Influenza Vaccine Administration Guidelines
Patient Selection and Assessment
- The Centers for Disease Control and Prevention recommends assessing for current moderate-to-severe acute illness with or without fever as a precaution to vaccination, and screening for history of severe allergic reaction to previous influenza vaccine or vaccine components, and history of Guillain-Barré syndrome within 6 weeks of prior influenza vaccination 1
- For Live Attenuated Influenza Vaccine (LAIV) candidates, the American Academy of Pediatrics recommends assessing for contraindications including pregnancy, immunocompromising conditions, aspirin therapy in children/adolescents, and asthma in children 2-4 years 1
Vaccine Selection and Administration
- The American Academy of Pediatrics recommends Quadrivalent inactivated influenza vaccine (IIV4) for ages ≥6 months, and Cell culture-based IIV4 for ages ≥6 months 2, 3
- The Centers for Disease Control and Prevention recommends Live attenuated influenza vaccine (LAIV4) for ages 2-49 years (healthy, non-pregnant), and High-dose IIV3 or adjuvanted IIV3 for ages ≥65 years 1, 3, 4
- The Centers for Disease Control and Prevention recommends administering the vaccine via intramuscular injection, with the site being the deltoid muscle for adults and older children, and the anterolateral aspect of the thigh for infants and young children 3, 6
Dosing and Post-Vaccination Care
- The American Academy of Pediatrics recommends a dose of 0.25 mL or 0.5 mL for children 6-35 months, and 0.5 mL for children ≥36 months and adults, with a two-dose series required for children 6 months-8 years receiving influenza vaccine for the first time (minimum 4 weeks apart) 2, 3, 5
- The Centers for Disease Control and Prevention recommends observing the patient for 15 minutes for immediate adverse reactions, and counseling on expected local reactions (soreness, redness at injection site in 10-64% of patients) 1, 6