Making evidence-based selections of influenza vaccines

Figures & data

Table 1. Routes of influenza vaccine delivery⁷

Vaccine Name	Route of Administration
Flumist (LAIV)	Intranasal
Fluzone (TIV)	Intradermal
All other flu vaccines (QIV/TIV)	Intramuscular

Table 2. Comparative vaccine efficacy based on delivery mechanism

Study: Intramuscular vs Intradermal^11,12
Vaccine	Intradermal	Intramuscular
Seroconversion rate	78%	66%
Seroconversion rate	85%	79%
Study: Intramuscular vs Intranasal ^8
Vaccine	Intranasal	Intramuscular
Protective efficacy	85%	71%
Relative efficacy to intramuscular	27% (more effective)	—

Table 3. Flu vaccines available for 2013–2014 season⁷

Vaccine	Composition	Delivery Route	Restrictions	Notes
FluMist	Quadrivalent -LAIV	Intranasal	Ages 2–49 only	Not for persons with chronic disease
Fluarix	QIV	Intramuscular (IM)	Ages 3+
FluLaval	QIV	IM	6 mo +
Afluria	TIV	IM	Ages 9 +	Linked to fever in children under 9
Fluarix	TIV	IM	Ages 3+
Flucelvax	TIV	IM	Ages 18+, contraindicated in severe egg allergy	Cell culture-based vaccine
FluLaval	TIV	IM	Ages 3+
Fluvirin	TIV	IM	Ages 4+
Fluzone	TIV	IM	6 mo +
Fluzone ID	TIV	Intradermal (ID)	Ages 18–64	More common reactions at injection site
Fluzone HD	TIV	IM	Ages 65+	Contains 4X as much inactivated vaccine as standard injections
Flublok	Trivalent recombinant	IM	Ages 18–49	Completely egg-free

Figure 1. Selecting the Appropriate Flu Vaccine

Flu vaccines 2013-2014. Pharmacist's Letter/Prescriber's Letter Detail Document #291001. October 2013. Available at: www.pharmacistsletter.com. Accessed on January 9, 2014.

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