For many years, the trivalent inactivated influenza vaccine (TIV) has been the only alternative for seasonal influenza. TIV is an inactivated (non-live) injectable vaccine that contains virus fragments or purified virus components of each influenza strain. Lower age limit for TIV vaccines are 6 months. There are no upper age limit.

In autumn 2013, a new influenza vaccine which is administered as a nasal spray became available in Norway. This live, attenuated influenza vaccine (LAIV) contains viruses that are cold-adapted and temperature sensitive so they cannot cause influenza illness. The vaccine is quadrivalent (two influenza A strains and two influenza B strains). LAIV should not be given to children younger than two years or older than 17 years of age. Since the vaccine contains live viruses, it should not be given to pregnant girls or children or adolescents who are clinically immunodeficient.

Composition of the seasonal vaccine

The World Health Organization (WHO) has established a network of national influenza centres that monitor influenza activity and recommend the composition of next season's vaccine.

For the season 2018/2019, the influenza vaccine for the Northern Hemisphere contains the following three viruses:

an A/Michigan/45/2015 (H1N1)pdm09-like virus

an A/Singapore/INFIMH-16-0019/2016(H3N2)-like virus

a B/Colorado/06/2017-like virus (B/Victoria/2/87 lineage)

The quadrivalent vaccine (LAIV) also contains a B/Phuket/3073/2013-like virus(B/Yamagata/16/88 lineage).

Since the 2009 pandemic, influenza A (H1N1) has been included in the seasonal influenza vaccine. There are no separate vaccines against influenza A (H1N1).