
≥3yrs 0 0.5mL single-dose prefilled syringe
Fluarix
Quadrivalent		 ≥6mos IM egg protein, polysorbate 80, gentamicin, hydrocortisone, formaldehyde 0 0.5mL single-dose prefilled syringe
FluLaval
Quadrivalent		 ≥6mos IM egg protein, formaldehyde 0 0.5mL single-dose prefilled syringe
Fluzone
Quadrivalent		 ≥6mos IM egg protein, formaldehyde 25 5mL multi-dose vial
0 0.5mL single-dose prefilled syringe,3 0.5 mL single-dose vial
INACTIVATED INFLUENZA VACCINE, QUADRIVALENT, CELL-CULTURE-BASED (ccIIV4)
Flucelvax
Quadrivalent		 ≥6mos IM 0 0.5mL single-dose prefilled syringe
25 5mL multi-dose vial
LIVE, ATTENUATED INFLUENZA VACCINE, QUADRIVALENT (LAIV4)
FluMist Quadrivalent 2–49yrs IN egg protein, porcine gelatin, arginine, gentamicin, EDTA 0 0.2mL single-dose prefilled nasal spray
RECOMBINANT INFLUENZA VACCINE, QUADRIVALENT (RIV4)
Flublok 
Quadrivalent		 ≥18yrs IM polysorbate 20 0 0.5mL single-dose prefilled syringe
NOTES

Key: IM = intramuscular; IN = intranasal

IM: For adults and older children, the recommended site of IM administration is the deltoid muscle. The preferred site for infants and young children is the anterolateral aspect of the thigh. Specific guidance regarding site and needle length for intramuscular administration can be found in ACIP’s General Recommendations on Immunization.

1 Persons with a history of egg allergy may receive any licensed, recommended influenza vaccine appropriate for recipient’s age and health status. Those who report having had reactions to egg involving symptoms other than urticaria (eg, angioedema, respiratory distress, lightheadedness, recurrent emesis), or who required epinephrine or another emergency medical intervention, should be vaccinated in an inpatient or outpatient medical setting, under the supervision of a healthcare provider who is able to recognize and manage severe allergic reactions, if a vaccine other than ccIIV4 or RIV4 is used.

2 May be administered by needle/syringe (≥6mos) or PharmaJet Stratis Needle-Free Injection System (18–64yrs only). Dose volume is 0.25mL for 6–35mos and 0.5mL for ≥3yrs.

3 Fluzone Quadrivalent 0.25mL prefilled syringes are not expected to be available for the 2022–2023 season. If a prefilled syringe is used for the 6–35mos age group, use the 0.5mL syringe.

Immunization providers should review FDA-approved prescribing information for 2022–2023 influenza vaccines for the most updated information, including (but not limited to) indications, contraindications, and precautions. Table listing reflects vaccines expected to be available during the 2022–2023 influenza season. This information is subject to change. For information on individual vaccines, see the product entries, contact the manufacturer, or call the National Immunization Hotline at (800) 232-4636.
REFERENCES

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(No. RR-1):1–28. DOI: http://dx.doi.org/10.15585/mmwr.rr7101a1

(Rev. 9/2022)

Topics:

Immunization Infectious Disease Influenza Vaccines