Use the LAIV only for individuals ages 2 years to 49 years who do not have a contraindication listed in the TABLE.1 There are other conditions that pose a theoretical increased risk of complications with the use of LAIV (TABLE), but they do not preclude the use of the vaccine. Additionally, anyone providing care for a severely immunosuppressed individual should avoid being vaccinated with LAIV or, if vaccinated with the live virus, avoid contact with the individual for 7 days following vaccination.
Recommendations for use of influenza vaccines in those who say they are allergic to eggs remain unchanged from last year (FIGURE1). The amount of egg protein in influenza vaccines is very low and serious allergic reactions are rare. The availability of trivalent recombinant vaccine provides an egg-free option for those ages 18 and older.
Vaccines are not all we have to protect the public
Remember that while influenza vaccines are recommended and are the most effective intervention to prevent influenza morbidity and mortality, they are imperfect. Their effectiveness varies from year to year, and it wanes with time after administration. The proportion of the population vaccinated is also suboptimal, which makes other prevention interventions important to implement. These include good infection control practices in all health care facilities, social distancing of those who are infectious, infection control practices in homes with an infected person, vaccination of all health care workers, and judicious use of pre- and post-exposure chemoprevention when indicated. These have all been discussed in a previous Practice Alert.5