TABLE 1

LAIV Compared With TIV

Vaccine CharacteristicLAIVTIV
Route of administrationIntranasal sprayIntramuscular injection
Type of vaccineLive virusKilled virus
ProductAttenuated, cold-adaptedInactivated subvirion or surface antigen
No. of included virus strains3 (2 influenza A, 1 influenza B)3 (2 influenza A, 1 influenza B)
Vaccine virus strains updatedAnnuallyAnnually
Frequency of administrationaAnnuallyAnnually
Approved age and risk groupsHealthy persons aged 2–49 ybPersons aged ≥6 mo
Interval between 2 doses in children4 wk4 wk
Can be simultaneously administered with other vaccinesYescYesc
If not simultaneously administered,
    Can be administered within 4 wk of another live vaccineNo, prudent to space 4 wk apartYes
    Can be administered within 4 wk of an inactivated vaccineYesYes
  • a Two doses may be needed for children younger than 9 years, depending on individual circumstances.

  • b LAIV is not recommended for children with a history of asthma. In the 2- to 4-year age group, there are children who have a history of wheezing with respiratory illnesses that are diagnosed with reactive airways disease who later may have asthma diagnosed. Therefore, because of the potential for increased wheezing after immunization, children younger than 5 years with recurrent wheezing or a wheezing episode in the past 12 months should not receive LAIV. When offering LAIV to children younger than 5 years, a clinician should screen young children who might be at higher risk of asthma by asking parents/guardians of 2-, 3-, and 4-year-olds (24- to 59-month-olds) the question, “In the past 12 months, has a health care professional ever told you that your child had wheezing?” If parents answer “yes” to this question, LAIV is not recommended for those children.

  • c LAIV coadministration has been evaluated systematically only among children aged 12 to 15 months with measles, mumps, and rubella vaccine. TIV coadministration has been evaluated systematically only among adults with pneumococcal polysaccharide vaccine.

  • Sources: American Academy of Pediatrics, Committee on Infectious Diseases. Prevention of influenza: recommendations for influenza immunization of children, 2007–2008. Pediatrics. 2008;121(4). Available at: www.pediatrics.org/cgi/content/full/121/4/e1016; and Fiore AE, Shay DK, Broder K, et al. Prevention and control of influenza: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2008;57(RR-7):1–60.