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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.


SAME AS LAST YEAR:


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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