For which condition should a patient avoid receiving the live attenuated influenza vaccine?

The live attenuated influenza vaccine is specifically contraindicated in individuals who are immunocompromised. This vaccine contains a weakened form of the live influenza virus, which is generally safe for healthy individuals because their immune systems can handle the weakened virus. However, for those who are immunocompromised—whether due to medications, conditions such as HIV/AIDS, or organ transplant—there is a heightened risk of vaccine-related complications. These individuals may not only fail to develop adequate immune protection, but they may also be at risk of actual disease manifestation from the live virus present in the vaccine.

In contrast, the other conditions listed do not present the same level of risk concerning the live attenuated vaccine. For example, pregnant individuals are often advised against this vaccine due to considerations about the safety of any vaccine during pregnancy, and while patients with asthma may need to take precautions with vaccines, they are not typically advised against this specific vaccine. Furthermore, diabetes mellitus, while a condition that can complicate influenza infection, does not inherently disallow the use of live attenuated vaccines, as these patients generally maintain a functional immune response.