Influenza Vaccine Recommendations

General Recommendations

The Centers for Disease Control and Prevention recommends that all persons aged ≥6 months who do not have contraindications should receive routine annual influenza vaccination 2
For each recipient, a licensed and age-appropriate vaccine should be used 2
All seasonal influenza vaccines expected to be available in the United States are quadrivalent, containing hemagglutinin (HA) derived from one influenza A(H1N1)pdm09 virus, one influenza A(H3N2) virus, one influenza B/Victoria lineage virus, and one influenza B/Yamagata lineage virus 2

The Centers for Disease Control and Prevention recommends that for most persons who need only 1 dose of influenza vaccine for the season, vaccination should ideally be offered during September or October 1
Vaccination should continue after October and throughout the season as long as influenza viruses are circulating and unexpired vaccine is available 2
For adults aged ≥65 years and pregnant persons in the first or second trimester: Avoid vaccination during July and August unless there is concern that vaccination later in the season might not be possible 1
Children aged 6 months through 8 years who require 2 doses should receive the first dose as soon as possible after vaccine is available, including during July and August 1

For children aged 6 months through 35 months, appropriate dose volumes differ by product, with Afluria Quadrivalent: 0.25 mL per dose, Fluarix Quadrivalent: 0.5 mL per dose, Flucelvax Quadrivalent: 0.5 mL per dose, FluLaval Quadrivalent: 0.5 mL per dose, and Fluzone Quadrivalent: Either 0.25 mL or 0.5 mL per dose 3, 1, 4
For children aged 36 months through 17 years, all IIV4s are administered at 0.5 mL per dose 4
For adults aged ≥65 years, preferentially receive any one of the following: Quadrivalent high-dose inactivated influenza vaccine (HD-IIV4) - 0.7 mL per dose, Quadrivalent recombinant influenza vaccine (RIV4) - 0.5 mL per dose, or Quadrivalent adjuvanted inactivated influenza vaccine (aIIV4) - 0.5 mL per dose 1, 3, 4

Children aged 6 months through 8 years require 2 doses of influenza vaccine (separated by at least 4 weeks) if they have never received influenza vaccine before or have not received a total of ≥2 doses of influenza vaccine before July 1, 2022 1
There is no required waiting period after influenza infection before administering the vaccine, only that the child has clinically recovered from the acute illness 5