How should Fluarix (inactivated influenza vaccine) be administered, including dosage, injection site, and age-specific considerations?

How to Administer Fluarix

Fluarix is administered as a 0.5 mL intramuscular injection for all persons aged ≥6 months, regardless of age. 1

Dosage by Age

• All ages ≥6 months: 0.5 mL per dose 1
• Unlike some other influenza vaccines (Afluria, Fluzone), Fluarix does not have a reduced 0.25 mL dose option for young children 1
• This uniform dosing simplifies administration and reduces dosing errors 1

Injection Site Selection

For Infants and Young Children

• Anterolateral thigh is the preferred site for infants and younger children 1

For Older Children and Adults

• Deltoid muscle is the preferred site for older children and adults 1

Administration Technique

• Route: Intramuscular (IM) only 1
• Method: Needle and syringe only—Fluarix is not licensed for jet injector administration 1
• Refer to the General Best Practice Guidelines for Immunization for specific guidance on needle length selection based on patient age and size 1

Number of Doses for Children

• Children aged 6 months through 8 years who require 2 doses for the season need doses administered ≥4 weeks apart 1
• The number of doses needed depends on the child's prior influenza vaccination history 1

Storage Requirements

• Store at 2°C to 8°C (36°F to 46°F) 1
• Do not use if vaccine has been inadvertently frozen 1

Common Pitfalls to Avoid

Dosing Errors

• Do not split a 0.5 mL prefilled syringe into two 0.25 mL doses—this is never appropriate for Fluarix 1
• If a partial dose is inadvertently given to someone aged ≥36 months, administer the remaining volume during the same visit, or give a full 0.5 mL dose if the error is discovered later 1

Site Selection Errors

• Avoid using the deltoid in infants and very young children—use the anterolateral thigh instead 1
• Ensure proper needle length to achieve true intramuscular (not subcutaneous) administration 1

Contraindications and Precautions

Contraindications

• History of severe allergic reaction (anaphylaxis) to any component of Fluarix or to a previous dose of any influenza vaccine 1

Precautions

• Moderate or severe acute illness with or without fever—defer vaccination 1
• History of Guillain-Barré syndrome within 6 weeks of prior influenza vaccination 1

Egg Allergy Considerations

• Although Fluarix is egg-based, ACIP recommends that persons with egg allergy can receive any age-appropriate influenza vaccine, including Fluarix 1
• No special precautions or observation periods are required for egg-allergic individuals receiving Fluarix 1