Influenza Vaccine Types and Administration

Types of Influenza Vaccines

The American Academy of Pediatrics recommends the use of inactivated influenza vaccine (IIV) and live attenuated influenza vaccine (LAIV), with IIV administered intramuscularly and LAIV administered intranasally 1, 2, 3, 4
The inactivated influenza vaccine contains killed virus particles that cannot cause infection, and is approved for persons aged 6 months and older 5, 2, 4
The live attenuated influenza vaccine contains live but weakened influenza viruses that are temperature-sensitive, cold-adapted, and attenuated, producing mild or no symptoms related to influenza infection 3, 6

The Centers for Disease Control and Prevention (CDC) recommends that inactivated influenza vaccine (IIV) be administered via intramuscular injection, and is approved for persons with chronic medical conditions 2, 5
The American Academy of Family Physicians recommends that live attenuated influenza vaccine (LAIV) be administered via intranasal spray, but is only approved for healthy persons aged 2-49 years 4, 3
Recipients of LAIV may shed vaccine virus for up to 2-7 days after vaccination, and should take precautions to minimize contact with immunocompromised individuals 6

The CDC recommends that LAIV not be given to persons younger than 2 years or 50 years and older, persons with asthma or other chronic disorders, immunocompromised individuals, pregnant women, children or adolescents receiving aspirin or salicylates, and healthcare personnel who work with severely immunocompromised patients 4, 3, 7, 8
Solid organ transplant recipients should not receive LAIV, according to the American Society of Transplantation 7, 8

Healthcare workers caring for immunocompromised patients should preferentially receive inactivated vaccine rather than LAIV, as recommended by the American Journal of Transplantation 8
If household contacts of immunocompromised individuals receive LAIV, good hand hygiene and minimizing contact with secretions should be emphasized, as recommended by the American Journal of Transplantation 8