Contraindications and Precautions to Influenza Vaccine 2019-2020 Advisory Committee on Immunization Practices Recommendations
Download a printable version of recommendations and contraindications.
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Vaccine Type
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Contraindications
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Precautions
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Inactivated Influenza Vaccine (IIV)
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- History of severe allergic reaction to any component of the vaccine† or to a previous dose of any influenza vaccine
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- Moderate or severe acute illness with or without fever
- History of Guillain-Barré syndrome within 6 weeks of receipt of influenza vaccine
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Recombinant Influenza Vaccine (RIV)
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- History of severe allergic reaction to any component of the vaccine
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- Moderate or severe acute illness with or without fever
- History of Guillain-Barré syndrome within 6 weeks of receipt of influenza vaccine
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Live Attenuated Influenza Vaccine (LAIV)
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- 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 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 and adults who are immunocompromised due to any cause (including immunosuppression caused by medications or by HIV infection)
- Close contacts and caregivers of severely immunosuppressed persons who require a protected environment
- Pregnancy
- Receipt of influenza antiviral medication within the previous 48 hours
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- Moderate or severe acute illness with or without fever
- History of Guillain-Barré syndrome within 6 weeks of 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])
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† 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 any licensed, recommended, and age-appropriate influenza vaccine (IIV, RIV, or LAIV) may be administered to persons with egg allergy of any severity. Patients with 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.
Source: Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices - United States, 2019-2020 Influenza Season