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 influenza virus vaccine for the 1996-1997 season contains 15 micrograms each of HA (hemagglutinin antigens) of A/Texas/36/91-like (H1N1), HA of A/Nanchang/933/95 (H3N2) (A/Wuhan/359/95-like [H3N2]), and HA of B/Harbin/07/94 (B/Beijing/184/93-like) in each 0.5 mL dose.
The influenza vaccine is strongly recommended for:
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.
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.
The vaccine is considered safe for use during pregnancy. Pregnant women who have medical conditions that increase their risk of complications from influenza should be vaccinated. 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.
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 optimally undertaken in November.
In facilities such as nursing homes, it is important to avoid administering the vaccine too far in advance of the influenza season, because antibody levels start to decline in a few months. If regional influenza is expected to begin earlier than December, vaccinations may be given as soon as the vaccine is available.
Influenza vaccine should only be administered intramuscularly at the following dosages:
| Age Group | Dosage Schedule |
|---|---|
| > 8 years old | 0.5 mL x 1 dose |
| 3 to 8 years old | 0.5 mL, [1 or 2 doses]* |
| 6 to 35 months | 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.
In addition, the following types of reactions have occurred:
The 1996-1997 trivalent influenza vaccine will soon be available to KUMC clinics. The pharmacy will distribute an initial stock to each clinic by early October, 1996. Since supply is limited, initial stock will be determined by last years usage. Any of the 1995-1996 vaccine should be returned to the pharmacy. DO NOT use the 1995-1996 preparation. Only the split virus preparation will be stocked, as these agents are associated with fewer side effects in children.
The charge to the clinic is $3.65 per dose. An individual prescription for each dose administered will be needed, and stock will be replaced accordingly.
