Live Attenuated Influenza Vaccine (LAIV4)

NOTE: LAIV4 is not recommended for use in any population for 2017-18. Content provided for information only.





FluMist Quadrivalent (LAIV4) [MedImmune] 0.2 mL single-dose prefilled intranasal sprayer 2 through 49 yrs NR No NAS

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


  • 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.


  • 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).
Vaccine Abbreviations
  • IIV = Inactivated Influenza Vaccine.
    • IIV3 = Trivalent Inactivated Influenza Vaccine;
    • IIV4 = Quadrivalent Inactivated Influenza Vaccine.
  • RIV = Recombinant Influenza Vaccine.
    • RIV3 = Trivalent Recombinant Influenza Vaccine;
    • RIV4 = Quadrivalent Recombinant Influenza Vaccine.
  • LAIV4 = Quadrivalent Live Attenuated Influenza Vaccine
  • IIV, RIV, and LAIV denote vaccine categories; numeric suffix denotes number of antigens in the vaccine,
  • When referring specifically to adjuvanted vaccine, the prefix “a” is used (e.g., aIIV3).
  • When referring specifically to cell culture-based vaccine, the prefix “cc” is used (e.g., ccIIV4).
  • When referring specifically to High-dose vs. Standard-dose vaccines, the prefixes “HD-” and “SD-” are used (e.g., HD-IIV3 vs. SD-IIV3 and SD-IIV4).