This season’s influenza vaccine contains the A/California/7/2009 (H1N1)-like virus, and 2 new strains: an A/Victoria/ 361/2011 (H3N2)-like virus and a B/Wisconsin/1/2010-like virus (from the B/Yamagata lineage of viruses) (16). The 2012-2013 influenza vaccine is available in both inactivated and live attenuated forms. See Resources—CDC vaccine dosing table for currently licensed influenza vaccine formulations.
Trivalent inactivated vaccine (TIV) is available in intramuscular and intradermal formulations. The intradermal vaccine, Fluzone® Intradermal, is formulated as a single-dose, prefilled microinjection syringe that contains 40% less antigen in a smaller volume than intramuscular TIV preparations and has a much shorter needle. Fluzone Intradermal vaccine is indicated for use in adults aged 18 through 64 years (42). Fluzone® High-Dose is an intramuscular vaccine indicated for use in adults aged 65 years and older; it has a higher dose of antigen to stimulate a better immune response (43).
While there are few contraindications to TIV, people who have moderate to severe acute febrile illness should defer vaccination until their illness improves. A history of Guillain-Barré syndrome (GBS) within 6 weeks following a dose of TIV is considered a precaution for use of TIV (11). Allergy to eggs is no longer considered an absolute contraindication to vaccination with TIV (see Adverse Events).
Live attenuated influenza vaccine (LAIV) is administered intranasally and licensed for use only in healthy people aged 2 through 49 years. It should not be given to people aged 50 years or older; children aged 6 through 23 months; children 2 through 4 years of age with asthma or 1 or more episodes of wheezing within the past year; pregnant women; or people with certain chronic health conditions such as asthma, diabetes, heart disease, kidney disease (Box 2), or a history of GBS (11). When considering LAIV for children aged 2 through 4 years, screen for possible reactive airway disease and use TIV if hyperreactivity is identified (11). People, including health care personnel, who have received LAIV should wait 7 days after vaccination to visit severely immunocompromised patients in protected environments (eg, a bone marrow or stem cell transplant unit) (11) or use TIV instead.
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