TABLE 2. Contraindications and precautions to the use of influenza vaccines — United States, 2019–20 influenza season*.
| Vaccine type | Contraindications and conditions for which use is not recommended | Precautions |
|---|---|---|
| IIV |
History of severe allergic reaction to any component of the vaccine† or to a previous dose of any influenza vaccine |
Moderate or severe acute illness with or without fever History of Guillain-Barré syndrome within 6 weeks after receipt of influenza vaccine |
| RIV4 |
History of severe allergic reaction to any component of the vaccine |
Moderate or severe acute illness with or without fever History of Guillain-Barré syndrome within 6 weeks after receipt of influenza vaccine |
| LAIV4 | History of severe allergic reaction to any component of the vaccine† or to a previous dose of any influenza vaccine Concomitant aspirin- or salicylate-containing therapy in children and adolescents Children aged 2 through 4 years who have received a diagnosis of asthma or whose parents or caregivers report that a health care provider has told them during the past 12 months that their child had wheezing or asthma or whose medical record indicates a wheezing episode has occurred within the past 12 months Children and adults who are immunocompromised due to any cause (including immunosuppression caused by medications or HIV infection) Close contacts and caregivers of severely immunosuppressed persons who require a protected environment Pregnancy Receipt of influenza antiviral medication within the past 48 hours |
Moderate or severe acute illness with or without fever History of Guillain-Barré syndrome within 6 weeks after receipt of influenza vaccine Asthma in persons aged ≥5 years Other underlying medical conditions that might predispose to complications after wild-type influenza infection (e.g., chronic pulmonary, cardiovascular [excluding isolated hypertension], renal, hepatic, neurologic, hematologic, or metabolic disorders [including diabetes mellitus]) |
Abbreviations: ACIP = Advisory Committee on Immunization Practices; FDA = Food and Drug Administration; IIV = inactivated influenza vaccine; LAIV4 = live-attenuated influenza vaccine, quadrivalent; RIV4 = recombinant influenza vaccine, quadrivalent.
* Vaccination providers should check FDA-approved prescribing information for 2019–20 influenza vaccines for the most complete and updated information, including (but not limited to) indications, contraindications, warnings, and precautions. Package inserts for U.S.-licensed vaccines are available at https://www.fda.gov/vaccines-blood-biologics/approved-products/vaccines-licensed-use-united-states.
† History of severe allergic reaction (e.g., anaphylaxis) to egg is a labeled contraindication to the use of most IIVs and LAIV4. However, ACIP recommends that persons with a history of egg allergy may receive any licensed, recommended influenza vaccine that is otherwise appropriate for their age and health status. Those who report having had reactions to egg involving symptoms other than urticaria (e.g., angioedema or swelling, respiratory distress, lightheadedness, or recurrent emesis) or who required epinephrine or another emergency medical intervention should be vaccinated in an inpatient or outpatient medical setting (including, but not necessarily limited to, hospitals, clinics, health departments, and physician offices). Vaccine administration should be supervised by a health care provider who is able to recognize and manage severe allergic reactions.