A Clinician’s Handbook for Childhood & Adult Immunizations in Georgia

Influenza (IIV)

Recombinant Influenza (RIV) and cell culture-based (ccIIV)

Pathophysiology

  • Virus
  • Highly contagious
  • Respiratory transmission
  • Virus shed in respiratory secretions for 3-10 days

Dose & Route

Administer an age-appropriate formulation and dose of influenza vaccine intramuscularly annually. 

Vaccine Description

*All flu vaccines for the 2024-2025 season will be trivalent in the United States. Information for the 2024-2025 Flu Season | CDC

  • IIV 3 – Trivalent -Inactivated, split-virus vaccine composed of 3 virus strains two types A and one type B
  • IIV4 -Quadrivalent -Inactivated, split-virus vaccine composed of 4 virus strains two types A and two type B
  • RIV3 – Recombinant influenza vaccine trivalent
  • RIV4 – Recombinant Influenza vaccine quadrivalent
  • ccIIV4 – cell culture based

Brand Information

Fluzone® sanofi-pasteur (IIV3) (0.25 mL)
Approved for persons 6 months through 35 months

Fluzone® sanofi-pasteur (IIV3)  (0.5  mL)
Approved for persons 6 months and older

Fluzone High Dose® sanofi-pasteur (IIV3) (0.5 mL)
Approved for persons 65 years and older

Afluria® Seqirus (IIV3) (0.25 mL)
Approved for persons 6 months through 35 months

Afluria® Seqirus (IIV3) (0.5 mL)
Approved for persons 3 years and older

Fluarix™ GSK (IIV3) (0.5 mL)
Approved for persons 6 months of age and older

FluLaval ™ GSK (IIV3) (0.5 mL)
Approved for persons 6 months of age and older

Flublok® (RIV3) (0.5mL)
Approved for persons 18 years and older

Flucelvax® Seqirus (ccIIV3) (0.5 mL)
Approved for persons  6 months and older

Fluad™ Seqirus (aIIV3) (0.5 mL)
Approved for persons 65 years and older

Recommendations

** Beginning with the 2022-2023 flu season, there are three flu vaccines that are preferentially recommended for people aged 65 and older. These are Fluzone High-Dose Quadrivalent vaccineFlublok Quadrivalent recombinant flu vaccine, and Fluad Quadrivalent adjuvanted flu vaccine.

Contraindications

  • Severe allergic reaction (e.g., anaphylaxis) after previous dose of any influenza vaccine or to a vaccine component (other than egg proteins)
  • Moderate or severe acute illness with or without fever.
  • History of Guillain-Barre Syndrome (GBS) within 6 weeks of previous influenza vaccination.

Special Considerations

  • Pregnant people who are in their third trimester can get a flu vaccine in July or August to protect their babies from flu after birth, when they are too young to get vaccinated.
  • Children who need two doses of the flu vaccine should get their first dose of vaccine as soon as it becomes available. The second dose should be given at least four weeks after the first.
  • Vaccination in July or August can be considered for children who have health care visits during those months if there might not be another opportunity to vaccinate them.
  • For adults (especially those 65 years old and older) and pregnant people in the first and second trimester, vaccination in July and August should be avoided unless it won’t be possible to vaccinate in September or October.