Purpose of review: To review recent publications on the safety of influenza vaccines [both the injectable, inactivated trivalent influenza vaccine (TIV) and the intranasal, live attenuated influenza vaccine (LAIV)] and new recommendations regarding their use.
Recent findings: Numerous studies have demonstrated that TIV can be safely administered to patients with egg allergy. Influenza vaccines are very unlikely to cause or exacerbate Guillain-Barré syndrome (GBS). TIV cannot cause asthma exacerbations, whereas there may be some slight risk that LAIV could do so. TIV is well tolerated by patients with immunocompromise. Some brands of influenza vaccine are not indicated for certain age groups due to lack of effectiveness or possible side effects.
Summary: TIV should be administered to patients with egg allergy with appropriate precautions. Influenza vaccines should be withheld from patients with a history of GBS only if the GBS began within 6 weeks of prior influenza immunization. TIV should be given to patients with asthma, but they should not receive LAIV. TIV should be given to immunocompromised patients, but they should not receive LAIV. Contacts of most immunocompromised patients can receive either TIV or LAIV. Age appropriate brands of influenza vaccine should be used.