Influenza virus, also known as the flu, is caused by influenza A and B viruses. Each year in Canada, about five to ten percent of adults and 20 to 30 percent of children are infected with influenza, usually in the late fall and winter months. The flu can cause serious complications among young children, older adults, pregnant people, people with chronic medical conditions, Indigenous people, and residents of long-term care homes and other chronic care facilities. Symptoms can be difficult to distinguish from other common respiratory infections.
For more information on clinical signs and symptoms, surveillance, laboratory testing, IPAC, reporting and patient resources, please see Respiratory Viruses Information for Health Professionals.
6 months and older: FluLaval Tetra, Fluzone® QIV, Flucelvax® Quad
65 years and older: Fluzone® QIV-HD, Fluad® TIV-adj.
| Quadrivalent Inactivated Vaccines (QIV) for Children & Adults | Vaccines for Seniors | ||||
|---|---|---|---|---|---|
| Trade names | FluLaval®
Tetra |
Fluzone®
Quadrivalent |
Flucelvax® Quad | Fluzone®
HD-QIV |
Fluad®
Adjuvanted-TIV |
| Age eligibility | 6 months and older | 6 months and older |
6 months and older | 65 years and older | 65 years and older |
| Dosage | 0.5 mL | 0.5 mL | 0.5 mL | 0.7 mL | 0.5 mL |
| Route | IM injection | IM injection | IM injection | IM injection | IM injection |
| Hemagglutinin (HA) dose | 15 µg HA
per strain |
15 µg HA
per strain |
15 µg HA
per strain |
60 µg HA
per strain |
15 µg HA
per strain |
| Allergens | Egg protein1, thimerosal (only in MDV) |
Egg protein1,
thimerosal |
Does NOT contain egg protein or thimerosal | Egg protein1 | Egg protein1, Kanamycin, neomycin |
| Packaging | |||||
| Dimensions (cm) LxWxH
|
MDV=
2.7 x 2.7 x 6.9
|
MDV =
5.8 x 5.4 x 3.6 PFS = 10.4 x 9.9 x 3.8 |
PFS =
15.4 x 13 x 2.4
|
PFS =
10.4 x 9.9 x 2.3
|
PFS =
15.4 x 13 x 2.4
|
| Post-puncture shelf life | 28 days2
|
MDV =28 days2
PFS = Not |
Not applicable | Not applicable | Not applicable |
| Product distribution | Primary care providers/pediatricians, participating pharmacies3, retirement homes, long-term care homes, hospitals | ||||
| Abbreviations | Multi-dose vial (MDV), Prefilled syringe (PFS), Long-Term Care homes (LTCs), Intramuscular (IM) | ||||
1The National Advisory Committee on Immunization (NACI) indicates that egg allergy is not a contraindication for influenza vaccination and that that egg-allergic individuals may be vaccinated against influenza using the full dose of any age-appropriate product.
2 Providers are to report all vaccine wastage.
3 Trained pharmacists, pharmacy technicians, pharmacy students and interns may only administer publicly funded influenza vaccine to individuals 2 years of age and older.
Fluzone® Quadrivalent and Fluzone® High-Dose Quadrivalent are different products. Health care providers should use caution when administering Fluzone® products to ensure that the right vaccine is being administered to the right person.
Note: Fluzone® QIV-HD, Fluad® TIV-adj are approved just for seniors to give better protection against the flu. Both vaccines may cause more soreness, redness and swelling where the vaccine was given, lasting a few days longer than the standard flu vaccine.
For adults 65 years of age and older, the Fluzone® QIV-HD or Fluad® TIV-adj should be offered over QIV influenza vaccines. However, if a preferred product is not available, any of the available age-appropriate influenza vaccines (including QIV) should be used. The most important thing is for older adults to be vaccinated. DO NOT delay vaccination to wait for a particular vaccine product.
All available influenza vaccines can be given to individuals six months of age and older at the same time as most other vaccines, or at any time before or after, other vaccines, including the COVID-19 vaccine and/or Abrysvo, the recently approved vaccine for respiratory syncytial virus (RSV).
For more information about ordering vaccines for your practice please visit Vaccine Ordering from Toronto Public Health.
Since March 2020, there have been no confirmed naturally occurring B/Yamagata lineage virus detections.
The National Advisory Committee on Immunization (NACI) has provided the following guidance:
Toronto Paramedic Services offers fall vaccinations for homebound residents with medical, physical, cognitive, or psychosocial barriers, where transportation and other access solutions are unavailable or unsuitable.
The program closed March 31, 2025 for the season. The program will re-open in October, 2025 for the 2025-2026 season.
Resources & Publications – AMMI – under “Resources” click on “Influenza” tab
On November 13, 2024, the Public Health Agency of Canada (PHAC) released a statement confirming the first domestically acquired human case of H5N1 avian influenza in Canada.
Based on current evidence, the risk of avian influenza infection for the general public remains low. However, due to this evolving risk, there is a necessity for enhanced influenza surveillance of hospitalized patients, including: