Vaccination

All health-care personnel and persons at high risk for complications of influenza should receive annual influenza vaccination according to current national recommendations current national recommendations.

• Vaccination is the primary measure to prevent infection or development of illness from influenza, and thereby limits transmission of influenza and prevents complications from influenza.
  
  
• Inactivated influenza vaccine or live attenuated influenza vaccine may be used to vaccinate most health-care personnel.
  • Inactivated influenza vaccine may be used for all health-care personnel and is preferred for vaccinating health-care personnel who have close contact with severely immunosuppressed persons (e.g., patients with hematopoietic stem cell transplants) during those periods in which the immunosuppressed person requires care in a protective environment.
    The following persons should not receive inactivated influenza vaccine:
    • Persons known to have anaphylactic hypersensitivity to eggs or to other components of the influenza vaccine without first consulting a physician.
    • Persons with moderate-to-severe acute febrile illness usually should not be vaccinated until their symptoms have abated. However, minor illnesses with or without fever do not contraindicate use of influenza vaccine, particularly among children with mild upper-respiratory tract infection or allergic rhinitis.
    • Avoiding vaccination of persons who are not at high risk for severe influenza complications and who are known to have experienced GBS within 6 weeks after a previous influenza vaccination is prudent.
      
      
  • Live, attenuated vaccine (LAIV) may be given to health-care personnel younger than 50 years of age who do not have contraindications to receiving the nasal vaccine. Health-care personnel who may receive LAIV include those taking care of immunocompromised patients who do not require care in a protective environment.  If health-care personnel who care for severely immunocompromised patients in protected environments receive LAIV, then they should not care for these patients for 7 days following immunization.
    The following persons should not receive LAIV:
    
    • Persons <5 years of age or those >50 years of age.
    • Persons with asthma, reactive airways disease or other chronic disorders of the pulmonary or cardiovascular systems; persons with other underlying medical conditions, including such metabolic diseases as diabetes, renal dysfunction and hemoglobinopathies; or persons with known or suspected immunodeficiency diseases or who are receiving immunosuppressive therapies.
    • Children or adolescents receiving aspirin or other salicylates (because of the association of Reye’s syndrome with wild-type influenza infection).
    • Persons with a history of Guillain-Barré syndrome.
    • Pregnant women.
    • Persons with a history of hypersensitivity, including anaphylaxis, to any of the components of LAIV or to eggs.