ACEP ID:

Seasonal Influenza

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Section IconSeasonal Influenza
Overview
Defer if moderately or severely ill, history of anaphylaxis to flu vaccine, history of Guillain-Barre Syndrome within 6 weeks of receiving the flu vaccine
Patients with egg allergies (including anaphylaxis) can receive the vaccine in the ED
Questions to ask/Characteristics to consider
Age
Pregnancy status
Co-morbid conditions
Guidelines
Inactivated/Recombinant Influenza vaccine:
  • 0-6 months – not indicated
  • 6 mo - 8 y:
    • 1 dose IF they have have previously received ≥2 total doses of trivalent or quadrivalent influenza vaccine ≥4 weeks apart
    • 2 doses spaced ≥4 weeks apart IF they have not previously received ≥2 doses of trivalent or quadrivalent influenza vaccine ≥4 weeks apart or if their influenza vaccination status is unknown
  • Adults and children aged ≥9 y: only 1 dose
Live attenuated flu vaccine (LAIV):
  • may be administered to those ages 2-49 years
  • Contraindications:
    • Children 2-4 years of age with a diagnosis of asthma or wheezing within the past 12 months should not receive LAIV
    • LAIV should not be administered to: pregnant women, immunocompromised individuals, those who have close contact with immunocompromised individuals, children or adolescents taking aspirin or salicylate medications
  • For complete list of contraindication for IIV4, HD-IIV4, aIIV4, etc., see references below.
References
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