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Influenza virus vaccine, quadrivalent, live (LAIV4), for intranasal use

CPT4 code

Name of the Procedure:

Influenza Virus Vaccine, Quadrivalent, Live (LAIV4), Intranasal Common name: Nasal Flu Vaccine, Live Flu Vaccine.


The Influenza Virus Vaccine, Quadrivalent, Live (LAIV4) is a flu vaccine administered through the nose. Unlike the traditional flu shot, which is injected, this vaccine is sprayed into the nostrils to help build immunity against four strains of the influenza virus.


The LAIV4 is designed to protect against seasonal influenza (commonly known as the flu). The goal is to stimulate the immune system to recognize and combat the virus, reducing the likelihood of infection and the severity of illness in those who do contract the flu.


  • People aged 2 to 49 years.
  • Healthy individuals without underlying chronic conditions.
  • Individuals who prefer an alternative to the injection flu vaccine.


  • No fasting is required.
  • Inform your healthcare provider of any recent illnesses or current medications.
  • Avoid antiviral medication for 48 hours before receiving the vaccine.
  • Diagnostic tests or assessments typically aren’t needed unless advised by a doctor.

Procedure Description

  1. Patient sits in an upright position.
  2. Healthcare provider prepares the nasal vaccine spray.
  3. The provider gently sprays the vaccine into each nostril while the patient breathes normally.
  4. No needles or injections are involved.


The procedure takes approximately 5-10 minutes.


This procedure is usually performed in an outpatient clinic, doctor's office, or pharmacy.


A licensed healthcare provider, such as a nurse or pharmacist, administers the vaccine.

Risks and Complications

  • Common risks: Mild nasal congestion, runny nose, sore throat, headache.
  • Rare risks: Wheezing, severe allergic reactions.
  • Management: Most mild side effects resolve without treatment; seek medical attention for severe reactions.


  • Effective prevention against four strains of the flu.
  • Typically takes effect within two weeks.
  • Non-invasive and needle-free, making it suitable for needle-phobic individuals.


  • No specific post-procedure care is needed.
  • Normal activities can be resumed immediately.
  • Monitor for any signs of adverse reaction, and report them to your healthcare provider if they occur.


  • Quadrivalent inactivated influenza vaccine (the traditional flu shot).
  • Antiviral medications for flu prevention.
  • Each alternative has its own pros and cons; for example, the flu shot is suitable for a broader age range and individuals with chronic health conditions.

Patient Experience

  • Patients will likely feel a brief mist sensation in their nose during administration.
  • Discomfort is minimal, with most individuals experiencing mild and temporary side effects.
  • Pain management is usually unnecessary, and comfort measures involve staying calm and following the provider's instructions.

Medical Policies and Guidelines for Influenza virus vaccine, quadrivalent, live (LAIV4), for intranasal use

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