Medical - Vaccine Guide 2022 - 26

Appendix
Recommended Adult Immunization Schedule, United States, 2022
Guide to Contraindications and Precautions to Commonly Used Vaccines
Adapted from Table 4-1 in Advisory Committee on Immunization Practices (ACIP) General Best Practice Guidelines for Immunization: Contraindication and Precautions available at www.cdc.
gov/vaccines/hcp/acip-recs/general-recs/contraindications.html and ACIP's Recommendations for the Prevention and Control of 2021-22 Seasonal Influenza with Vaccines available at
www.cdc.gov/mmwr/volumes/70/rr/rr7005a1.htm
Interim clinical considerations for use of COVID-19 vaccines including contraindications and precautions can be found at
www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html
Vaccine
Influenza, egg-based,
inactivated injectable (IIV4)
Contraindications1
* Severe allergic reaction (e.g., anaphylaxis) after previous dose of any influenza vaccine
(i.e., any egg-based IIV, ccIIV, RIV, or LAIV of any valency)
* Severe allergic reaction (e.g., anaphylaxis) to any vaccine component3
(excluding egg)
Precautions2
* Guillain-Barré syndrome (GBS) within 6 weeks after a previous dose of any type of
influenza vaccine
* Persons with egg allergy with symptoms other than hives (e.g., angioedema,
respiratory distress) or required epinephrine or another emergency medical
intervention: Any influenza vaccine appropriate for age and health status may be
administered. If using egg-based IIV4, administer in medical setting under supervision
of health care provider who can recognize and manage severe allergic reactions. May
consult an allergist.
* Moderate or severe acute illness with or without fever
Influenza, cell culture-based
inactivated injectable
[(ccIIV4), Flucelvax®
Quadrivalent]
* Severe allergic reaction (e.g., anaphylaxis) to any ccIIV of any valency, or to any
component3
of ccIIV4
* Guillain-Barré syndrome (GBS) within 6 weeks after a previous dose of any type of
influenza vaccine
* Persons with a history of severe allergic reaction (e.g., anaphylaxis) after a previous
dose of any egg-based IIV, RIV, or LAIV of any valency. If using ccIV4, administer in
medical setting under supervision of health care provider who can recognize and
manage severe allergic reactions. May consult an allergist.
* Moderate or severe acute illness with or without fever
Influenza, recombinant
injectable [(RIV4), Flublok®
Quadrivalent]
* Severe allergic reaction (e.g., anaphylaxis) to any RIV of any valency, or to any
component3
of RIV4
* Guillain-Barré syndrome (GBS) within 6 weeks after a previous dose of any type of
influenza vaccine
* Persons with a history of severe allergic reaction (e.g., anaphylaxis) after a previous
dose of any egg-based IIV, ccIIV, or LAIV of any valency. If using RIV4, administer in
medical setting under supervision of health care provider who can recognize and
manage severe allergic reactions. May consult an allergist.
* Moderate or severe acute illness with or without fever
Influenza, live attenuated
[LAIV4, Flumist®
Quadrivalent]
* Severe allergic reaction (e.g., anaphylaxis) after previous dose of any influenza vaccine
(i.e., any egg-based IIV, ccIIV, RIV, or LAIV of any valency)
* Severe allergic reaction (e.g., anaphylaxis) to any vaccine component3
(excluding egg)
* Adults age 50 years or older
* Anatomic or functional asplenia
* Immunocompromised due to any cause including, but not limited to, medications and
HIV infection
* Close contacts or caregivers of severely immunosuppressed persons who require a
protected environment
* Pregnancy
* Cochlear implant
* Active communication between the cerebrospinal fluid (CSF) and the oropharynx,
nasopharynx, nose, ear, or any other cranial CSF leak
* Received influenza antiviral medications oseltamivir or zanamivir within the previous 48
hours, peramivir within the previous 5 days, or baloxavir within the previous 17 days.
* Guillain-Barré syndrome (GBS) within 6 weeks after a previous dose of any type of
influenza vaccine
* Asthma in persons aged 5 years old or older
* Persons with egg allergy with symptoms other than hives (e.g., angioedema,
respiratory distress) or required epinephrine or another emergency medical
intervention: Any influenza vaccine appropriate for age and health status may be
administered. If using LAIV4 (which is egg based), administer in medical setting under
supervision of health care provider who can recognize and manage severe allergic
reactions. May consult an allergist.
* Persons with underlying medical conditions (other than those listed under
contraindications) that might predispose to complications after wild-type influenza
virus infection [e.g., chronic pulmonary, cardiovascular (except isolated hypertension),
renal, hepatic, neurologic, hematologic, or metabolic disorders (including diabetes
mellitus)]
* Moderate or severe acute illness with or without fever
1. When a contraindication is present, a vaccine should NOT be administered. Kroger A, Bahta L, Hunter P. ACIP General Best Practice Guidelines for Immunization. www.cdc.gov/vaccines/hcp/acip-recs/general-recs/
contraindications.html
2. When a precaution is present, vaccination should generally be deferred but might be indicated if the benefit of protection from the vaccine outweighs the risk for an adverse reaction. Kroger A, Bahta L, Hunter P.
ACIP General Best Practice Guidelines for Immunization. www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html
3. Vaccination providers should check FDA-approved prescribing information for the most complete and updated information, including contraindications, warnings, and precautions. Package inserts for U.S.licensed
vaccines are available at www.fda.gov/vaccines-blood-biologics/approved-products/vaccines-licensed-use-united-states.
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http://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/general/contraindications.html http://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/general/contraindications.html http://www.cdc.gov/mmwr/volumes/70/rr/rr7005a1.htm http://www.cdc.gov/vaccines/covid-19/clinical-considerations/covid-19-vaccines-us.html http://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html http://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html http://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/contraindications.html http://www.fda.gov/vaccines-blood-biologics/approved-products/vaccines-licensed-use-united-states http://www.henryschein.com/medical

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