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|
|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.