Olivia, a 9-year-old girl, has no record of ever receiving an influenza vaccination. She has a fear of needles. What would be an appropriate recommendation for an influenza vaccination for Olivia?

Recommending one dose of inactivated influenza vaccine (IIV) for Olivia is appropriate given her age and vaccination history.

Children aged 6 months to 8 years who have never received the influenza vaccine before are generally recommended to receive two doses of the vaccine, spaced four weeks apart, to ensure adequate antibody response. However, since Olivia's option specifically suggests a single dose, it's also important to consider the circumstances surrounding her vaccination—specifically, her fear of needles. The IIV is administered via injection, which may increase her anxiety.

Among the available options, recommending just one dose of IIV serves as a practical approach to begin her vaccination process, particularly if she is encountering significant fear around needles. It allows for the initiation of her vaccination history without overwhelming her in the moment. Furthermore, she can still be advised to receive a second dose later if she agrees to it once her confidence has built up.

Other potential options such as recommending two doses of IIV separated by 4 weeks could serve as a more thorough immunization strategy but might be difficult to implement immediately given Olivia's fear. Additionally, recommending LAIV (live attenuated influenza vaccine) is not appropriate because it is not generally recommended in children with certain conditions or for all