TABLE 3

LAIV Compared With TIV

Vaccine CharacteristicLAIVTIV
Route of administrationIntranasal sprayIntramuscular or intradermal injectiona
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 administrationbAnnuallyAnnually
Approved age groupsAll healthy persons aged 2–49 yAll persons aged ≥6 mo (intradermal 18–64 y)
Interval between 2 doses in children4 wk4 wk
Can be given to persons with medical risk factors for influenza-related complicationsNoYes
Can be given to children with asthma or children aged 2–4 y with wheezing in the previous yearNocYes
Can be simultaneously administered with other vaccinesYesdYesd
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 The preferred site of TIV intramuscular injection for infants and young children is the anterolateral aspect of the thigh.

  • b See Fig 4 for decision algorithm to determine the number of doses of 2011–2012 seasonal influenza vaccine recommended for children this year.

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

  • d LAIV coadministration has been evaluated systematically only among children 12 to 15 months of age with measles-mumps-rubella and varicella vaccines. TIV coadministration has been evaluated systematically only among adults with pneumococcal polysaccharide and zoster vaccines.

  • Data sources: American Academy of Pediatrics, Committee on Infectious Diseases. Pediatrics. 2010;126(4):816–826; and Fiore AE, Fry A, Shay D, Gubareva L, Bresee JS, Uyeki TM; Centers for Disease Control and Prevention. MMWR Recomm Rep. 2011;60(RR-1):1–24.