• For many people, there is more than one appropriate vaccine. The first, Fluzone High-Dose Quadrivalent (HD-IIV4), gained FDA approval in November 2019 and is expected to replace the trivalent formulation of Fluzone High-Dose that was available in previous years — HD-IIV4 contains 4 times the amount of HA per vaccine virus in each dose compared with standard-dose inactivated influenza vaccines (60μg per virus vs. 15μg in standard-dose IIVs), … The injectable Fluzone Quadrivalent 2020-2021 (flu shot) is a "killed virus" vaccine. Fluzone HD contains 4 times the amount of antigen as the standard trivalent dose. • For children 6 through 35 months of age, volume per dose is different than for older persons—refer to PI for dose volumes. Fluzone High-Dose Quadrivalent is the only licensed high-dose inactivated influenza (flu) vaccine; it is manufactured by Sanofi Pasteur Inc. Fluzone High-Dose Quadrivalent is a four-ingredient (quadrivalent) flu vaccine approved for people 65 years and older. The vaccine produces a greater immune response than standard vaccine. A February 2020 study published in the Journal of Infectious Diseases found that among Medicare beneficiaries 65 years and older, Fluad, like Fluzone, provided greater protection against flu-related hospitalizations than standard-dose egg-based flu vaccines. There are three ways to look at the effectiveness of flu vaccines: The number of flu strains the vaccine protects against. Fluzone High-Dose Quadrivalent is the only licensed high-dose inactivated influenza (flu) vaccine; it is manufactured by Sanofi Pasteur Inc. Fluzone High-Dose Quadrivalent is a four-ingredient (quadrivalent) flu vaccine approved for people 65 years and older. Nadia Archambault, PharmD, a graduate of the University of Rhode Island, is a performance specialist for Pharmacy Development Services. Seqirus makes Fluad with MF59 adjuvant to elicit a stronger immune response. The most common adverse events experienced during clinical studies were mild and temporary, and included pain, redness at the injection site, headache, muscle aches, and malaise. Fluzone High-Dose contains four times the antigen that's in a standard dose, effectively making it a stronger version of the regular flu shot. The new shot, called Fluzone High-Dose, was approved by the Food and Drug Administration in late 2009 for people age 65 and older. Measures of immunogenicity were assessed in a study by Nace et al. IM‡ — IIV4, standard dose, egg based* with MF59 adjuvant. Fluad is a standard adjuvanted trivalent vaccine made with the MF59 additive, which creates a stronger immune response to vaccination than the standard trivalent vaccine alone. Where can I find more information about Fluzone High-Dose Quadrivalent? High-dose vaccine. La vacuna Fluzone High-Dose Quadrivalent contiene cuatro veces más la cantidad de antígeno —la parte de la vacuna que hace que el organismo produzca anticuerpos para protegerse contra los virus de la influenza— que la Fluzone Quadrivalent y otras vacunas inactivadas contra la influenza de dosis estándar. Find medication information including related drug classes, side effects, patient statistics and answers to frequently asked questions. Both Fluad and Fluzone HD are administered intramuscularly as a single dose of 0.5 mL. Fluad Quadrivalent is another flu vaccine product licensed for use in adults 65 and older. The 2 flu vaccine options to consider for people 65 years and older are Fluad and Fluzone High-Dose (HD). Seqirus makes Fluad with MF59 adjuvant to elicit a stronger immune response. The intended use of these vaccines by age group of recipient for the 2020/21 season is as follows: Age Group Vaccine A When the vaccine is furnished in the hospital outpatient department, payment for the vaccine is based on reasonable cost. [206] [207] In February 2020, the FDA approved Fluad Quadrivalent for use in the United States. Given unknown but theoretical concerns of increased reactogenicity when administering two High-dose quadrivalent vaccine may be used in VA for people aged 65 years and older. The overall aim of the study is to compare safety and immunogenicity of adjuvanted inactivated influenza vaccine (IIV) (FLUAD) versus High-Dose inactivated influenza (Fluzone High Dose) vaccine in ≥65 years (20% aged ≥80 years). Accessed May 13, 2019. As with Fluzone High-Dose, there’s only limited evidence that Fluad is significantly more effective than the regular vaccine, and there are no randomized studies that compare the two head to … Fluzone High-Dose Quadrivalent and Fluzone Quadrivalent are both made using eggs. En español | The news these days is all about the much-anticipated COVID-19 vaccine, but there's another existing shot that experts say should be on your radar: Fluzone High-Dose. What is the difference between Fluzone High-Dose Quadrivalent and Fluzone Quadrivalent? For patients with an egg allergy that results in symptoms more severe than hives (ie, angioedema or respiratory distress), the vaccine should be administered in a medical setting under supervision of a health care provider who is able to recognize and manage a severe allergic reaction. This study was conducted during the 2013-14 flu season among more than 38,000 resident of 823 nursing homes in 38 states. (Quadrivalent) High Dose (Trivalent) Protection: 2 influenza A viruses + 2 influenza B viruses (broader protection with both B viruses included in vaccine) 2 influenza A + 2 influenza B. clinicaltrials.gov/ct2/show/study/NCT03694808. Updated September 27, 2018. Trivalent flu vaccines offer protection against three flu strains. People 65 years and older are at the highest risk for flu-related deaths and they have poorer immune responses to flu vaccines than younger people. Seqirus. Swiftwater, PA: Sanofi Pasteur Inc; 2019. vaccineshoppe.com/image.cfm?doc_id=14054&image_type=product_ pdf. A 2020 study concluded that the high-dose vaccine has higher effectiveness in adults 65 years of age and older than the standard-dose vaccine. More information about Fluzone High-Dose Quadrivalentexternal icon is available on the Food and Drug Administration (FDA) web site. MedImmune. Like most flu vaccines, it is made through an egg-based process and given in the upper arm. FLUAD vs Fluzone High-Dose Study. The high-dose flu vaccine (Fluzone High-Dose Quadrivalent) contains four times the amount of antigen as the standard-dose inactivated flu vaccine, and has been associated with a stronger immune response following vaccination and better effectiveness than the regular dose flu vaccine in older people in a two-season randomized trial. Fluad is a standard adjuvanted trivalent vaccine made with the MF59 additive, which creates a stronger immune response to vaccination than the standard trivalent vaccine alone. Who can receive Fluzone High-Dose Quadrivalent? Both are quadrivalent vaccines. Fluzone High-Dose Quadrivalent. Fluzone High-Dose Quadrivalent was as immunogenic as Fluzone High-Dose for GMTs and seroconversion rates for the common influenza strains. La Fluzone High-Dose Quadrivalent es la única vacuna inactivada contra la influenza (gripe) de dosis alta aprobada; la fabrica Sanofi Pasteur Inc. La Fluzone High-Dose Quadrivalent es una vacuna contra la influenza de cuatro ingredientes (tetravalente) aprobada para personas de 65 años de edad o más. Visit cvs.com … The Medicare Part B payment allowance limits for seasonal influenza and pneumococcal vaccines are 95% of the Average Wholesale Price (AWP) as reflected in the published compendia except where the vaccine is furnished in a hospital outpatient department. © 2021 MJH Life Sciences and Pharmacy Times. Accessed May 13, 2019. The Centers for Disease Control and Prevention (CDC) cannot attest to the accuracy of a non-federal website. What is high-dose quadrivalent flu vaccine? In the United States, Fluzone High-Dose Quadrivalent is licensed only for persons aged 65 years and older. This page provides information on the high-dose seasonal flu vaccine, Fluzone High-Dose Quadrivalentexternal icon. A high-dose vaccine (Fluzone High-Dose) four times the strength of standard flu vaccine was approved by the FDA in 2009. Linking to a non-federal website does not constitute an endorsement by CDC or any of its employees of the sponsors or the information and products presented on the website. Patients with a history of Guillain-Barré syndrome within 6 weeks of a previous dose of flu vaccine are not advised to be vaccinated unless their health care provider has advised that the benefit of receiving the vaccine outweighs the risk. Data from clinical trials comparing Fluzone (a trivalent standard dose vaccine) to Fluzone High-Dose (a trivalent high-dose vaccine) among persons aged 65 years and older indicate that a stronger immune response (i.e., higher antibody levels) occurs after vaccination with Fluzone High-Dose. FLUAD QUADRIVALENT is an active immunization of persons 65 years of age and older against influenza disease caused by seasonal influenza virus subtypes A and types B. Flu-related complications increase with age because older individuals have a … And it's important to remember flu vaccines are, at best, only partially protective. In contrast to Fluzone High-Dose Quadrivalent (Sanofi Pasteur), Fluad is a standard-dose vaccine, containing 15 mcg of hemagglutinin per virus per dose. Injected quadrivalent inactivated influenza vaccines, available from the 2014/2015 season in some EU/EEA countries, are expected to replace the trivalent vaccines over time. high-dose or adjuvanted flu vaccine to patients 65 years of age or older. Another study published in The Lancet Respiratory Medicineexternal icon reported that Fluzone High-dose was associated with a lower risk of hospital admissions compared with standard-dose Fluzone in adults 65 years and older, especially those living in long-term care facilities. Studies published in the Journal of Infectious Diseases conducted during the 2017-2018external icon and 2018-2019external icon flu seasons among Medicare beneficiaries aged 65 years and older found that Fluzone High-Dose and FLUAD provided greater protection against flu-related hospitalizations than standard-dose, egg based vaccines in both seasons, while Flucelvax provided greater protection during the 2017-2018 season only. Fluzone High-Dose Quadrivalent (2020/2021) $ 60.982 . Adverse effects seen for both vaccines are mild and may include pain, redness, or swelling at the injection site; headache; muscle ache; and malaise.3,4, Patients should be advised that immunity will start to develop about 2 weeks after receiving the vaccination. In addition to Fluzone High-Dose Quadrivalent, one other influenza vaccine is licensed specifically for people 65 years and older. A new vaccine called Fluzone High-Dose Quadrivalent that is made up of four flu strains has been approved for people age 65 and older. High-dose flu vaccine, brand name Fluzone High-Dose Quadrivalent. In a small observational study among adults age 65 years and older Fluad was about 63% more effective than unadjuvanted trivalent standard dose inactivated influenza vaccine. Fluzone® High-Dose is a trivalent influenza vaccine only authorized for those 65 years of age and older. So people who are allergic to eggs should avoid receiving Fluzone High … Fluzone High-Dose Quadrivalent contains four times the antigen, the part of the vaccine that helps your body build up protection against flu viruses, then Fluzone Quadrivalent and other standard-dose inactivated flu vaccines. Contains four times the amount of antigen (prompts the body to make antibodies) contained in regular flu shots, to create a stronger immune response. High-dose quadrivalent shot . CDC twenty four seven. The higher dose of antigen in the vaccine is intended to give older people a better immune response, and therefore, better protection against flu. Sanofi Pasteur Inc. manufactures a senior shot known as Fluzone High-Dose Quadrivalent. Sanofi Pasteur. Quadrivalent flu vaccines offer protection against four flu strains. This vaccine is intended for people 65 and over, who typically have weakened immune response due to normal aging. Does CDC recommend one vaccine above another for people 65 years and older? Vaccine Types Fluzone ® High-Dose Quadrivalent Influenza-Impfstoff. Treating Cardiovascular Disease Means Making Choices, Influenza Vaccine Considerations in the 65+ Population, Uncertainty Remains in the Match or Mismatch for the 2019-2020 Flu Vaccine, Early Interventions Are Vital for Treating Influenza, Especially in Patients With Chronic Conditions. Fluzone® Quadrivalent and Fluzone® High-Dose are different products. The Fluzone High-Dose has four times the amount of antigen as a regular flu shot does, while the FLUAD contains an added ingredient called adjuvant MF59. Older adults typically show lower protective immune responses after flu vaccination compared to healthy young people. Find medication information including related drug classes, side effects, patient statistics and answers to frequently asked questions. Fluzone ® High Dose Quadrivalent entspricht dem deutschen Produkt Efluelda ®, das Ende Mai 2020 von der Europäischen Kommission zugelassen wurde … 8/12/2020 – 07/31/2021: 90674. All rights reserved. For the 2020-21 season, trivalent Fluzone High-Dose will be replaced by Fluzone High-Dose Quadrivalent. 8/01/2020 – 07/31/2021: 90662. Fluzone High-Dose Suspension for injection drug summary. Fluad Quadrivalent: High-dose HD-IIV4 (egg) Fluzone High-Dose Quadrivalent: LAIV4 (egg) FluMist Quadrivalent • No influenza vaccines are licensed for children under 6 months of age. While there have been no randomized studies comparing both vaccines head-to-head against influenza, “anecdotally, we have … The Fluzone High Dose is specifically for people 65 and older; the difference is that it has four times the antigen dose of the standard Fluzone. Fluzone High-Dose Quadrivalent (Sanofi Pasteur) • Licensed for ≥65 years • 60 mcg hemagglutinin per vaccine virus in a 0.7 mL dose (240 mcg total) • Will replace previous trivalent Fluzone High-Dose for 2020–21 February 2020: The first, Fluzone High-Dose Quadrivalent (HD-IIV4), gained FDA approval in November 2019 and is expected to replace the trivalent formulation of Fluzone High-Dose that was available in previous years — HD-IIV4 contains 4 times the amount of HA per vaccine virus in each dose compared with standard-dose inactivated influenza vaccines (60μg per virus vs. 15μg in standard-dose IIVs), ACIP … Visit cvs.com for more details. Influenza virus vaccine works by exposing you to a small dose of the virus, which … quadrivalent, influsplit® tetra, fluviral®, agriflu®, fluad® and fluzone® high-dose. Fluzone High-Dose is a flu vaccine for people age 65 and older that's given by injection. FLUAD vs FLUZONE HD Influenza Vaccine in Residents of Long Term Care. 1. INFLUENZA VIRUS VACCINE (in floo EN zuh VAHY ruhs vak SEEN) helps to reduce the risk of getting influenza also known as the flu. (2015) comparing high dose influenza vaccine [Fluzone ® High Dose (60μg HA/strain)] and a standard dose influenza vaccine (15μg HA/strain) in 187 frail adults 65 years and older residing in long-term care facilities over two influenza seasons (2011-12, 2012-13) Footnote 63. The vaccine only helps protect you against some strains of the flu. You will be subject to the destination website's privacy policy when you follow the link. FLUAD [prescribing information]. People 65 years and older & influenza. Summit, NJ: Sequris USA Inc; 2018. labeling.seqirus.com/PI/US/FLUAD/EN/FLUAD-Prescribing-Information.pdf. FLUAD QUADRIVALENT is a sterile injectable emulsion supplied in 0.5 mL single-dose pre-filled syringes. Most people had minimal or no adverse events after receiving the Fluzone High-Dose. Fluzone High-Dose is a flu vaccine for people age 65 and older that's given by injection. Afluria ® Tetra (5 years and older), Flulaval ® Tetra (6 months and older), Fluzone ® Quadrivalent (6 months and older), Influvac ® Tetra (3 years and older) Return to footnote b referrer. What is high dose inactivated influenza vaccine and how is it different from other influenza vaccines? INFLUENZA VIRUS VACCINE helps to reduce the risk of getting influenza also known as the flu.The vaccine only helps protect you against some strains of the flu. To receive weekly email updates about Seasonal Flu, enter your email address: Centers for Disease Control and Prevention. The HD-IIV4 replaces Fluzone High-Dose (trivalent). Fluzone High-Dose Quadrivalent: For active immunization for the prevention of influenza disease caused by influenza virus subtypes A and type B viruses contained in the vaccine. Fluzone High-Dose Suspension for injection drug summary. In November 2019, the FDA approved Fluzone High-Dose Quadrivalent for use in the United States starting with the 2020-2021 influenza season. exclamation square light iconGetting a flu vaccine is more important than ever during 2020-2021 to protect yourself and the people around you from flu, and to help reduce the strain on healthcare systems responding to the COVID-19 pandemic. US Package Insert 03 … Why is there a need for flu vaccines designed specifically for people 65 years and older? Diese Zusammenfassung soll nicht das Gespräch mit Ihrem medizinischen Fachpersonal ersetzen. Fluzone High-Dose is a flu vaccine for people age 65 and older that's given by injection. Although available in the private market in some European countries, vaccine authorisation, vaccine availability, observed vaccine effectiveness and the cost may influence the speed of this replacement. Footnote c. Fluad Pediatric ® (6-23 months) or Fluad ® (65 years and older) Return to footnote c referrer. Data comparing the effectiveness of Fluzone High-Dose Quadrivalent with standard-dose inactivated vaccines are not yet available. Bitte lesen Sie diese Patienteninformation, bevor Sie den Impfstoff Fluzone High-Dose Quadrivalent erhalten. Lower immune responses may lead to lower vaccine effectiveness (i.e., a measure of how well the flu vaccine protects against flu illness). Sanofi Pasteur. HD TIIV contains 60 µg of hemagglutinin (HA) protein for each of the three vaccine strains (180 µg in total) compared to 15 µg of HA per strain (45 µg in total) in SD TIIV. Ambas son vacunas tetravalentes. For the 2018 to 2019 flu season, we have three brands of trivalent vaccines (Afluria, Fluad, Fluzone High-Dose) and seven brands of quadrivalent vaccines (Flulaval, Fluzone, Fluarix, FluMist, Flucelvax, Afluria Quadrivalent, and Flublok). Arriola C, Garg S, Anderson EJ, et al. All rights reserved. Updated April 9, 2019. Accessed May 13, 2019. Both these products are flu vaccines produced by the same manufacturer. Fluzone High-Dose Quadrivalent (HD-IIV4, Sanofi Pasteur) and Fluad Quadrivalent (Seqirus), both for adults 65 years and older, are new for 2020–21. The US government requires hospitals to report worker vaccination rates. (Quadrivalent) High Dose (Trivalent) Protection: 2 influenza A viruses + 2 influenza B viruses (broader protection with both B viruses included in vaccine) 2 influenza A + 2 influenza B. © 2021 MJH Life Sciences™ and Pharmacy Times. CDC studies conducted during previous flu seasons estimateexternal icon that people 65 years and older account for 70 to 85 percent of flu-related deaths and 50 to 70 percent of flu-related hospitalizations each flu season. Footnote d. Fluzone ® High-Dose (65 years and older) Return to footnote d referrer. What is Fluzone High-Dose Quadrivalent vaccine? Accessed May 13, 2019. Some adverse events were reported more frequently after vaccination with trivalent Fluzone High-Dose than after standard-dose inactivated flu vaccines. The intended use of these vaccines by age group of recipient for the 2020/21 season is as follows: Age Group Vaccine A. Saving Lives, Protecting People. How safe is Fluzone High-Dose Quadrivalent? What other flu vaccines are available for people 65 years and older? cdc.gov/flu/highrisk/65over.htm. Information about vaccine ingredients is located in package inserts from each manufacturer. The lowest GoodRx price for the most common version of Fluzone High-Dose Quadrivalent is around $56.01, 23% … Fluzone High-Dose Quadrivalent (HD-IIV4) is intended to replace the trivalent formulation of Fluzone High-Dose (HD-IIV3). Fluad on Par With High-Dose Flu Vax in High-Risk Seniors ... Point estimates were much larger in favor of adjuvanted trivalent flu vaccine versus standard quadrivalent vaccine in … The intranasal flu vaccine, FluMist, is not recommended for this age group because of its potentially poor efficacy.1,3,4. Both are recommended for use only in people aged 65 and over. Influenza is a respiratory infection that can cause serious complications, particularly in young children, older adults and people with certain medical conditions. CDC recommends flu vaccination as the first and most important step in protecting against flu. 0.7-mL prefilled syringe ≥ 65 years. flu vaccines produced by other manufacturers, study published in the New England Journal of Medicine, study published in The Lancet Respiratory Medicine, adjuvanted flu vaccines (FLUAD and FLUAD Quadrivalent), studies conducted during previous flu seasons estimate, Centers for Disease Control and Prevention, National Center for Immunization and Respiratory Diseases (NCIRD), Reconstruction of the 1918 Influenza Pandemic Virus, 2019-2020 Preliminary In-Season Burden Estimate, Who is at High Risk for Flu Complications, Who Should & Who Should NOT Get Vaccinated, Live Attenuated Influenza Vaccine (LAIV)/Nasal Spray Vaccine, Selecting Viruses for the Seasonal Influenza Vaccine, Flu Vaccine and People with Egg Allergies, Frequently Asked Questions on Vaccine Supply, Historical Reference of Vaccine Doses Distributed, Hospitalized Adult Influenza Vaccine Effectiveness Network (HAIVEN), How Vaccine Effectiveness and Efficacy are Measured, What People with a Staph Infection Should Know about Flu, Resources for Hosting a Vaccination Clinic, Overview of Influenza Surveillance in the United States, Influenza Hospitalization Surveillance Network (FluSurv-NET), Weekly U.S. Compared … Fluzone High-Dose Quadrivalent induced a superior immune response, based on a pre-specified superiority criterion, with respect to the additional B strain than the immune response induced by Fluzone High-Dose formulation that did not contain the … If you have questions about which vaccine is best for you, talk to your doctor or other health care professional. … The CDC and its Advisory Committee on Immunization Practices have not expressed a preference for any flu vaccine indicated for people 65 years and older. Because between 70% and 85% of seasonal influenza (flu)-related deaths occur in people 65 years and older and between 54% and 70% of seasonal flu-related hospitalizations occur in this age group, the CDC recommends that adults 65 years and older receive a flu vaccination each year (see table).1 Influenza vaccination in these patients also has shown to decrease mortality and intensive care unit admissions, as well as hospital length of stay.2 Many patients in this population do not realize that more than 1 vaccine formulation is available or that they may benefit from a higher-dose vaccine, so pharmacists have a crucial role in educating these patients about the importance of receiving the most appropriate flu vaccine. Given the high risk of severe flu illness and low protective immune response after vaccination among older adults, substantial research and development have produced new flu vaccines intended to provide better immunity in this age group. The high-dose quadrivalent vaccine (Fluzone) is designed specifically for people ages 65 and older. The two free vaccines for over-65s work in different ways: FluZone High Dose is a high-dose version; Fluad adds an additional ingredient to boost its effectiveness. 60 mcg per 0.7 mL . Does Fluzone High-Dose Quadrivalent offer better protection than the adjuvanted flu vaccine? There are a number of other flu vaccines produced by other manufacturers. Injected quadrivalent inactivated influenza vaccines, available from the 2014/2015 season in some EU/EEA countries, are expected to replace the trivalent vaccines over time. FluMist Quadrivalent (2020/2021) $26.876 . It can protect you from four types of flu. Fluad Quadrivalent. Fluad Quad 2020-2021(65Yr Up)(PF) 60 Mcg (15 X 4)/0.5Ml IM Syringe Influenza Vaccine Generic Name(S): flu vac 2020 65up-adjMF59C(PF) View Free Coupon Flucelvax Quadrivalent (2020/2021) (Pres Free) $29.228 . The results of a clinical trial indicated that adults 65 years and older who received Fluzone HD had 24% fewer influenza infections compared with those who received the standard trivalent-dose vaccine.1 Randomized clinical trials are underway comparing Fluad and Fluzone HD to determine more definitively if one vaccine is inferior to the other; however, the CDC and its advisory committee have not indicated a preference between Fluzone HD and Fluad for prevention of flu in people 65 years and older.1,5,6 Vaccination choice should therefore be based on insurance coverage and cost for patients. Seqirus makes FLUAD and FLUAD Quadrivalent, approved for use in people 65 and older. INFLUENZA VIRUS VACCINE helps to reduce the risk of getting influenza also known as the flu.The vaccine only helps protect you against some strains of the flu. Quadrivalent flu vaccines offer protection against four flu strains. This vaccine is intended for people 65 and over, who typically have weakened immune response due to normal aging. Fluzone Quadrivalent 2020-2021 works by exposing you to a small dose of the virus, which helps your body to develop immunity to the disease. Influenza Surveillance Report (FluView), Past Flu Seasons Flu Forecasting Accuracy Results, Tools to Prepare Your Practice for Flu Season, Information for Clinicians on Influenza Virus Testing, Multiplex Assays Authorized for Simultaneous Detection of Influenza Viruses and SARS-CoV-2, Information on Collection of Respiratory Specimens for Influenza Virus Testing, Information for Clinicians on Rapid Diagnostic Testing for Influenza, Information on Rapid Molecular Assays, RT-PCR, and other Molecular Assays for Diagnosis of Influenza Virus Infection, Algorithm: Interpreting Influenza Testing Results When Influenza is Circulating, Algorithm: Interpreting Influenza Testing Results When Influenza is NOT Circulating, Guide: Influenza Diagnostic Testing in Closed Setting Outbreaks, Guidance: Standard-Based Electronic Laboratory Reporting, Guidance: Antiviral and Obstetric Health Care, Guidance: Outbreak Management in Long-Term Care Facilities, Guidance: Use of Mask to Control Influenza Transmission, Guidance: Prevention & Control in Peri- and Postpartum Settings, Health Professional References & Resources, Responding to Problems with Purchasing Needles for Flu Vaccination, U.S. Department of Health & Human Services. CDC website. Fluzone HD contains 4 times the amount of antigen as the standard trivalent dose.