Influenza vaccination guidelines at the Seattle Cancer Care Alliance
| Population . | Inactivated vaccine (injection)* . | Live-attenuated vaccine (nasal spray)† . | Comments . |
|---|---|---|---|
| Hematologic malignancy patients (non-HCT) | Yes | No (within 3 mo of chemotherapy‡) | |
| HCT recipients | Yes (6 mo after transplantation) | No | During shortage of inactivated vaccine, LAIV vaccine may be considered late after hematopoietic cell transplantation > 6 mo after discontinuation of all immunosuppressive agents |
| Health care workers | Yes | Yes (second line) | LAIV only during shortage of inactivated vaccine; should not have direct patient contact for at least 3 d |
| Caregivers | Yes | Yes (second line) | If LAIV recipients develop fever (particularly in children), nasal stuffiness, or runny nose (rhinorrhea), they are at higher risk of shedding the vaccine virus, and should remain sequestered from the patient for at least 3 d |
| Visitors | Yes | Yes (second line) |
| Population . | Inactivated vaccine (injection)* . | Live-attenuated vaccine (nasal spray)† . | Comments . |
|---|---|---|---|
| Hematologic malignancy patients (non-HCT) | Yes | No (within 3 mo of chemotherapy‡) | |
| HCT recipients | Yes (6 mo after transplantation) | No | During shortage of inactivated vaccine, LAIV vaccine may be considered late after hematopoietic cell transplantation > 6 mo after discontinuation of all immunosuppressive agents |
| Health care workers | Yes | Yes (second line) | LAIV only during shortage of inactivated vaccine; should not have direct patient contact for at least 3 d |
| Caregivers | Yes | Yes (second line) | If LAIV recipients develop fever (particularly in children), nasal stuffiness, or runny nose (rhinorrhea), they are at higher risk of shedding the vaccine virus, and should remain sequestered from the patient for at least 3 d |
| Visitors | Yes | Yes (second line) |
Contraindications (obtained from package insert): Persons with a history of Guillain-Barré syndrome that occurred after receiving influenza vaccine; persons who have a severe allergy to chicken eggs.
Contraindications (obtained from package insert): persons younger than 2 or older than 50 years; persons with a medical condition that places them at high risk for complications from influenza, including those with chronic heart or lung disease, such as asthma or reactive airways disease; people with medical conditions such as diabetes or kidney failure; or people with illnesses that weaken the immune system, or who take medications that can weaken the immune system; children younger than 5 years with a history of recurrent wheezing; children or adolescents receiving aspirin; persons with a history of Guillain-Barré syndrome that occurred after receiving influenza vaccine; pregnant women; and persons who have a severe allergy to chicken eggs or who are allergic to any of the nasal spray vaccine components.
Based on authors' opinion.