Flu Shot Education

Flu Season and Flu shot education.

The 2015-2016 influenza vaccine is made to protect against the following three viruses:

an (H1N1) virus

an A/Switzerland (H3N2)-like virus )

a B/Phuket like virus. (This is a B/Yamagata lineage virus)

Some of the 2015-2016 flu vaccine is quadrivalent vaccine and also protects against an additional B virus (B/Brisbane like virus). This is a B/Victoria lineage virus.

1- Current US recommendations for influenza vaccination:

Everyone six months and older should get a flu vaccine each year. This recommendation has been in place since February 24, 2010 when CDC’s Advisory Committee on Immunization Practices (ACIP) voted for "universal" flu vaccination in the U.S. to expand protection against the flu to more people.

CDC states no preference for any type of flu vaccine for the 2015-2016 season.

Intramuscular (IM) vaccines will be available in both trivalent and quadrivalent formulations.

2- Nasal spray vaccines will all be quadrivalent

Intradermal vaccine will all be quadrivalent

3- Children under eight years of age who have not received at least two flu vaccines prior to 2015 should receive two vaccines doses one month apart during this season. The two doses need not have been received in the same season or consecutive seasons.

4- Who should not get Type of vaccine named LAIV (This type assigned for person >18 years old)???

Immunocompromised persons

Persons with a history of egg allergy;

Children aged 2 through 4 years who have asthma or who have had a wheezing episode noted in the medical record within the past 12 months, or for whom parents report that a health care provider stated that they had wheezing or asthma within the last 12 months

For persons aged ≥5 years with asthma, recommendations are described in item 4 of this list;

Persons who have taken influenza antiviral medications within the previous 48 hours

The package insert also notes that the safety of LAIV in persons with other underlying medical conditions that might predispose them to complications after wild-type influenza virus infection (e.g., chronic pulmonary, cardiovascular [except isolated hypertension], renal, hepatic, neurologic, hematologic, or metabolic disorders [including diabetes mellitus]) (2), has not been established. These conditions, in addition to asthma in persons aged ≥5 years, should be considered precautions for the use of LAIV.

Persons who care for severely immunosuppressed persons who require a protective environment should not receive LAIV, or should avoid contact with such persons for 7 days after receipt, given the theoretical risk for transmission of the live attenuated vaccine virus to close contacts.

Where to vaccinate

If you have a patient 5 years of age or older that requires a FluMist or Fluzone HD type vaccine. Your health care provider knows about all types of vaccines. People who should NOT be vaccinated include:

Persons with a history of egg allergy who have experienced only hives after exposure to egg should receive influenza vaccine. Because relatively few data are available for use of LAIV (Flumist) in this setting, IIV (standard flu vaccine) or trivalent recombinant influenza vaccine (RIV, Flublok) should be used. RIV3 may be used for persons aged ≥18 years who have no other contraindications. However, IIV (egg- or cell culture-based) may also be used, with the following additional safety measures:

Vaccine should be administered by a health care provider who is

Familiar with the potential manifestations of egg allergy; and

Vaccine recipients should be observed for ≥30 minutes for signs of a reaction after administration of each vaccine dose.

Persons who report having had reactions to egg involving such symptoms as angioedema, respiratory distress, lightheadedness, or recurrent emesis; or who required epinephrine or another emergency medical intervention, may receive RIV3 vaccine if they are aged ≥18 years and there are no other contraindications.

Persons who are able to eat lightly cooked egg (e.g., scrambled egg) without reaction are unlikely to be allergic. Egg-allergic persons might tolerate egg in baked products (e.g., bread or cake). Tolerance to egg-containing foods does not exclude the possibility of egg allergy. Egg allergy can be confirmed by a consistent medical history of adverse reactions to eggs and egg-containing foods, plus skin and/or blood testing for immunoglobulin E directed against egg proteins (39).

For persons with no known history of exposure to egg, but who are suspected of being egg-allergic on the basis of previously performed allergy testing, consultation with a physician with expertise in the management of allergic conditions should be obtained before vaccination). Alternatively, RIV3 may be administered if the recipient is aged ≥18 years.

People who have had a severe reaction to an influenza vaccination.

Children younger than six months of age (influenza vaccine is not approved for children in this age group).

People who are moderately or severely ill with or without fever should usually wait until they recover before getting flu vaccine.

A history of Guillain-Barre Syndrome (GBS) within six weeks following receipt of influenza vaccine is a precaution for the use of influenza vaccine. Such individuals have a risk of recurrence of GBS with subsequent vaccination, and if not at high risk of severe influenza complications should generally not be vaccinated. However, while data are limited, the established benefits of influenza vaccination might outweigh the risks for many people who have a history of GBS (Guillain Barre Syndrome) and who also are at high risk for severe complications from influenza.

Dr.A. Shamani