* Trivalent inactivated vaccine. †Children aged 6 months–8 years who did not receive at least 1 dose of an influenza A (H1N1) 2009 monovalent vaccine, who have never received a seasonal TIV before, or who were vaccinated for the first time with the seasonal 2009–10 seasonal vaccine but who received only 1 dose should receive 2 doses of the 2010–11 influenza vaccine formula, spaced ≥4 weeks apart. §For adults and older children, the recommended site of vaccination is the deltoid muscle. The preferred site for infants and young children is the anterolateral aspect of the thigh. ¶Afluria (CSL Biotherapies) is approved by FDA for use in persons aged 6 months and older in the U.S. However, ACIP recommends that Afluria not be administered to children aged 6 months through 8 years of age during 2010-2011, because of an increased frequency of febrile seizures reported among young children (mostly among children aged < 5 years) in Australia in 2010. Therefore, another age-appropriate, licensed seasonal influenza vaccine formulation should be used for prevention of influenza in children aged 6 months through 8 years. If no other age-appropriate, licensed seasonal influenza vaccine is available for a child aged 5 years through 8 years old who has a medical condition that increases their risk for influenza complications, providers should discuss the benefits and risks of influenza vaccination with the parents or caregivers before administering Afluria. **Trivalent inactivated vaccine high dose. A 0.5-mL dose contains 60 mcg each of A/California/7/2009 (H1N1)-like, A/Perth/16/2009 (H3N2)-like, and B/Brisbane/60/2008-like antigens. ††Live attenuated influenza vaccine. §§FluMist is shipped refrigerated and stored in the refrigerator at 36°F–46°F (2°C–8°C) after arrival in the vaccination clinic. The dose is 0.2 mL divided equally between each nostril. Health-care providers should consult the medical record, when available, to identify children aged 2–4 years with asthma or recurrent wheezing that might indicate asthma. In addition, to identify children who might be at greater risk for asthma and possibly at increased risk for wheezing after receiving LAIV, parents or caregivers of children aged 2–4 years should be asked: "In the past 12 months, has a health-care provider ever told you that your child had wheezing or asthma?" Children whose parents or caregivers answer "yes" to this question and children who have asthma or who had a wheezing episode noted in the medical record within the past 12 months should not receive FluMist. |