Influenza Vaccines and Use of Influenza Antiviral Medications

Influenza Prevention and Control Recommendations

Published for the 2010-11 Influenza Season; Adapted for the 2012-13 Influenza Season

Administration of trivalent inactivated influenza vaccine (TIV) to persons receiving influenza antivirals for treatment or chemoprophylaxis is acceptable. The effect on safety and effectiveness of live-attenuated influenza vaccine (LAIV) coadministration with influenza antiviral medications has not been studied. However, because influenza antivirals reduce replication of influenza viruses, and LAIV viruses replicate in the nasal passages and can be detected in nasal specimens for several days (and possibly for longer periods) following vaccination, LAIV should not be administered until 48 hours after cessation of influenza antiviral therapy. If influenza antiviral medications are administered within 2 weeks after receipt of LAIV, the vaccine dose should be repeated 48 or more hours after the last dose of antiviral medication. Persons receiving antivirals within the period 2 days before to 14 days after vaccination with LAIV should be revaccinated at a later date with any approved vaccine formulation.

References

Block SL, Yogev R, Hayden FG, Ambrose CS, Zeng W, Walker RE. Shedding and immunogenicity of live attenuated influenza vaccine virus in subjects 5-49 years of age. Vaccine. 2008 Sep 8;26(38):4940-6.

Mallory RM, Yi T, Ambrose CS. Shedding of Ann Arbor strain live attenuated influenza vaccine virus in children 6-59 months of age. Vaccine. 2011 Jun 10;29(26):4322-7.