October
2000
Because of
manufacturer backorder, approximately 40% of total doses will be available by
October 14th. The remaining 60% of doses will be available by
November 11th
INTRODUCTION
Influenza virus infections occur every year
in the United States but vary greatly in incidence and geographic distribution.
Efforts to prevent or control influenza in the U.S. have been aimed at
protecting persons at risk of serious illness or death.
The 2000-2001 trivalent vaccine virus strains are A/Moscow/10/99 (H3N2)-like, A/New Caledonia/20/99 (H1N1)-like, and Beijing/184/93-like strains.
The influenza vaccine is strongly
recommended for:
1. Any person greater than or equal to six
months of age, who by virtue of age or underlying conditions is at increased
risk for complications of influenza.
2. Health care workers and others (including
household members) who may have close contact with high risk persons to
decrease risk of transmitting disease.
3. Any other person who wishes to reduce his/her
chance of becoming infected with influenza, even if that person is not at
increased risk for complications.
The
vaccine is also recommended for persons at high risk for influenza related
complications, including persons greater or equal to 50 years, nursing
home/chronic care facility residents with chronic medical conditions,
adults/children with chronic pulmonary or cardiovascular disease, persons
requiring hospitalization within the last year for a chronic metabolic disease,
renal failure, hemoglobinopathies or immunosuprression, and children/teenagers
taking long term aspirin therapy.
For
persons infected with HIV, vaccination is advised because influenza may result
in serious illness and complications in these individuals. The effectiveness of
vaccination may be reduced due to the inability of HIV patients to mount an
antibody response.
Women
beyond the 1st trimester of pregnancy (> 14 wks) during the influenza season should be vaccinated. Pregnant women
who have medical conditions that increase their risk of complications from
influenza should be vaccinated before the influenza season – regardless of
pregnancy stage. To minimize the theoretical possibility of teratogenecity, it
is reasonable to administer the vaccine after the first trimester if
immunization will be accomplished when
the influenza season begins. Breastfeeding is not a contraindication for
vaccination.
Persons with acute febrile illnesses usually should
NOT be vaccinated until symptoms have abated. Inactivated influenza vaccine
should NOT be given to persons with known hypersensitivity to eggs.
TIMING OF ADMINISTRATION/DOSAGE
High levels of influenza activity generally
do not occur before December in the United States. Influenza vaccine may be
offered to high risk patients presenting for routine care or hospitalization
starting in September. Organized vaccination campaigns for high risk persons
are optimal from October to mid November.
Only the split virus preparation will be stocked at KUMC, as this preparation is associated with fewer febrile reactions in children and is the only preparation recommended for use in children < 12 years. Influenza vaccine should only be administered intramuscularly at the following dosages.
|
Age Group |
Dosage Schedule |
|
> 9
years old |
0.50 mL x 1 dose |
|
3
to 8 years old |
0.50 mL, [1 or 2 doses]* |
|
6 to 35 months 0.25 mL, [1 or 2 doses]* |
0.25 mL, [1 or 2 doses]* |
* For children younger than 9 years who have received at least one dose of the influenza vaccine, a single dose is sufficient. For those < 9 yrs who are receiving the vaccine for the first time, two doses at least four weeks apart are recommended. Both doses are recommended for maximum protection.
The recommended site of vaccination is the
deltoid muscle for adults and older children. The anterolateral aspect of the
thigh is recommended for infants and small children. NEVER administer
the vaccine intravenously.
SIDE EFFECTS AND ADVERSE REACTIONS
Because influenza vaccine contains only
non-infectious viruses, it cannot cause influenza. The most frequent side effect is soreness around the injection
site. Any significant adverse reactions should be reported to the Drug
Information Center at ext 2328 and the appropriate VAERS (Vaccine Adverse Event
Reporting System) forms will be completed and forwarded to the CDC and
FDA. The following reactions have also
occurred:
1. Fever, malaise and myalgia
infrequently affect persons who have had no
exposure to the influenza virus
antigens. Symptoms usually occur six to
12
hours after the vaccination and can persist for one to two days.
2. Immediate, presumably allergic
reactions are extremely rare post influenza
vaccine administration. Persons who
have anaphylactic hypersensitivity
to
eggs should not be vaccinated. This includes people who develop hives,
swelling of the lips, or respiratory
distress after eating eggs.
KUMC AVAILABILITY AND CHARGING
The 2000-2001 trivalent influenza vaccine will soon be available to KUMC clinics by early November, 2000. Since supply is limited, initial stock will be determined by last years usage. Any of the 1999-2000 vaccine should be returned to the pharmacy. DO NOT use the 1999-2000 preparation. The charge to the clinic is $3.50 per dose. An individual prescription for each dose administered will be needed, and stock will be replaced accordingly.