What influenza vaccines are available in India?

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Influenza Vaccines Available in India

In India, both trivalent (IIV3) and quadrivalent (IIV4) inactivated influenza vaccines are available, with quadrivalent vaccines offering broader protection against circulating influenza B viruses and therefore being the preferred option for vaccination.

Types of Influenza Vaccines in India

Quadrivalent Inactivated Influenza Vaccines (IIV4)

  • Fluzone Quadrivalent (Sanofi Pasteur) - Available for individuals aged ≥6 months 1

    • Demonstrated good immunogenicity and safety profile in Indian children, adolescents, and adults
    • Available in different dose formulations: 0.25 mL for children 6-35 months and 0.5 mL for individuals ≥36 months

  • Influvac Tetra (Abbott) - Available for adults and elderly 2

    • Demonstrated adequate immune response with favorable safety profile in Indian adults and elderly

  • VaxiFlu-4 (Zydus Cadila Healthcare) - Available for adults and elderly 2

    • Comparable immunogenicity and safety profile to Influvac Tetra

Trivalent Inactivated Influenza Vaccines (IIV3)

While less commonly used now, trivalent vaccines have been available in India and may still be found in some settings 3.

Formulations and Administration

Age-Specific Dosing

  • Children 6-35 months: 0.25 mL dose 4
  • Individuals ≥36 months: 0.5 mL dose 4

Administration Route

  • Most influenza vaccines are administered intramuscularly 4
  • For adults and older children, the deltoid is the preferred site
  • For infants and younger children, the anterolateral thigh is recommended

Timing of Vaccination in India

The Indian Academy of Pediatrics (IAP) recommends that the ideal time for offering influenza vaccines in India is just before the onset of the rainy season 3:

  • June to August for most regions of India
  • October to December for Tamil Nadu

Vaccine Composition

Quadrivalent vaccines contain:

  • Two influenza A strains (H1N1 and H3N2)
  • Two influenza B strains (Victoria and Yamagata lineages)

This composition provides broader protection compared to trivalent vaccines, which contain only one B lineage strain 4.

Safety Profile

  • Most common injection site reactions: pain, redness, and swelling 1, 5
  • Most common systemic reactions:
    • Fever (especially in children 6-23 months)
    • Myalgia in older children and adolescents
    • Headache, fatigue, and mild gastrointestinal symptoms 1
  • Most reactions are mild to moderate (grade 1 or 2) and resolve within 3 days 1

Special Considerations

Egg Allergy

Most influenza vaccines are manufactured using egg-based technology and may contain residual egg protein. However, individuals with egg allergy can typically receive influenza vaccines with appropriate precautions 4.

Vaccine Effectiveness

The effectiveness of influenza vaccines depends on the match between vaccine strains and circulating viruses. Quadrivalent vaccines offer improved protection against circulating B viruses compared to trivalent vaccines 6.

Current Recommendations

The Indian Academy of Pediatrics recommends influenza vaccination for children with risk factors but not as a universal measure 3. Priority groups have been identified based on:

  • Contribution to overall influenza burden
  • Disease severity
  • Vaccine effectiveness in different age groups and categories

Conclusion

Quadrivalent influenza vaccines are now widely available in India and offer broader protection than trivalent vaccines. The choice of vaccine should be based on age, availability, and individual risk factors.

References

4
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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