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FLUZONE® Quadrivalent Vaccine
Image: Fluzone® Quadrivalent vaccine can help better protect you from the flu.
Image: Fluzone® Quadrivalent influenza vaccine can help better protect you from the flu.

Four strains of flu viruses commonly circulate among people today – two influenza A strains (A/H1N1 and A/H3N2) and two influenza B strains (B/Victoria lineage and B/Yamagata lineage). Both A and B types circulate worldwide and can infect children and adults1.

What is the traditional (trivalent) flu vaccine?

Traditional flu vaccines (called “trivalent” vaccines) cover two type A strains and one type B strain – however, it is difficult to predict which B strain will dominate since it varies from season to season2. This led to the development of quadrivalent influenza vaccines.

What is the quadrivalent influenza vaccine?

The quadrivalent flu vaccine covers four strains of influenza viruses. It targets a second B strain, in addition to the three other strains2.

Scientists at the World Health Organization (WHO) make predictions each year to determine which strains should be included in the annual seasonal influenza vaccine; however, it has been challenging to accurately predict which strains of influenza A and B will dominate. Over the past 15 flu seasons, the dominating circulating B strain was different in 8 of these seasons than predicted by health authorities2 ,7. You can see this in the chart below.

Influenza B in Canada: Summary of Laboratory Tests

YearPredominant B lineage identified by NML*WHO** recommended B lineage in vaccine Predominant and recommended B lineages the same
2001/02 Victoria YamagataNo
2002/03 Victoria Victoria Yes
2003/04 Yamagata Victoria No
2004/05 Yamagata Yamagata Yes
2005/06 Victoria Yamagata No
2006/07 Yamagata Victoria No
2007/08 Yamagata Victoria No
2008/09 Victoria Yamagata No
2009/10 Victoria Victoria Yes
2010/11 Victoria Victoria Yes
2011/12 Yamagata (Victoria also high) Victoria No
2012/13 Yamagata Yamagata Yes
2013/14 Yamagata Yamagata Yes
2014/15 Yamagata Yamagata Yes
2015/16 Victoria Yamagata No

*National Microbiology Laboratory
**World Health Organization

What is FLUZONE® Quadrivalent?

FLUZONE® Quadrivalent vaccine is designed to help protect people 6 months and older against 4 different strains of the influenza virus contained in the vaccine: 2 influenza A viruses and 2 influenza B viruses3. Current trivalent flu vaccines help protect against 2 influenza A viruses but only 1 influenza B virus2.

Helping to protect against 2 influenza B viruses is important. Data show that influenza B viruses are responsible for a substantial burden of flu-related hospitalizations and complications, especially in children4. But for adults 65 years of age or older, consider FLUZONE® High-Dose vaccine, a three-strain flu vaccine specifically designed for seniors with 4 times the amount of antigens of a regular flu shot, which has been shown to generate a stronger protection against the flu than a regular flu vaccine5, 6.

Canada's National Advisory Committee on Immunization (NACI) recommendations4

NACI states that influenza vaccine may be administered to anyone 6 months of age and older who does not have any contraindications. NACI recommends flu vaccination especially for those4:

  • Who are at high risk of influenza-related complications or hospitalizations

    • Adults and children with underlying chronic health conditions

    • Residents of nursing homes and other chronic care facilities

    • People ≥ 65 years of age

    • Children 6 to 59 months of age

    • Healthy pregnant women

    • Aboriginal peoples

  • Who are capable of transmitting influenza to those at high risk

    • Healthcare providers in facilities and community settings

    • Household contacts of persons at high risk of complications including infants < 6 months of age

    • Those providing care for children ≤ 59 months of age

    • Those who provide services within close or relatively close settings to persons at high risk

    • Those who provide essential community services

FLUZONE® Quadrivalent vaccine is approved for use by anyone 6 months of age or older. For children 6-23 months of age, NACI recommends that, given the burden of influenza B disease, quadrivalent influenza vaccines should be used. If quadrivalent influenza vaccines are not available, either unadjuvanted or adjuvanted trivalent influenza vaccines should be used6.

There's a FLUZONE® vaccine for you.

Have questions? Get answers.

How can I learn more about influenza?

There's a Fluzone vaccine for you.

Indication and Safety Information:

FLUZONE® Quadrivalent is a vaccine used to prevent influenza caused by the 4 strains of influenza virus (A/H1N1, A/H3N2, B/Victoria lineage, B/Yamagata lineage) contained in the vaccine. This vaccine may be given to adults and children 6 months of age and older. Persons with a history of severe allergic reaction to eggs or egg products or any component of FLUZONE® Quadrivalent should not receive the vaccine. FLUZONE® Quadrivalent will only protect against the strains of influenza virus contained in the vaccine. It will not protect against any other strains of influenza virus. As with any vaccine, 100 percent protection cannot be guaranteed. Because flu viruses change over time, annual influenza vaccination is recommended for influenza. Some persons may experience side effects and allergic reactions. The most common are soreness at the site of injection and muscle pain, and children may suffer from irritability. Most patients recover fully. Talk to your healthcare provider to ensure that FLUZONE® Quadrivalent is right for you.For more information, visit


  1. National Advisory Committee on Immunization (NACI). Literature Review on Quadrivalent Influenza Vaccines. July 2014. Accessed on February 12, 2016.
  2. National Advisory Committee on Immunization (NACI). Statement on Seasonal Influenza Vaccine for 2014-2016. July 2014. Accessed on February 10, 2016.
  3. FLUZONE® Quadrivalent Product Monograph. Sanofi Pasteur Limited. May, 2016.
  4. National Advisory Committee on Immunization (NACI). Statement on Seasonal Influenza Vaccine for 2015-2016. July 2015. Accessed on February 10, 2016.
  5. FLUZONE® High-Dose Product Monograph. Sanofi Pasteur Limited. May, 2016.
  6. National Advisory Committee on Immunization (NACI). Statement on Seasonal Influenza Vaccine for 2016-2017. May 2016. Accessed on May 10, 2016.
  7. Public Health Agency of Canada (PHAC). FluWatch. August 10 to August 23, 2014, August 16 to August 29, 2015, and April 24 to April 30, 2016.


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