Seasonal Influenza Vaccine Pocket Guide 2020-2021 Edition

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Type: Pocket guide

Date Published: 2020-10-05

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Recommendations from the National Advisory
Committee on Immunization (NACI) 2020-2021

Who should receive the vaccine?

Everyone 6 months of age and older, who do not have contraindications to the vaccine, especially:

People at high risk of influenza-related complications or hospitalization

People capable of transmitting influenza to those at high risk

Others

Schedule

Adults and children 9 years of age and older should receive 1 dose of influenza vaccine each year.

Children 6 months to less than 9 years of age who have never received the influenza vaccine in a previous influenza season should be given 2 doses of influenza vaccine in the current season, with a minimum interval of 4 weeks between doses. If they have been properly vaccinated with one or more doses in the past, they should receive 1 dose of influenza vaccine per season thereafter.

Simultaneous administration with other vaccines

All seasonal influenza vaccines, including LAIV, may be given at the same time as, or at any time before or after administration of other live attenuated or inactivated vaccines.

Who should not receive the vaccine?

Live attenuated influenza vaccine (LAIV) is contraindicated for:

Choice of vaccine product

Abbreviations: IIV3: trivalent inactivated influenza vaccine; IIV4: quadrivalent inactivated influenza vaccine; LAIV: live attenuated influenza vaccine.

Children

Children 6-23 months of age

Healthy Children (2-17 years of age)

Children with immune compromising conditions (2-17 years of age)

Children with severe asthma or medically attended wheezing in previous 7 days (2-17 years of age)

Adults

Healthy adults (18-59 years of age)

Adults with chronic health conditions (18-59 years of age)

Adults 60-64 years of age

Adults ≥65 years of age

Others

Pregnant women

Healthcare workers

RECOMMENDED DOSAGE & ROUTE, BY AGE, FOR THE 2020-2021 SEASON
Age
group
Influenza vaccine type
(route of administration)
Number of doses
required
IIV3 Footnote a or IIV4 Footnote b
standard dose
(IM)
IIV3 adjuvanted Footnote c
(IM)
IIV3 high dose Footnote d
(IM)
LAIV Footnote e
(intranasal)
6-23 months 0.5 mL
Footnote f
0.25 mL - - 1 or 2Footnote g
2-8 years 0.5 mL - - 0.2 mL
(0.1 mL per nostril)
1 or 2Footnote g
9-17 years 0.5 mL - - 0.2 mL
(0.1 mL per nostril)
1
18-59 years 0.5 mL - - 0.2 mL
(0.1 mL per nostril)
1
60-64 years 0.5 mL - - - 1
≥65 years 0.5 mL 0.5 mL 0.5 mL - 1

Abbreviations: IIV3: trivalent inactivated influenza vaccine; IIV4: quadrivalent inactivated influenza vaccine; LAIV: live attenuated influenza vaccine; IM: intramuscular.

Footnote a

Agriflu®(6 months and older), Fluviral®(6 months and older), Influvac®(3 years and older).

Return to footnote a referrer

Footnote b

Afluria® Tetra (5 years and older), Flulaval® Tetra (6 months and older), Fluzone® Quadrivalent (6 months and older), Influvac® Tetra (3 years and older)

Return to footnote b referrer

Footnote c

Fluad Pediatric®(6-23 months) or Fluad®(65 years and older)

Return to footnote c referrer

Footnote d

Fluzone® High-Dose (65 years and older)

Return to footnote d referrer

Footnote e

FluMist® Quadrivalent (2-59 years)

Return to footnote e referrer

Footnote f

Evidence suggests moderate improvement in antibody response in infants, without an increase in reactogenicity, with the use of full vaccine doses (0.5 mL) for unadjuvanted inactivated influenza vaccines. This moderate improvement in antibody response without an increase in reactogenicity is the basis for the full dose recommendation for unadjuvanted inactivated vaccine for all ages.

Return to footnote f referrer

Footnote g

Children 6 months to less than 9 years of age receiving seasonal influenza vaccine for the first time in their life should be given 2 doses of influenza vaccine, with a minimum interval of 4 weeks between doses. Children 6 months to less than 9 years of age who have been properly vaccinated with one or more doses of seasonal influenza vaccine in the past should receive 1 dose of influenza vaccine per season thereafter.

Return to footnote g referrer

Source: 2020 Public Health Agency of Canada. An Advisory Committee Statement, National Advisory Committee on Immunization (NACI), Canadian Immunization Guide Chapter on Influenza and Statement on Seasonal Influenza Vaccine for 2020-2021 (See under Influenza for full document as well as related addenda available at www.canada.ca/en/public-health/services/immunization/national-advisory-committee-on-immunization-naci.html).

For recommendations regarding vaccine delivery and guidance in the context of COVID-19, refer to the Guidance for Influenza Vaccine Delivery in the Presence of COVID-19 and the Influenza section on the National Advisory Committee on Immunization (NACI): Statements and publications web page.

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