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  • Influenza
  • Contraindications & Precautions

What are the contraindications and precautions for FluMist Quadrivalent (LAIV4)?

Contraindications are:
• a history of severe allergic reaction to a vaccine component (except egg) or after a previous dose of any influenza vaccine (people with egg allergy of any severity may receive LAIV if it is otherwise appropriate for their age and health status)
• concomitant aspirin or salicylate-containing therapy in children and adolescents because of the risk of Reye syndrome
• children age 2 through 4 years who have received a diagnosis of asthma or whose parents or caregivers report that a healthcare provider has told them during the preceding 12 months that their child had wheezing or asthma or whose medical record indicates a wheezing episode during the preceding 12 months
• immunosuppression due to any cause including medications or HIV infection
• cerebral spinal fluid (CSF) leak, cochlear implant, or anatomic asplenia or functional asplenia (e.g., due to sickle cell anemia)
• close contacts and caregivers of severely immunosuppressed people who require a protected environment (e.g., reverse isolation in a hospital)
• pregnancy
• receipt of influenza antiviral medication within the previous 48 hours (oseltamivir or zanamivir), previous 5 days (peramivir), or previous 17 days (baloxavir)

Precautions are:
• moderate or severe acute illness with or without fever (defer)
• history of Guillain-Barré syndrome within 6 weeks after a dose of influenza vaccine
• asthma in a person age 5 years or older
• underlying medical conditions that might predispose to complications after influenza virus infection, such as chronic pulmonary, cardiovascular (except isolated hypertension), renal, hepatic, neurologic, hematologic, or metabolic disorders including diabetes mellitus

Last reviewed: September 10, 2023

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