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Guideline Alert - Canadian National Flu Updates

NACI has released their 2020-2021 Canadian Guideline for influenza vaccination. Here are the highlights from the 68-page document:

IT’S BACK FOR 2020-21: Intranasal Vaccine

Though this has been used in the past, the LAIV (Live Attenuated Intranasal Vaccine) wasn’t readily available last year. This year, it will be available for:

  • Children 2-17 years old

  • Adults 18-59 years old

Because it’s a live vaccine, the vaccine recipient should not be near an immunocompromised person for 2 weeks following the vaccine administration.

CONTRAINDICATED - Do NOT give the LAIV to adults with HIV (though it can be considered in some children with stable HIV). See more contraindications below.


Offer Immunization As soon as possible (Season starts in October in Northern Hemisphere) to:

  • At risk individuals who have not been vaccinated even AFTER influenza activity is documented in the community;

  • All over 6 months old, and household contacts and care providers of those under 6 months old; and

  • Pregnant women

  • High-risk patients

- Healthcare Workers & other care providers in facilities and community settings

- Indigenous peoples

- Direct contact with poultry during culling operations - Comorbidities: Cardiac/Pulmonary, cystic fibrosis, asthma, DM, renal disease, seizure disorders, mobird obesity (BMI >40)

- Nursing home & chronic care facilities

- Children 6-59 months of age & adults >65

First Time Vaccination?

  • Children 6 months to less than 9 years receiving FIRST TIME influenza vaccination should be given TWO doses, with at LEAST FOUR weeks between doses.

Where should the intramuscular injection be given?

  • 6-12 months - Anterolateral Thigh

  • Toddlers/Older children - Anterolateral Thigh/Deltoid

  • Adolescents/Adults - Deltoid

Egg Allergy

  • Not a contraindication to vaccination

LAIV (Nasal) Contraindications

  • Severe asthma

  • Medically attended wheezing 7 days prior

  • Children <24 months

  • 2–17 years old & receiving aspirin NOTE: DELAY aspirin-containing products for FOUR weeks in those <18 years old

  • Pregnant women

  • Anti-influenza antiviral drug in previous 48hrs

National Advisory Committee on Immunization. Canadian Immunization Guide chapter on influenza and statement on seasonal influenza vaccine for 2020–2021.

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