LAIV Compared With TIV

Vaccine CharacteristicLAIVTIV
Route of administrationIntranasal sprayIM or ID 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 people aged 2–49 yAll people aged ≥6 mo (ID 18–64 y)
Interval between 2 doses in children4 wk4 wk
Can it be given to persons with medical risk factors for influenza-related complications?NoYes
Can it be given to children with asthma or children aged 2 through 4 y with wheezing in the previous year?NocYes
Can it be simultaneously administered with other vaccines?YesdYesd
If not simultaneously administered, can it be administered within 4 wk of another live vaccine?No, prudent to space 4 wk apartYes
Can it be administered within 4 wk of an inactivated vaccine?YesYes
  • Sources: American Academy of Pediatrics, Committee on Infectious Diseases. Recommendations for prevention and control of influenza in children, 2011-2012. Pediatrics. 2011;128(4):813–825; and Fiore AE, Fry A, Shay D, Gubareva L, Bresee JS, Uyeki TM; Centers for Disease Control and Prevention (CDC). Antiviral agents for the treatment and chemoprophylaxis of influenza—recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2011;60(1):1–24.

  • a The preferred site of TIV IM injection for infants and young children is the anterolateral aspect of the thigh.

  • b See Fig 2 for decision algorithm to determine number of doses of 2012–2013 seasonal influenza vaccine recommended for children this year.

  • c LAIV is not recommended for children who have a history of asthma. In the 2- to 4-year-old 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 pediatrician should screen those who might be at higher risk of asthma by asking the parents/guardians of 2-, 3-, and 4-year-olds (24- through 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.