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Healthcare institutions are being asked to immunize an increasingly higher percentage of healthcare providers against influenza each year, with an eventual target of ≥90%. The live-attenuated influenza vaccine (LAIV) is an attractive approach for needle-averse individuals, but concerns have persisted about the use of a live vaccine in the healthcare setting.
A recent guidance statement from the Society for Healthcare Epidemiology of America reviews available data on LAIV virus shedding and the risk for secondary transmission of LAIV virus from an immunized individual to another person. The guideline endorses:
Use of LAIV as an alternative to the standard inactivated influenza vaccine for healthy, nonpregnant healthcare workers aged <50
Restriction on the use of LAIV for healthcare workers who, during the week following vaccination, will have frequent contact with patients receiving care in a protective environment (e.g., a bone marrow transplantation unit)
Talbot TR et al. The use of live attenuated influenza vaccine (LAIV) in healthcare personnel (HCP): Guidance from the Society for Healthcare Epidemiology of America (SHEA). Infect Control Hosp Epidemiol 2012 Oct; 33:981.
Comment
This guideline provides further reassurance for healthcare facilities that incorporate LAIV into their immunization programs. It emphasizes that the restriction on LAIV use for healthcare providers working in a protective environment is recommended “as a result of an abundance of caution” and notes that the restriction need not be extended to individuals who have infrequent contact with this patient population.