Both the inactivated (IIV) and recombinant (RIV) influenza vaccine VIS and the live influenza vaccine VIS were updated on August 6, 2021.
The IIV and RIV influenza vaccine VIS and all available translations of it are here: www.immunize.org/vaccines/vis/influenza-inactivated/. The live attenuated influenza (LAIV) VIS and all available translations of it are here: www.immunize.org/vaccines/vis/influenza-live/.
Immunize.org also offers a printable PDF document with QR codes for easy access to all IIV and RIV influenza vaccine VIS translations: www.immunize.org/wp-content/uploads/catg.d/p2092.pdf. Healthcare providers or recipients can scan the QR codes to access a digital copy of the English version or any translation on their mobile device.
Last reviewed:
August 11, 2024
CDC discourages the practice of prefilling vaccine into syringes for several reasons, including:
- The increased possibility of administration and dosing errors
- The increased risk of inappropriate storage temperature
- The probability of bacterial contamination
- The probability of reducing the vaccine’s potency over time
Prefilling vaccine into syringes also violates basic medication administration guidelines, which state that an individual should administer only those medications he or she has prepared and drawn up.
Although pre-drawing vaccine is discouraged, a limited amount of vaccine may be pre-drawn in a mass vaccination clinic setting under the following conditions:
- Only a single type of vaccine (for example, influenza) is administered at the mass vaccination clinic setting
- Vaccine is not drawn up in advance of its arrival at the mass vaccination clinic site
- These pre-drawn syringes are stored at temperatures appropriate for the vaccine
- No more than 1 vial or 10 doses (whichever is greater) is drawn into syringes
- Clinic staff monitor patient flow carefully and avoid drawing up unnecessary doses or delaying administration of pre-drawn doses
At the end of the clinic day, all remaining vaccine in syringes prefilled by staff should be discarded.
Last reviewed:
August 11, 2024
Vaccinating people against influenza who have recently tested positive for COVID-19 involves multiple considerations, such as whether vaccinating them could expose others to COVID-19, how sick they are, their risk for severe influenza illness, the ability to vaccinate at a later date, and the desire to avoid confusing postvaccination symptoms with those of COVID-19. Usually, people who are known to be infectious should not be brought to a vaccination setting if doing so could expose others to COVID-19. Any moderate or severe acute illness is a precaution to influenza vaccination: vaccination should generally be deferred until recovery. For people with mild or asymptomatic COVID-19, delaying vaccination also might be considered to avoid confusing COVID-19 symptoms with postvaccination reactions.
Last reviewed:
August 11, 2024
Inactivated and recombinant influenza vaccines are not known to cause false positive nasal swab tests. The results may indicate real infections; however, false positive test results are possible with rapid tests, and these are more likely to occur if the tests are done when influenza prevalence in the area is low, such as early in the influenza season. For more information regarding interpretation of rapid influenza tests see www.cdc.gov/flu/professionals/diagnosis/rapidlab.htm.
Last reviewed:
August 11, 2024
IIV should be administered in the anterolateral thigh muscle of an infant or young child. IIV and RIV (approved for people age 18 years and older) should be administered in the deltoid muscle of an older child, adolescent, or adult. The anterolateral thigh muscle can also be used for an older child, adolescent, or adult if necessary. It is critical that intramuscular influenza vaccine be injected into a muscle. Influenza vaccination season is an opportune time to review proper intramuscular injection techniques with your staff. Immunize.org has prepared a printable document on how to administer intramuscular vaccine injections (available at www.immunize.org/catg.d/p2020.pdf) that can be used as a staff training tool.
Last reviewed:
August 11, 2024
This is not an acceptable practice. Doses of influenza vaccine (or any other vaccine) should never be split into “half doses.” If a “half dose” is administered, it should not be accepted as a valid dose. The second half of the dose may be administered if the error is caught and corrected on the same day; if not, repeat the vaccination on a different day as soon as possible with a full age-appropriate dose.
Last reviewed:
August 11, 2024
Yes. Syncope may occur following any vaccination. It is prudent for all people to be observed for syncope for at least 15 minutes after any vaccination. Immunize.org has a 1-page resource for healthcare professionals that summarizes ways to reduce the risk of post-vaccination syncope: www.immunize.org/wp-content/uploads/catg.d/p4260.pdf.
Last reviewed:
August 11, 2024
Certain vaccine syringes have small hubs where a volume of the vaccine that is withdrawn from the vial collects and is not available to be injected. Syringes without a hub are available; their use results in less vaccine wastage.
Last reviewed:
August 11, 2024
No. Only the number of doses indicated in the manufacturer’s package insert should be withdrawn from the vial. For a 5.0 mL vial of Fluzone this is 10 doses. For Afluria 5.0 mL multidose vial, the package insert states that the stopper can be punctured up to 20 times, allowing up to 20 doses of 0.25 mL dose for children age 6–35 months old. After the maximum number of doses has been withdrawn or number of punctures of the stopper has met the FDA-recommended limit, the vial should be discarded, even if there is vaccine remaining in the vial and the expiration date has not been reached.
Last reviewed:
August 11, 2024
The dose does not need to be repeated. However, this is a vaccine administration error. Clinicians should carefully select an influenza vaccine and vaccine dose that is licensed for the age group of the person being vaccinated. The error should be conveyed to the child’s parent or guardian and reported to Vaccine Adverse Events Reporting System (VAERS) at www.vaers.hhs.gov. Actions should be taken to limit vaccine administration errors at the clinic where the error occurred. Immunize.org’s educational piece “Influenza Vaccine Products for the 2024-2025 Influenza Season” (available at www.immunize.org/catg.d/p4072.pdf) provides helpful information on the wide variety of influenza vaccines in use this season.
Last reviewed:
August 11, 2024
RIV is not licensed for people younger than 18 years of age, so there are no data regarding safety and efficacy in this age group. However, no serious side effects would be expected. The dose does not need to be repeated and should be considered valid. Even if no adverse reaction occurs, vaccine administration errors like this should be reported to the Vaccine Adverse Events Reporting System (VAERS) at www.vaers.hhs.gov.
Last reviewed:
August 11, 2024
If the error is discovered on the same clinic day you can administer the other “half” of the FluLaval dose on the same day. If the error cannot be corrected on the same day, the partial dose should not be counted. The child should be recalled to the office as soon as possible and given a full age-appropriate repeat dose, either a 0.5 mL dose of FluLaval , a 0.5 mL dose of Fluarix , a 0.25 or 0.5 mL dose of Fluzone , a 0.25 mL dose of Afluria , or a 0.5 mL dose of Flucelvax.
Last reviewed:
August 11, 2024
