- 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.