infectious diseases
Influenza Vaccine
Contraindications and Precautions for Influenza Vaccine
Themain contraindication for IIVis A severe allergic reaction (eg, Anaphylaxis ) after previous dose of IIV or to a vaccine component, including egg protein Precautions with IIVinclude Moderate or severe acute illness with or without fever (vaccination is postponed until illness resolves) Guillain-Barré Syndrome (GBS) (GBS) within 6 weeks after a previous dose of an influenza vaccine Contraindications for LAIVinclude A severe allergic reaction (eg, anaphylaxis) to any vaccine component (excluding egg) or to a previous dose of any influenza vaccine Immunocompromise (eg, due to disorders, including HIV infection, or use of immunosuppressants) For children and adolescents, concomitant use ofaspirinor other salicylates Close contact with and/or caring for severely immunocompromised patients who require a protected environment (unless contact is avoided for 7 days after receiving LAIV) Pregnancy Anatomical or functional Asplenia None Receipt of influenza antiviral drugs in the past 48 hours Cerebrospinal fluid leak or a cochlear implant Age < 2 years or ≥ 50 years Age 2 to 4 years if children have asthma or have had wheezing or asthma episodes in the past 12 months Precautions for LAIVinclude Certain chronic disorders such as chronic lung, heart, kidney, liver, hematologic (eg, hemoglobinopathies), or metabolic (eg, diabetes mellitus) disorders Asthma in people aged ≥ 5 years Moderate or severe acute illness with or without fever (vaccination is postponed until illness resolves) Guillain-Barré Syndrome (GBS) within 6 weeks after a previous dose of an influenza vaccine Use of specific antiviral drugs: ie,amantadine,rimantadine,zanamivir,oseltamivir(these drugs are stopped 48 hours before vaccination and are not resumed for 14 days after vaccination) Themain contraindication for RIV4is A severe allergic reaction (eg, anaphylaxis) after a previous dose of RIV4 Precautions with RIV4include Moderate or severe acute illness with or without fever (vaccination is postponed until illness resolves) Guillain-Barré syndrome within 6 weeks after a previous dose of an influenza vaccine Precautions for patients with suspected egg allergy:Patients with a history of egg allergy who have had only hives after exposure to egg should be given the influenza vaccine. Any influenza vaccine that is otherwise recommended based on the recipient’s age and health status can be used. Patients who report reactions to egg involving symptoms other than hives (such as angioedema, respiratory distress, light-headedness, or recurrent emesis) or who requiredepinephrineor another emergency medical intervention may similarly be given any influenza vaccine that is otherwise recommended based on the recipient’s age and health status. If using an egg-based vaccine such as IIV or LAIV, the vaccine should be given in a medical setting and supervised by a health care professional capable of recognizing and managing severe allergic conditions. 