• Influenza
  • Contraindications & Precautions

What are the contraindications and precautions for people with a history of a severe allergic reaction to a previous influenza vaccination?

A severe allergic reaction to any influenza vaccine is a contraindication to receiving additional doses of the same vaccine or receiving any egg-based influenza vaccines. The following table summarizes the contraindications and precautions for different types of influenza vaccine and is adapted from table 3 of the 2022–23 influenza ACIP recommendations at www.cdc.gov/mmwr/volumes/71/rr/pdfs/rr7101a1-H.pdf:

Vaccine (of any valency) associated with previous serious or anaphylactic reaction Available 2022–23 influenza vaccines
Egg-based IIV4s
and LAIV4
Cell-culture- based IIV4: ccIIV4 (Flucelvax) Recombinant IIV4: RIV4 (Flublok)
Any egg-based IIV or LAIV Contraindication Precaution † Precaution †
Any ccIIV Contraindication Contraindication Precaution †
Any RIV Contraindication Precaution † Contraindication
Unknown influenza vaccine Allergist consultation recommended

† Note regarding patients having either of the above precautions for either ccIIV or IIV: use of ccIIV4 and RIV4 in such instances should occur in an inpatient or outpatient medical setting under the supervision of a healthcare provider (HCP) who can recognize and manage severe allergic reaction; HCPs can also consider consulting with an allergist to help identify the vaccine component responsible for the reaction.

Last reviewed: September 10, 2023

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