Live Attenuated Influenza Vaccine (LAIV4)

Abbreviations: NAS = intranasal; NR = not relevant (does not contain thimerosal); yrs = years.

LAIV Administration

LAIV is not recommended for use in any population for 2017-18. Providers who use it should note the following:

• • LAIV is administered intranasally using the supplied prefilled, single-use sprayer containing 0.2 mL of vaccine.
    • Half of the total sprayer contents is sprayed into the first nostril while the recipient is in the upright position.
    • The attached divider clip is removed and the second half of the dose administered into the other nostril.
  • If the vaccine recipient sneezes immediately after administration, the dose should not be repeated.
• If nasal congestion impedes delivery of the vaccine to the nasopharyngeal mucosa, deferral of administration should be considered, or another age-appropriate vaccine should be administered instead.

LAIV Contraindications and Precautions

Contraindications:

• History of severe allergic reaction to any vaccine component or after previous dose of any influenza vaccine;
  • Information about vaccine components is located in package inserts from the manufacturer.
• Concomitant aspirin or salicylate-containing therapy in children and adolescents;
• Children aged 2 through 4 years who have received a diagnosis of asthma or whose parents or caregivers report that a health care provider has told them during the preceding 12 months that their child had wheezing or asthma or whose medical record indicates a wheezing episode has occurred during the preceding 12 months;
• Children and adults who are immunocompromised due to any cause (including immunosuppression caused by medications or by HIV infection);
• Close contacts and caregivers of severely immunosuppressed persons who require a protected environment;
• Pregnancy;
• Receipt of influenza antiviral medication within previous 48 hours.

Precautions:

• Moderate to severe acute illness with or without fever;
• History of Guillain-Barré syndrome within 6 weeks of receipt of influenza vaccine;
• Asthma in persons aged ≥5 years;
• Other underlying medical conditions that might predispose to complications attributable to severe influenza (e.g., chronic pulmonary, cardiovascular [except isolated hypertension], renal, hepatic, neurologic, hematologic, or metabolic disorders (including diabetes mellitus).