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Influenza Vaccination Immunosuppressed — RACP Adult Medicine MCQ

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EasyGeneral Internal MedicineInfluenza Vaccination ImmunosuppressedRACP Adult Medicine

A 45-year-old man with inflammatory bowel disease on anti-TNF therapy requires influenza vaccination. Which influenza vaccine formulation can he safely receive?

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Correct answer: A — Inactivated quadrivalent influenza vaccine (standard IM injection)

The inactivated influenza vaccine (standard IM injection) is safe and recommended for all immunosuppressed patients, including those on anti-TNF therapy. The live attenuated intranasal influenza vaccine (LAIV) is CONTRAINDICATED in immunosuppressed patients due to the risk of vaccine-strain infection. Annual influenza vaccination is particularly important for immunosuppressed patients as they are at higher risk of influenza complications. Vaccine efficacy may be reduced on immunosuppressive therapy, but vaccination still provides meaningful protection.

Reference: ATAGI – 2024 – Australian Immunisation Handbook; eTG – 2025 – Immunology