Influenza Vaccine Options 2020-2021 Season

Annual vaccination is recommended for everyone age 6 months and older as the best way to prevent influenza (flu) and related complications. Flu vaccines are updated annually to protect against the influenza viruses research indicates are most likely to circulate during the upcoming season. Even in cases when vaccination does not prevent infection completely, it can reduce the severity of the disease and prevent the most serious complications of flu, including hospitalization and death.

There are several types of flu vaccines offered at many convenient locations, including physician offices, public health departments, pharmacies and retail stores, workplaces, and schools. Many insurance plans pay for annual flu vaccination. Individuals covered by Medicare Part B can get a flu vaccine at no cost (no co-pay, no deductible). Health experts advise not to delay if your first choice of vaccine is not available.

What types of flu vaccines are available?

The Centers for Disease Control and Prevention (CDC) recommends the use of any licensed, age-appropriate influenza (flu) vaccine during the 2020-2021 influenza season. Options include inactivated influenza vaccine [IIV], recombinant influenza vaccine [RIV4], and live attenuated influenza vaccine (LAIV4). Different vaccines are licensed for different age groups, and some vaccines are not recommended for certain groups of people. But where more than one suitable vaccine is available, no preference is expressed for any influenza flu vaccine over another.
Most vaccines available for the 2020-2021 season will be quadrivalent, with the exception of MF59-adjuvanted IIV, which is expected to be available in both quadrivalent and trivalent formulations.

Trivalent flu vaccine:

  • A trivalent flu vaccine with an adjuvant (an ingredient that helps create a stronger immune response), approved for adults age 65 years and older (also available as a quadrivalent vaccine).

Quadrivalent flu vaccines:

  • Standard-dose quadrivalent flu vaccines without adjuvant that are manufactured using virus grown in eggs. Several different brands are available, and they are approved for different age groups. Some are approved for children as young as 6 months of age. Most flu vaccines are given in the arm (muscle) with a needle. One quadrivalent flu vaccine can be given either with a needle (for individuals age 6 months and older) or with a jet injector (for individuals age 18 through 64 years only).
  • A quadrivalent cell-based flu vaccine containing virus grown in cell culture, approved for individuals age 4 years and older.
  • A recombinant quadrivalent flu vaccine (made without influenza viruses or eggs) approved for individuals age 18 years and older.
  • A quadrivalent live attenuated influenza nasal spray vaccine (LAIV4) made with attenuated (weakened) live flu viruses, approved for use in individuals age 2 years through 49 years. This vaccine is not recommended for use in pregnant women or in individuals with certain medical conditions.
  • Flu vaccines approved for adults age 65 years and older include a high-dose, egg-based quadrivalent and a standard-dose, egg-based quadrivalent made with an adjuvant to create a stronger immune response (also available as a trivalent vaccine.)

Influenza vaccine should be used with caution in anyone with a history of Guillain-Barré Syndrome within 6 weeks following a previous influenza vaccine dose.

COVID-19: The 2020-2021 influenza season may coincide with circulation of SARS-CoV-2, the novel coronavirus that causes COVID-19. Flu vaccines will not prevent COVID-19, but flu vaccination can help prevent illness, hospitalization, and death; reduce occurrence of symptoms that may be confused with COVID-19; and reduce the potential strain on the US healthcare system.

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Source: Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices – United States, 2020-2021 Influenza Season. MMWR Recomm Rep 2020;69(No. RR-8):1-24. DOI:

September 2020