Table 1

All persons ≥6 months of age should receive influenza vaccine annually. Influenza vaccination should not be delayed to procure a specific vaccine preparation if an appropriate one is already available.

LAIV or IIV are appropriate options for people between ages 2–49 without contraindications.

LAIV should not be used in the following populations:

  • Persons aged <2 years or >49 years
  • Persons with contraindications listed in the package insert
  • Pregnant women
  • Immunocompromised persons
  • Persons with a history of egg allergy
  • Children aged 2–4 years who have asthma or who have had a wheezing episode in the past 12 months
  • Persons who have taken influenza antiviral medications within the previous 48 hours

Persons of any age with asthma might be at increased risk for wheezing after administration of LAIV.

Precautions should be taken in persons with other underlying medical conditions that might predispose them to complications after wild-type influenza virus infection (e.g., chronic pulmonary, cardiovascular [except isolated hypertension], renal, hepatic, neurologic, hematologic, or metabolic disorders [including diabetes mellitus]).

Caregivers for severely immunosuppressed persons who require a protective environment should not receive LAIV, or should avoid contact with the immunosuppressed patient for seven days after receipt of the vaccination.

Special precautions must be taken in individuals with allergies to eggs and in immunocompromised individuals.