Influenza Vaccine Contraindications and Precautions
| Vaccine . | Contraindication . | Precaution . | Provider Discretion . | Not Contraindication . |
|---|---|---|---|---|
| IIVa | • Anaphylaxis or severe allergic reaction to previous influenza vaccination | • Moderate to severe illness, including COVID-19 | • Minor illness, with or without fever | |
| • History of GBS within 6 wk of previous influenza vaccination | • Egg allergy | |||
| LAIV | • Anaphylaxis or severe allergic reaction to previous influenza vaccination | • Moderate to severe illness, including COVID-19 | • Defer to resolution of symptoms or use IIV if a patient has nasal congestion that could impede vaccine delivery | • Minor illness, with or without fever |
| • Allergy to gelatin | • History of GBS within 6 wk of previous influenza vaccination | • Egg allergy | ||
| • Age 2–4 y with diagnosis of asthma or history of wheezing in last 12 mo | • Diagnosis of asthma and age ≥5 y | |||
| • Cochlear implants | • Certain underlying chronic conditions that might predispose to complications after influenza (eg, chronic pulmonary disease, cardiovascular disease, renal, hepatic, neurologic, hematologic, or metabolic disorders) | |||
| • Active cerebrospinal fluid leaks | ||||
| • Immunosuppression because of any cause, including | ||||
| • Primary or acquired immunodeficiency, including HIV | ||||
| • Immunosuppressive or immunomodulatory therapy | ||||
| • Anatomic or functional asplenia | ||||
| • Close contacts or caregivers of severely immunocompromised individuals | ||||
| • On aspirin or salicylate-containing medications | ||||
| • Receiving or recently received influenza antiviral medicationb | ||||
| • Currently pregnant |
| Vaccine . | Contraindication . | Precaution . | Provider Discretion . | Not Contraindication . |
|---|---|---|---|---|
| IIVa | • Anaphylaxis or severe allergic reaction to previous influenza vaccination | • Moderate to severe illness, including COVID-19 | • Minor illness, with or without fever | |
| • History of GBS within 6 wk of previous influenza vaccination | • Egg allergy | |||
| LAIV | • Anaphylaxis or severe allergic reaction to previous influenza vaccination | • Moderate to severe illness, including COVID-19 | • Defer to resolution of symptoms or use IIV if a patient has nasal congestion that could impede vaccine delivery | • Minor illness, with or without fever |
| • Allergy to gelatin | • History of GBS within 6 wk of previous influenza vaccination | • Egg allergy | ||
| • Age 2–4 y with diagnosis of asthma or history of wheezing in last 12 mo | • Diagnosis of asthma and age ≥5 y | |||
| • Cochlear implants | • Certain underlying chronic conditions that might predispose to complications after influenza (eg, chronic pulmonary disease, cardiovascular disease, renal, hepatic, neurologic, hematologic, or metabolic disorders) | |||
| • Active cerebrospinal fluid leaks | ||||
| • Immunosuppression because of any cause, including | ||||
| • Primary or acquired immunodeficiency, including HIV | ||||
| • Immunosuppressive or immunomodulatory therapy | ||||
| • Anatomic or functional asplenia | ||||
| • Close contacts or caregivers of severely immunocompromised individuals | ||||
| • On aspirin or salicylate-containing medications | ||||
| • Receiving or recently received influenza antiviral medicationb | ||||
| • Currently pregnant |
COVID-19, coronavirus disease 2019; GBS, Guillain-Barre syndrome.
Egg-based IIVs for children include Afluria quadrivalent, Fluarix quadrivalent, FluLaval quadrivalent, and Fluzone quadrivalent. Flucelvax quadrivalent is a cell culture-based IIV for children.
Within 48 hours (oseltamivir, zanamivir), 5 days (peramivir), or 17 days (baloxavir) of stopping influenza antiviral therapy.