Influenza Vaccine Dosing Recommendations

Dose Volume by Age Group

The Centers for Disease Control and Prevention recommends that children 6-35 months receive either 0.25 mL or 0.5 mL of influenza vaccine, depending on the specific vaccine product, and children ≥36 months and adults receive 0.5 mL, and adults ≥65 years receive either 0.5 mL or 0.7 mL 1
For children 6-35 months, the dose volume varies by vaccine brand, with Afluria being 0.25 mL per dose, and Fluarix, Flucelvax, and FluLaval being 0.5 mL per dose 1, 2
For children ≥36 months through adults <65 years, the standard dose is 0.5 mL per dose for all inactivated influenza vaccines 1, 5
For adults ≥65 years, the standard dose is 0.5 mL per dose, and the high-dose vaccine is 0.7 mL per dose 1, 3, 5

The American Academy of Pediatrics recommends that children 6 months through 8 years receive one dose of influenza vaccine if they have previously received ≥2 total doses of influenza vaccine ≥4 weeks apart before July 1 of the current season, and two doses if they have not previously received ≥2 doses ≥4 weeks apart 2, 1, 6
Children ≥9 years and adults require one dose per season, regardless of vaccination history 2, 6

Inactivated vaccines should be administered via intramuscular injection, with the deltoid muscle preferred for adults and older children, and the anterolateral thigh for infants and younger children 1, 5
Live attenuated vaccine should be administered via intranasal spray 2

Pregnant persons can receive any licensed, age-appropriate inactivated or recombinant vaccine at standard adult dose, but live attenuated vaccine should not be used during pregnancy 3, 6
Immunocompromised persons should receive standard dosing, and live attenuated vaccine should not be used 2, 5