Influenza vaccine (live attenuated, intranasal)

How it works

Contains attenuated influenza virus strains that replicate in the cooler nasopharyngeal mucosa to induce mucosal and systemic immunity without causing influenza disease.

Prescribing in practice

• As a live vaccine it is contraindicated in clinically significant immunosuppression and should be avoided where this poses a risk; seek specialist advice for at-risk children.
• Strain composition is updated annually to match the strains recommended for the forthcoming season.
• Use caution in children with active wheezing or severe asthma, where an inactivated vaccine may be preferred per current immunisation guidance.

Monitoring

No routine laboratory monitoring is required; observe for immediate hypersensitivity after administration.

Counselling the patient

• Mild nasal congestion or runny nose, headache and reduced appetite are common and usually short-lived.
• The vaccine cannot give you influenza, but full protection takes a couple of weeks to develop.
• Tell the clinician about any egg allergy, immune problems or recent unwell contacts before vaccination.

Evidence & guidelines

Recommended within the UK childhood seasonal influenza programme per the Green Book (Immunisation against infectious disease) and UKHSA guidance.