Dosage Forms. Suspension for Intramuscular Injection: 0.5 mL vial (available as trivalent product containing two strains of influenza A virus and one influenza B virus strain and as a quadrivalent product containing two strains of influenza A virus and two influenza B virus strains); Suspension for Intradermal Injection: 0.1 mL in prefilled intradermal injection system
Common FDA Label Indication, Dosing, and Titration.
1. Prevention of influenza infection: Adults, one dose annual prior to or during influenza season; Children aged 6 mo to 8 y who have not been vaccinated in the past, 2 doses separated by at least 4 wk during the first season they receive influenza vaccine
Off-Label Uses. None
Drug Characteristics: Influenza Virus Vaccine, Inactivated
Medication Safety Issues: Influenza Virus Vaccine, Inactivated
Drug Interactions: Influenza Virus Vaccine, Inactivated
Adverse Reactions: Influenza Virus Vaccine, Inactivated
Efficacy Monitoring Parameters. Prevention of influenza infection.
Toxicity Monitoring Parameters. Syncope.
Key Patient Counseling Points. Annual seasonal immunization is recommended.
Clinical Pearls. Choose the vaccine preparation for appropriate age group. Use current year vaccine only (virus strains and vaccine vary year to year). Not all influenza vaccines are licensed for young children. Intradermal influenza vaccine licensed for adults aged 18-64 y. High-dose influenza vaccine licensed for individuals aged 65 y and older and immunocompromised or chronically ill patients. Flubok, a recombinant influenza vaccine for adults aged 18-49 y, is cultured in cells rather than eggs, so egg allergy is not a concern. Recommendations for dosing based on age group vary from year to year. Flucelvax is manufactured without chicken eggs and can be used in egg-allergic patients. Afuria is not recommended in children <9 y due to risk of febrile seizures.