Recommended Seasonal Influenza Vaccines for Different Age Groups: United States, 2022–2023 Influenza Season
| Vaccine . | Trade Name (Manufacturer) . | Age Group . | Presentation and Hemagglutinin Antigen Content (IIVs and RIV4) or Virus Count (LAIV4) Per Dose for Each Antigen . | Thimerosal Mercury Contenta (μg Hg Per 0.5-mL Dose) . | CPT Code . |
|---|---|---|---|---|---|
| Quadrivalent standard dose: egg-based vaccines | |||||
| IIV4 | Afluria quadrivalent (Seqirus) | 6–35 mo | 0.25-mL prefilled syringeb (7.5 μg per 0.25 mL) | 0 | 90685 |
| ≥36 mo | 0.5-mL prefilled syringe (15 μg per 0.5 mL) | 0 | 90686 | ||
| ≥6 moc | 5.0-mL multidose viald (15 μg per 0.5 mL) | 24.5 | 90687 | ||
| IIV4 | Fluarix quadrivalent (GlaxoSmithKline) | ≥6 mo | 0.5-mL prefilled syringe (15 μg per 0.5 mL) | 0 | 90686 |
| IIV4 | FluLaval quadrivalent (GlaxoSmithKline) | ≥6 mo | 0.5-mL prefilled syringe (15 μg per 0.5 mL) | 0 | 90686 |
| IIV4 | Fluzone quadrivalent (Sanofi Pasteur) | ≥6 mo | 0.5-mL prefilled syringe (15 μg per 0.5 mL)(0.25 mL prefilled syringe no longer availablee) | 0 | 90686 |
| ≥6 mo | 0.5-mL single-dose viale,f (15 μg per 0.5 mL) | 0 | 90686 | ||
| ≥6 mo | 5.0-mL multidose viald,e (15 μg per 0.5 mL) | 25 | 90687 | ||
| Quadrivalent standard dose: cell culture-based vaccines | |||||
| ccIIV4 | Flucelvax quadrivalent (Seqirus) | ≥6 mo | 0.5-mL prefilled syringe (15 μg per 0.5 mL) | 0 | 90674 |
| ≥6 mo | 5.0-mL multidose viald (15 μg per 0.5 mL) | 25 | 90756 | ||
| Quadrivalent standard dose: egg-based with adjuvant vaccines | |||||
| aIIV4 | Fluad quadrivalent (Seqirus)g | ≥65 y | 0.5-mL prefilled syringe (15 μg per 0.5 mL) | 0 | 90653 |
| MF-59 adjuvanted | |||||
| Quadrivalent high dose: egg-based vaccine | |||||
| IIV4 | Fluzone high-dose (Sanofi Pasteur)g | ≥65 y | 0.7-mL prefilled syringe (60 μg per 0.7 mL) | 0 | 90662 |
| Recombinant vaccine | |||||
| RIV4 | Flublok quadrivalent (Sanofi Pasteur) | ≥18 y | 0.5-mL prefilled syringe (45 μg per 0.5 mL) | 0 | 90682 |
| Live attenuated vaccine: egg-based vaccine | |||||
| LAIV4 | FluMist quadrivalent (AstraZeneca) | 2–49 y | 0.2-mL prefilled intranasal sprayer (virus dose: 10 6.5–7.5 FFU per 0.2 mL) | 0 | 90672 |
| Vaccine . | Trade Name (Manufacturer) . | Age Group . | Presentation and Hemagglutinin Antigen Content (IIVs and RIV4) or Virus Count (LAIV4) Per Dose for Each Antigen . | Thimerosal Mercury Contenta (μg Hg Per 0.5-mL Dose) . | CPT Code . |
|---|---|---|---|---|---|
| Quadrivalent standard dose: egg-based vaccines | |||||
| IIV4 | Afluria quadrivalent (Seqirus) | 6–35 mo | 0.25-mL prefilled syringeb (7.5 μg per 0.25 mL) | 0 | 90685 |
| ≥36 mo | 0.5-mL prefilled syringe (15 μg per 0.5 mL) | 0 | 90686 | ||
| ≥6 moc | 5.0-mL multidose viald (15 μg per 0.5 mL) | 24.5 | 90687 | ||
| IIV4 | Fluarix quadrivalent (GlaxoSmithKline) | ≥6 mo | 0.5-mL prefilled syringe (15 μg per 0.5 mL) | 0 | 90686 |
| IIV4 | FluLaval quadrivalent (GlaxoSmithKline) | ≥6 mo | 0.5-mL prefilled syringe (15 μg per 0.5 mL) | 0 | 90686 |
| IIV4 | Fluzone quadrivalent (Sanofi Pasteur) | ≥6 mo | 0.5-mL prefilled syringe (15 μg per 0.5 mL)(0.25 mL prefilled syringe no longer availablee) | 0 | 90686 |
| ≥6 mo | 0.5-mL single-dose viale,f (15 μg per 0.5 mL) | 0 | 90686 | ||
| ≥6 mo | 5.0-mL multidose viald,e (15 μg per 0.5 mL) | 25 | 90687 | ||
| Quadrivalent standard dose: cell culture-based vaccines | |||||
| ccIIV4 | Flucelvax quadrivalent (Seqirus) | ≥6 mo | 0.5-mL prefilled syringe (15 μg per 0.5 mL) | 0 | 90674 |
| ≥6 mo | 5.0-mL multidose viald (15 μg per 0.5 mL) | 25 | 90756 | ||
| Quadrivalent standard dose: egg-based with adjuvant vaccines | |||||
| aIIV4 | Fluad quadrivalent (Seqirus)g | ≥65 y | 0.5-mL prefilled syringe (15 μg per 0.5 mL) | 0 | 90653 |
| MF-59 adjuvanted | |||||
| Quadrivalent high dose: egg-based vaccine | |||||
| IIV4 | Fluzone high-dose (Sanofi Pasteur)g | ≥65 y | 0.7-mL prefilled syringe (60 μg per 0.7 mL) | 0 | 90662 |
| Recombinant vaccine | |||||
| RIV4 | Flublok quadrivalent (Sanofi Pasteur) | ≥18 y | 0.5-mL prefilled syringe (45 μg per 0.5 mL) | 0 | 90682 |
| Live attenuated vaccine: egg-based vaccine | |||||
| LAIV4 | FluMist quadrivalent (AstraZeneca) | 2–49 y | 0.2-mL prefilled intranasal sprayer (virus dose: 10 6.5–7.5 FFU per 0.2 mL) | 0 | 90672 |
Data sources: Centers for Disease Control and Prevention. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices, United States, 2022–2023 influenza season. MMWR Recomm Rep. 2022; in press. Implementation guidance on supply, pricing, payment, Current Procedural Terminology coding, and liability issues can be found at www.aapredbook.org/implementation. aIIV4, quadrivalent adjuvanted inactivated influenza vaccine; ccIIV4, quadrivalent cell culture-based inactivated influenza vaccine; CPT, Current Procedural Terminology; FFU, fluorescent focus unit; LAIV4, quadrivalent live attenuated influenza vaccine; RIV4, quadrivalent recombinant influenza vaccine.
See thimerosol-containing vaccines in the technical report.4
The 0.25-mL prefilled syringes are not expected to be available for the 2022-2023 season. For children aged 6 through 35 months, a 0.25-mL dose must be obtained from a multidose vial.
The dose is 0.25 mL for children 6 through 35 months of age and a 0.5-mL product for children 3 years and older.
For vaccines that include a multidose vial presentation, the maximum number of doses withdrawn should not exceed the number specified in the package insert (eg, 10 doses for Fluzone, 20 doses for Afluria). Residual product should be discarded.
A total of 0.25 mL drawn from a single or multidose vial is an acceptable dose for children 6 to 35 months of age.
Single-dose vials should be used for only 1 dose (0.25 mL or 0.5 mL). Residual product remaining in the vial should be discarded.
Not approved for use in children.