2009-10 Influenza Prevention & Control Recommendations

Persons Who Should Not Be Vaccinated

TIV

TIV is contraindicated and should not be administered to persons known to have anaphylactic hypersensitivity to eggs or to other components of the influenza vaccine unless the recipient has been desensitized. Prophylactic use of antiviral agents is an option for preventing influenza among such persons. Information about vaccine components is located in package inserts from each manufacturer. Persons with moderate to severe acute febrile illness usually should not be vaccinated until their symptoms have abated. Moderate or severe acute illness with or without fever is a precaution§ for TIV. GBS within 6 weeks following a previous dose of influenza vaccine is considered to be a precaution for use of influenza vaccines.

LAIV

The effectiveness or safety of LAIV is not known for the following groups and administration of LAIV is contraindicated:

• persons with a history of hypersensitivity, including anaphylaxis, to any of the components of LAIV or to eggs.
• persons aged <2 years or those aged 50 years and older;
• adults and children who have chronic pulmonary (including asthma), cardiovascular (except hypertension), renal, hepatic, neurological/neuromuscular, hematological, or metabolic disorders (including diabetes mellitus);
• adults and children who have immunosuppression (including immunosuppression caused by medications or by HIV);
• children aged 2--4 years 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 or adolescents aged 6 months--18 years receiving aspirin or other salicylates (because of the association of Reye syndrome with wild-type influenza virus infection); or
• pregnant women.

A moderate or severe illness with or without fever is a precaution for use of LAIV. GBS within 6 weeks following a previous dose of influenza vaccine is considered to be a precaution for use of influenza vaccines. LAIV should not be administered to close contacts of immunosuppressed persons who require a protected environment.