Seasonal Influenza

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

Age

Pregnancy status

Co-morbid conditions

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.