NJLINCS Health Alert Network
Public Health Advisory
Distributed by the New Jersey Department of Health and Senior Services
Subject: LAIV Use in Health Care Settings
Date: 10/7/2009; 10:21:43
Contact Info: Barbara Montana, MD, MPH, FACP, NJDHSS
Phone: 609-588-7500; Email: Barbara.Montana@doh.state.nj.us
The attached document from the CDC provides information regarding the use of the LAIV (live-attenuated influenza vaccine) in the health care setting. Pertinent information is copied below for your convenience.
Close Contacts of Immunocompromised Persons
Immunocompromised persons are at risk for influenza complications but might have inadequate protection after vaccination. Close contacts of immunocompromised persons, including HCP, should be vaccinated to reduce the risk for influenza transmission. TIV is recommended for vaccinating household members, HCP, and others who have close contact with severely immunosuppressed persons (e.g., patients with hematopoietic stem cell transplants) during those periods in which the immunosuppressed person requires care in a protective environment (typically defined as a specialized patient-care area with a positive airflow relative to the corridor, high-efficiency particulate air filtration, and frequent air changes) (360,380).
LAIV transmission from a recently vaccinated person causing clinically important illness in an immunocompromised contact has not been reported. The rationale for avoiding use of LAIV among HCP or other close contacts of severely immunocompromised patients is the theoretical risk that a live, attenuated vaccine virus could be transmitted to the severely immunosuppressed person. As a precautionary measure, HCP who receive LAIV should avoid providing care for severely immunosuppressed patients requiring a protected environment for 7 days after vaccination. Hospital visitors who have received LAIV should avoid contact with severely immunosuppressed persons in protected environments for 7 days after vaccination but should not be restricted from visiting less severely immunosuppressed patients.
No preference is indicated for TIV use by persons who have close contact with persons with lesser degrees of immunosuppression (e.g., persons with diabetes, persons with asthma who take corticosteroids, persons who have recently received chemotherapy or radiation but who are not being cared for in a protective environment as defined above, or persons infected with HIV) or for TIV use by HCP or other healthy non-pregnant persons aged 2 - 49 years in close contact with persons in all other groups at high risk.