Flulaval Quadrivalent, Afluria Quadrivalent, Fluarix Quadrivalent, Fluzone Quadrivalent

Written by Helen Marshall, BPharm, MRPharmS
Medically reviewed by Victor Nguyen, PharmD, MBA
Updated on June 8, 2023

This article describes Fluzone Quadrivalent’s uses, side effects, and more. You’ll also find some coupon options to help save on the cost of Fluzone Quadrivalent.

This article doesn’t provide coupons for all forms of Fluzone Quadrivalent. To find coupons for Fluzone High-Dose Quadrivalent, see this article.

Below you’ll find answers to a few commonly asked questions about Fluzone Quadrivalent.

Can Fluzone Quadrivalent be given as an intradermal injection?

No, Fluzone Quadrivalent can’t be given as an intradermal injection (injection into the skin). It’s only given as an intramuscular injection (injection into a muscle). The vaccine may not work as well if it’s given intradermally.

There used to be a version of the Fluzone vaccine that could be given intradermally. But it was discontinued by the manufacturer. At this time, there aren’t any flu vaccines that can be given by intradermal injection available in the United States.

Talk with your doctor if you have questions about what to expect with Fluzone Quadrivalent.

Is Fluzone Quadrivalent preservative-free?

Sometimes, but it depends on the form. Single-dose forms of Fluzone Quadrivalent and Fluzone High-Dose Quadrivalent are preservative-free. But multi-dose vials of Fluzone Quadrivalent contain the preservative thimerosal. (Multi-dose vials contain more than one dose.)

The preservative helps prevent the growth of germs that may enter the vial each time a dose is prepared.

Thimerosal is made from mercury. You might be concerned about the safety of receiving a vaccine containing thimerosal. However, the amount of thimerosal you receive with a dose of vaccine is very low. It isn’t known to cause harmful effects. But minor swelling or discoloration at the injection site may occur in some people.

If you’d prefer to receive a preservative-free form of Fluzone Quadrivalent, talk with your doctor.

Can I receive Fluzone Quadrivalent if I have an egg allergy?

No, you should not receive Fluzone Quadrivalent if you have an egg allergy. All forms of this vaccine are made using eggs. They could cause an allergic reaction in people with an egg allergy.

If you’re allergic to eggs, talk with your doctor about flu vaccines that are safe for you. They’ll likely recommend a flu vaccine that’s not made using eggs, such as Flublok.

Is Fluzone Quadrivalent a live vaccine?

No, Fluzone Quadrivalent is not a live vaccine. It’s an inactivated vaccine. It contains inactivated strains of four different influenza viruses. It can’t cause you to become ill with the flu.

Some flu vaccines are live vaccines that contain weakened forms of flu viruses. Live vaccines don’t cause disease in people with healthy immune systems. Your immune system is your body’s defense system. If you have a weak immune system, receiving a live vaccine could cause the disease it’s meant to help prevent.

Inactivated vaccines, such as Fluzone Quadrivalent, contain a dead version of the germ. They don’t cause disease, even in people with weakened immune systems.

If you have questions about different kinds of vaccines, talk with your doctor. 

How does Fluzone Quadrivalent work? And how long does it take to start working?

Fluzone Quadrivalent stimulates your immune system to make antibodies against the flu virus. Antibodies are immune system proteins that attack germs, such as viruses, and can keep them from causing disease.

After you get a flu vaccine, the antibodies made by your immune system stay in your body. Then, if you’re exposed to the flu virus naturally, the antibodies help your immune system attack it. This stops you from getting ill with the flu.

It takes about 2 weeks for your immune system to make enough antibodies to protect against the flu.

If you’d like to know more about Fluzone Quadrivalent, talk with your doctor or pharmacist.

The Food and Drug Administration (FDA) approves prescription drugs such as Fluzone Quadrivalent for certain conditions. Approved uses for Fluzone Quadrivalent are described below.

Use for flu prevention

Doctors may prescribe the Fluzone Quadrivalent vaccine and Fluzone High-Dose Quadrivalent vaccine to help prevent influenza (the flu). Fluzone Quadrivalent is prescribed for this purpose in people ages 6 months and older. Fluzone High-Dose Quadrivalent is prescribed to adults ages 65 years and older.

The flu is a respiratory infection caused by the influenza virus. You may have symptoms such as fever, chills, headache, muscle aches, low energy, and cough. These symptoms are often severe enough to keep you in bed for several days.

In some people, the flu can also cause severe or even life threatening complications. These include:

• pneumonia
• dehydration (low fluid level in your body)
• complication with or worsened long-term health conditions, such as heart failure and asthma

It’s usually recommended that you receive an updated flu vaccine every year. There are several strains of flu virus, and they are continually changing. Flu vaccines are updated each year to include the most common strains of the virus likely to be circulating that flu season.

Fluzone Quadrivalent may cause mild or serious side effects. More common mild side effects of Fluzone Quadrivalent and its serious side effects are listed below. This article doesn’t include all possible side effects of the vaccine. Side effects can vary based on your age, overall health, and any other medications you take.

To learn more about Fluzone Quadrivalent’s side effects, ask your doctor or pharmacist. You can also read the prescribing information* for Fluzone Quadrivalent.

* To view Fluzone Quadrivalent’s prescribing information, see the “Article resources” section.

Mild side effects

More common mild side effects reported with Fluzone Quadrivalent are listed below. These side effects may differ based on your age.

This article doesn’t include all possible mild side effects of the drug. To learn more about Fluzone Quadrivalent’s side effects, see the prescribing information* for Fluzone Quadrivalent.

With many drugs, mild side effects may go away within a few days or a couple of weeks. If the side effects are bothersome, tell your doctor or pharmacist. They may be able to suggest ways to manage them.

Fluzone Quadrivalent vaccine and Fluzone High-Dose Quadrivalent vaccine’s mild side effects include:

• pain, swelling, or discoloration at the injection site
• muscle aches
• headache
• a general unwell feeling
• mild allergic reaction†

* To view Fluzone Quadrivalent’s prescribing information, see the “Article resources” section.
† For details about this side effect, see the “Interactions and warnings for Fluzone Quadrivalent” section.

Serious side effects

Serious side effects of Fluzone Quadrivalent are listed below.

This article doesn’t include all possible serious side effects of the drug. To learn more about Fluzone Quadrivalent’s side effects, see the prescribing information* for Fluzone Quadrivalent.

With many drugs, serious side effects are possible but not common. If you have serious side effects from this drug, call your doctor right away. If you’re having severe symptoms or a medical emergency, call 911 or a local emergency number.

Fluzone Quadrivalent’s serious side effects include:

• fainting (passing out)
• severe allergic reaction†

* To view Fluzone Quadrivalent’s prescribing information, see the “Article resources” section.
† For details about this side effect, see the “Interactions and warnings for Fluzone Quadrivalent” section.

Below, you’ll find information about Fluzone Quadrivalent’s possible interactions and warnings.

Interactions of Fluzone Quadrivalent

Certain things may affect how the drug works. These include getting vaccines, consuming alcohol or certain foods, or taking the drug with other medications. This effect is called a drug interaction.

Before you receive Fluzone Quadrivalent, ask your doctor to check for possible interactions. Be sure to tell them about any of the following you take or use:

• prescription or over-the-counter drugs
• vitamins, herbs, or supplements

To learn about drug-condition interactions, see the “Warnings for Fluzone Quadrivalent” section below.

Warnings for Fluzone Quadrivalent

Some people should not receive Fluzone Quadrivalent, and others should receive it cautiously.

Fluzone Quadrivalent could cause harm to people with certain health conditions. This effect is called a drug-condition interaction. Other factors can also affect whether Fluzone Quadrivalent is a safe option for you.

Ask your doctor about specific warnings for Fluzone Quadrivalent, and be sure to tell your doctor about your:

• current health, including any allergies to medications
• past health conditions or surgeries

Allergic reaction

Fluzone Quadrivalent can cause an allergic reaction in some people. Severe allergic reactions are rare but possible.

If you’ve had an allergic reaction to Fluzone Quadrivalent or any of its ingredients, your doctor will likely not prescribe Fluzone Quadrivalent. They can tell you about vaccines that are safer options for you.

A mild allergic reaction may cause the following symptoms:

• skin rash
• itchiness
• flushing (temporary warmth, redness, or deepening of skin color)

A severe allergic reaction may cause the following symptoms:

• swelling under your skin, usually in your hands, feet, eyelids, or lips
• swelling of your mouth, throat, or tongue, which can cause breathing problems

If you have an allergic reaction to Fluzone Quadrivalent, call your doctor right away. If you have severe symptoms, call 911 or a local emergency number.

Pregnancy or breastfeeding and Fluzone Quadrivalent

Information about Fluzone Quadrivalent and pregnancy and breastfeeding is described below.

Fluzone Quadrivalent and pregnancy

In general, Fluzone Quadrivalent is considered safe to receive during pregnancy. That said, ask your doctor about whether they feel it’s safe for you.

Fluzone Quadrivalent and breastfeeding

In general, Fluzone Quadrivalent is considered safe to receive while breastfeeding. That said, ask your doctor about whether they feel it’s safe for you.

This article describes Fluzone Quadrivalent’s uses and side effects, ways to save on cost, and more. Let your doctor know if you have questions about Fluzone Quadrivalent or would like more details about it.

Here’s a list of some possible questions you may want to ask your doctor:

• How effective is Fluzone Quadrivalent at helping to prevent the flu?
• How does Fluzone Quadrivalent differ from other flu vaccines?
• Can I receive Fluzone Quadrivalent at the same time as other vaccines?

• Fluzone Quadrivalent (influenza vaccine) suspension for intramuscular injection. (2022). https://www.vaccineshoppe.com/us/medias/Prescribing-Information?context=bWFzdGVyfGRvY3VtZW50c3w5NjI4NnxhcHBsaWNhdGlvbi9wZGZ8aDk5L2hlOC85MjQzMDgxNzAzNDU0L2luZno0LWZwbHItc2wtbm92MjIucGRmfDBjYzQ0NjQ0NmU1NmI3YTlkNTU4YjQ2NWY3NGVlNDRhNzU1ZDU0YzFmNjUwMmQ4ODI0NTI4ZWI5YzgzOWE5ZWU
• Fluzone High-Dose Quadrivalent (influenza vaccine), suspension, for intramuscular injection. (2023). https://www.vaccineshoppe.com/us/medias/Prescribing-Information.pdf?context=bWFzdGVyfGRvY3VtZW50c3w2MTgwMXxhcHBsaWNhdGlvbi9wZGZ8aGYxL2g2OS85MzY5NDM4ODc5Nzc0L2luaGRxLWZwbHItc2wtZmViMjMucGRmfDYxNmMwNTc1OTJiNDFiMDA5YWI3YWY2ZmRiZjRjOGEwNzUxY2IzMDdiOGZmYjM0MzBhNTQzNWMxODM4YTk3OWE
• Food and Drug Administration. (2023). Purple Book: Database of licensed biological products. https://purplebooksearch.fda.gov

Disclaimer: Optum Perks has made every effort to make certain that all information is factually correct, comprehensive, and up to date. However, this article should not be used as a substitute for the knowledge and expertise of a licensed healthcare professional. You should always consult your doctor or another healthcare professional before taking any medication. The drug information contained herein is subject to change and is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. The absence of warnings or other information for a given drug does not indicate that the drug or drug combination is safe, effective, or appropriate for all patients or all specific uses.