Updates this year include the antigenic composition of seasonal influenza vaccines available in the United States, the addition of two new influenza vaccines for use in people 65 years and older, and new contraindications and precautions for the use of live attenuated influenza vaccine (LAIV) Because the 2020–2021 influenza season will coincide with the coronavirus disease 2019 (COVID-19) pandemic, vaccination of people six months and older is of particular importance to reduce symptoms that could be confused with those of COVID-19 and to alleviate stress on the health care system Influenza Vaccines—United States, 2020–2021 Influenza Season Trade name Formulation Age indication Hemagglutinin or virus count per vaccine virus (per dose) Route of administration Mercury from thimerosal (mcg per 0 5 mL) IIV4, standard dose, egg based* Afluria Quadrivalent 0 25-mL prefilled syringe† 6 to 35 months 7 5 mcg per 0 25 mL IM‡ — 0 5-mL prefilled syringe† ≥ 3 years 15 mcg per 0 5 mL IM‡ — 5 0-mL multidose vial† ≥ 6 months (needle/syringe) 7 5 mcg per 0 25 mL/15 mcg per 0 5 mL IM‡ 24 5 18 to 64 years (jet injector) Fluarix Quadrivalent 0 5-mL prefilled syringe ≥ 6 months 15 mcg per 0 5 mL IM‡ — Flulaval Quadrivalent 0 5-mL prefilled syringe ≥ 6 months 15 mcg per 0 5 mL IM‡ — Fluzone Quadrivalent 0 5-mL prefilled syringe§ ≥ 6 months 15 mcg per 0 5 mL IM‡ — 0 5-mL single-dose vial ≥ 6 months 15 mcg per 0 5 mL IM‡ — 5 0-mL multidose vial ≥ 6 months 15 mcg per 0 5 mL IM‡ 25 IIV4, standard dose, cell culture based Flucelvax 0 5-mL prefilled syringe ≥ 4 years 15 mcg per 0 5 mL IM‡ — Quadrivalent 5 0-mL multidose vial ≥ 4 years 15 mcg per 0 5 mL IM‡ 25 IIV4, high dose, egg based* Fluzone High-Dose Quadrivalent 0 7-mL prefilled syringe ≥ 65 years 60 mcg per 0 7 mL IM‡ — IIV4, standard dose, egg based* with MF59 adjuvant Fluad Quadrivalent 0 5-mL prefilled syringe ≥ 65 years 15 mcg per 0 5 mL IM‡ — IIV3, standard dose, egg based* with MF59 adjuvant Fluad 0 5-mL prefilled syringe ≥ 65 years 15 mcg per 0 5 mL IM‡ — Recombinant influenza vaccine Flublok Quadrivalent 0 5-mL prefilled syringe ≥ 18 years 45 mcg per 0 5 mL IM‡ — Live attenuated influenza vaccine, egg based* Flumist Quadrivalent 0 2-mL prefilled single-use intranasal sprayer 2 to 49 years 106 5–7 5 fluorescent focus units per 0 2 mL Intranasal — Note: Vaccination providers should consult prescribing information for 2020–2021 influenza vaccines for the most complete and updated information Higher-risk people: ○ Adults 50 years and older ○ American Indians/Alaska Natives ○ Children six to 59 months of age ○ Children up to 18 years of age who are receiving aspirin- or salicylate-containing medications (risk of Reye syndrome after influenza virus infection) ○ Immunocompromised people ○ People with a body mass index of 40 kg per m2 or greater ○ People with chronic pulmonary, cardiovascular, renal, hepatic, neurologic, hematologic, or metabolic disorders other than uncomplicated hypertension ○ Pregnant women ○ Residents of long-term care facilities Household contacts and caregivers of higher-risk people Health care professionals, including students and staff who could be exposed to infectious agents Guideline source: