Influenza Vaccination: A Summary for All

Influenza vaccination is the most
effective method for preventing influenza virus infection and its
potentially severe complications.

• There are two types of influenza vaccine:
  
  
  
  • Trivalent Inactivated Influenza Vaccine (TIV) [51KB, 2 pages]
    
  • Live, Intranasal Influenza Vaccine (LAIV) [48KB, 2 pages]
    
  
  </li>
  
• TIV is injected into the muscle of the upper arm or thigh. It can
  be used for people 6 months of age or older, including healthy people,
  those with chronic medical conditions, and pregnant women.
  
• LAIV is given as a nasal spray. It can be used for healthy* people 2-49 years of age who are not pregnant.
  
• Influenza vaccine reduces the likelihood of becoming ill with influenza or transmitting influenza to others.
  

When should vaccination occur?


2010-11 flu vaccine shipments have begun. Doctors and nurses are
encouraged to begin vaccinating their patients as soon as flu vaccine is
available in their area, even as early as August, and continue
vaccinating through the remainder of the flu season. While influenza
outbreaks can happen as early as October, most of the time influenza
activity peaks in January or later.

When should health care providers start and stop vaccination efforts?


Vaccine shipments have already begun, so vaccination should begin as
soon as flu vaccine is delivered to their location. Flu vaccines should
be offered to people when they are seen by health care providers for
routine care or as a result of hospitalization.

However, persons and institutions planning substantial organized
vaccination campaigns (e.g., health departments, occupational health
clinics, and community vaccinators) should consider scheduling these
events after at least mid-October, because the availability of vaccine
in any location cannot be ensured consistently in early fall. Scheduling
campaigns after mid-October will minimize the need for cancellations
because vaccine is unavailable. These vaccination clinics should be
scheduled through December, and later if feasible, with attention to
settings that serve children, pregnant women, other persons younger than
50 years of age at increased risk for influenza-related complications,
persons aged 50 years and older, health care personnel, and persons who
are household contacts of children aged younger than 60 months (5 years)
or other persons at high risk.

In addition, vaccination efforts should be structured to ensure the
vaccination of as many persons as possible over the course of several
months, with emphasis on vaccinating before influenza activity in the
community begins. Even if vaccine distribution begins before October,
distribution probably will not be completed until December or January.
Flu seasons vary in terms of length and severity. As a result, instead
of setting a firm date to stop vaccinating, CDC generally recommends
that vaccination efforts continue as long as influenza is circulating in
the community. Clinicians should be aware that more than one wave of
influenza can occur in communities, and that a decline in influenza
illnesses during the fall or winter might be followed by another
increase in illness caused by a different influenza virus strain.
Clinicians deciding whether to continue vaccination efforts into May
might consider accessing state and/or local influenza surveillance
information to determine if flu is still circulating in the community.

However, end-of-season vaccination (in April and May) may particularly benefit the following people:

• Persons likely to be traveling to the Southern Hemisphere, where
  influenza may be circulating before the 2010-11 vaccine is available,
  and
  
• Children younger than 9 years of age being vaccinated against
  influenza for the first time who still have not gotten their second
  recommended dose of vaccine.
  

Who Should Get Vaccinated?


On February 24, 2010 vaccine experts voted
that everyone 6 months and older should get a flu vaccine each year
starting with the 2010-2011 influenza season. While everyone should get
a flu vaccine each flu season, it’s especially important that certain
people get vaccinated either because they are at high risk of having
serious flu-related complications or because they live with or care for
people at high risk for developing flu-related complications.



Why did ACIP/CDC broaden the flu vaccination recommendations this season to include everyone aged 6 months and older?


CDC's Advisory Committee on Immunization Practices (ACIP) voted to
expand the influenza vaccination recommendations for the 2010-2011 flu
season to include all persons 6 months of age and older who do not have a
contraindication to the vaccine. The recommendations are intended to
remove barriers to flu immunization, such as the need to determine
whether each person has a specific indication for vaccination, and
protect as many people as possible against the dangers of flu.
The decision is supported by evidence that influenza vaccination is a
safe and effective preventive health measure with potential benefit
across all age groups. Even healthy adults with no previously identified
risk factors can develop influenza-related complications, including
adults ages 19-49 years old. They were not specifically recommended for
vaccination in previous influenza seasons, however they were unusually
affected by the 2009 H1N1 pandemic.
The updated ACIP recommendations identify new populations at high risk of serious flu-related complications,
including people who are morbidly obese (those with a body mass index
[BMI] of 40 or higher), Alaskan Natives and American Indians. Earlier
ACIP recommendations for seasonal flu vaccination – which focused on
vaccination of people at higher risk of flu-related complications,
including children 6 months through 18 years of age, and close contacts
of higher risk people – already applied to 85% of the U.S. population.



Vaccination for Children


Influenza vaccination is recommended for all children aged 6 months up to their 19th birthday.

All children 6 months through 8 years of age are recommended to receive 2 doses of 2010-11 flu vaccine 4 or more weeks apart unless they have received:

1. at least 1 dose of 2009 H1N1 vaccine last flu season, and
   
2. at least 1 dose of seasonal vaccine prior to the 2009-2010 flu season or 2 doses of 2009-10 seasonal flu vaccine
   
   If a child has fulfilled both requirements, they only need 1 2010-11 flu vaccine.
   

The first dose should be given as soon as vaccine becomes available,
and the second dose should be given 28 more days after the first dose.
The first dose "primes" the immune system; the second dose provides
immune protection. Children who only get one dose but need two doses can
have reduced or no protection from a single dose of flu vaccine. Two
doses are necessary to protect these children. If your child needs the
two doses, begin the process early, so that children are protected
before influenza starts circulating in your community. Be sure to follow
up to get your child a second dose if they need one. It usually takes
about two weeks after the second dose for protection to begin.

Children and adolescents at higher risk for influenza complications
should continue to be a focus of vaccination efforts as providers and
programs transition to routinely vaccinating all children and
adolescents. Children under 6 months old are the pediatric group at
highest risk of influenza complications, but they are too young to get
an influenza vaccine. The best way to protect young children is to make
sure members of their household and their caregivers are vaccinated.

Vaccination for Adults


Everyone 6 months of age and older are recommended to get the flu
vaccine, which includes even the healthiest adults. Vaccination is
especially important for people at higher risk of serious influenza
complications or people who live with or care for people at higher risk
for serious complications.

Persons working in health care settings also should be vaccinated
annually against influenza. Vaccination of health care professionals has
been associated with reduced work absenteeism and with fewer deaths
among nursing home patients.



People recommended for vaccination based on their risk of
complications from influenza or because they are in close contact with
someone at higher risk of influenza complications include:

• Children aged 6 months until their 5th birthday,
  
• Pregnant women,
  
• People 50 years of age and older,
  
• People of any age with certain chronic health conditions (such as asthma, diabetes, or heart disease),
  
• People who live in nursing homes and other long-term care facilities,
  
• Household contacts of person at high risk for complications from influenza,
  
• Household contacts and out of home caregivers of children less than 6 months of age, and
  
• Health care workers.
  

People who should NOT be vaccinated include:

• People who have a severe allergy to chicken eggs,
  
• People who have had a severe reaction to an influenza vaccination,
  
• People who have developed Guillian-Barré syndrome within 6 weeks of getting an influenza vaccine,
  
• Children less than 6 months of age (influenza vaccine is not approved for this age group), and
  
• People who have a moderate to severe illness with a fever (they should wait until they recover to get vaccinated).
  

Trivalent Inactivated Influenza Vaccine (TIV) Dosing and Side Effects

• TIV is recommended for use in people 6 months and older, including those with high-risk conditions.
  
• All children 6 months through 8 years of age are recommended to receive 2 doses of 2010-11 flu vaccine 4 or more weeks apart unless they have received:
  
  
  1. at least 1 dose of 2009 H1N1 vaccine last flu season, and
     
  2. at least 1 dose of seasonal vaccine prior to the 2009-2010 flu season or 2 doses of 2009-10 seasonal flu vaccine
     If a child has fulfilled both requirements, they only need 1 2010-11 flu vaccine.
     
  
  </li>
  
• The viruses in the injectable influenza vaccine are inactivated so they do not cause influenza.
  
• Minor side effects that can occur include soreness,
  redness or swelling at the injection site, fever (low grade), or aches.
  If these problems occur, they begin soon after vaccination and usually
  last 1 or 2 days.
  

Live, Attenuated Influenza Vaccine (LAIV) Dosing and Side Effects

• LAIV is recommended for use in healthy* people 2-49 years of age who are not pregnant.
  
• All children 2 years through 8 years of age are recommended to receive 2 doses of 2010-11 flu vaccine 4 or more weeks apart unless they have received:
  
  
  1. at least 1 dose of 2009 H1N1 vaccine last flu season, and
     
  2. at least 1 dose of seasonal vaccine prior to the 2009-2010 flu season
     or 2 doses of 2009-10 seasonal flu vaccine
     
     If a child has fulfilled both requirements, they only need 1 2010-11 flu vaccine.
     
  </li>
  
• LAIV is made from weakened viruses and does not cause influenza. The vaccine can cause mild illness in some people who get it.
  
• In children, minor side effects can include runny nose or mild
  temporary wheezing. Occasionally headache, vomiting, muscle aches, or
  fever have been reported.
  
• In adults, minor side effects can include runny nose, headache, sore throat, or cough.
  

* "Healthy" indicates persons who do not have an underlying medical condition that predisposes them to influenza complications.

Trivalent Inactivated Influenza Vaccine (TIV) [51KB, 2 pages]

see,,,,

INACTIVATED INFLUENZAVACCINE
W H A T Y O U N E E D T O K N O W 2010-11
Many Vaccine Information Statements are available in Spanish and other languages. See http://www.immunize.org/vis
Hojas de Informacián Sobre Vacunas están disponibles en Español y en muchos otros idiomas. Visite http://www.immunize.org/vis
Why get vaccinated?1
Infl uenza (“flu”) is a contagious disease.
It is caused by the influenza virus, which can be spread by coughing, sneezing, or nasal secretions.
Anyone can get influenza, but rates of infection are highest among children. For most people, symptoms last only a few days. They include:
• fever
• sore throat
• chills
• fatigue
• cough
• headache
• muscle aches
Other illnesses can have the same symptoms and are often mistaken for influenza.
Infants, the elderly, pregnant women, and people with certain health conditions – such as heart, lung or kidney disease or a weakened immune system – can get much sicker. Flu can cause high fever and pneumonia, and make existing medical conditions worse. It can cause diarrhea and seizures in children. Each year thousands of people die from seasonal influenza and even more require hospitalization.
By getting vaccinated you can protect yourself from influenza and may also avoid spreading influenza to others.
Inactivated infl uenza vaccine 2
There are two types of infl uenza vaccine:
1.
Inactivated (killed) vaccine, or the “flu shot” is given by injection into the muscle.
2.
Live, attenuated (weakened) influenza vaccine is sprayed into the nostrils. This vaccine is described in a separate Vaccine Information Statement.
A “high-dose” inactivated influenza vaccine is available for people 65 years of age and older. Ask your healthcare provider for more information.
Influenza viruses are always changing, so annual vaccination is recommended. Each year scientists try to match the viruses in the vaccine to those most likely to cause flu that year.
The 2010-2011 vaccine provides protection against A/H1N1 (pandemic) influenza and two other influenza viruses – influenza A/H3N2 and influenza B. It will not prevent illness caused by other viruses.
It takes up to 2 weeks for protection to develop after the shot. Protection lasts about a year.
Some inactivated influenza vaccine contains a preservative called thimerosal. Thimerosal-free influenza vaccine is available. Ask your healthcare provider for more information. Who should get inactivated
3 influenza vaccine and when?
WHO
All people 6 months of age and older should get flu vaccine. Vaccination is especially important for people at higher risk of severe infl uenza and their close contacts, including healthcare personnel and close contacts of children younger than 6 months. People who got the 2009 H1N1 (pandemic) influenza vaccine, or had pandemic fl u in 2009, should still get the 2010-2011 seasonal infl uenza vaccine.
WHEN
Getting the vaccine as soon as it is available will provide protection if the fl u season comes early. You can get the vaccine as long as illness is occurring in your community. Infl uenza can occur at any time, but most infl uenza occurs from November through May. In recent seasons, most infections have occurred in January and February. Getting vaccinated in December, or even later, will still be benefi cial in most years. Adults and older children need one dose of influenza vaccine each year. But some children younger than 9 years of age need two doses to be protected. Ask your healthcare provider. Infl uenza vaccine may be given at the same time as other vaccines, including pneumococcal vaccine.
Some people should not getinactivated influenza vaccine or should wait 4
• Tell your healthcare provider if you have any severe (life-threatening) allergies. Allergic reactions to influenza vaccine are rare.
5
-Influenza vaccine virus is grown in eggs. People with a severe egg allergy should not get infl uenza vaccine.
-A severe allergy to any vaccine component is also a
reason not to get the vaccine.
-If you ever had a severe reaction after a dose of
influenza vaccine, tell your healthcare provider.
•
Tell your healthcare provider if you ever had Guillain- Barré Syndrome (a severe paralytic illness, also called GBS). Your provider will help you decide whether the vaccine is recommended for you.
•
People who are moderately or severely ill should usually wait until they recover before getting flu vaccine. If you are ill, talk to your healthcare provider about whether to reschedule the vaccination. People with a mild illness can usually get the vaccine.
What are the risks from
inactivated infl uenza vaccine?
A vaccine, like any medicine, could possibly cause serious problems, such as severe allergic reactions. The risk of a vaccine causing serious harm, or death, is extremely small. Serious problems from inactivated infl uenza vaccine are very rare. The viruses in inactivated infl uenza vaccine have been killed, so you cannot get infl uenza from the vaccine. Mild problems: • soreness, redness, or swelling where the shot was given • hoarseness; sore, red or itchy eyes; cough
• fever
• aches
If these problems occur, they usually begin soon after the shot and last 1-2 days.
Severe problems:
•
Life-threatening allergic reactions from vaccines are very rare. If they do occur, it is usually within a few minutes to a few hours after the shot.
•
In 1976, a type of inactivated infl uenza (swine flu) vaccine was associated with Guillain-Barré Syndrome (GBS). Since then, flu vaccines have not been clearly linked to GBS. However, if there is a risk of GBS from current flu vaccines, it would be no more than 1 or 2 cases per million people vaccinated. This is much lower than the risk of severe influenza, which can be prevented by vaccination.
One brand of inactivated fl u vaccine, called Afluria, should not be given to children 8 years of age or younger, except in special circumstances. A related vaccine was associated with fevers and fever-related seizures in young children in Australia. Ask your healthcare provider for more information.
The safety of vaccines is always being monitored. For more information, visit:
http://www.cdc.gov/vaccinesafety/Vaccine_Monitoring/Index.html
and
http://www.cdc.gov/vaccinesafety/Activities/Activities_Index.html
6 What if there is a severereaction?
What should I look for? Any unusual condition, such as a high fever or behavior changes. Signs of a severe allergic reaction can include diffi culty breathing, hoarseness or wheezing, hives, paleness, weakness, a fast heart beat or dizziness. What should I do? • Call a doctor, or get the person to a doctor right away. • Tell the doctor what happened, the date and time it
happened, and when the vaccination was given.
• Ask your healthcare provider to report the reaction by fi ling a Vaccine Adverse Event Reporting System (VAERS) form. Or you can fi le this report through the VAERS website at http://www.vaers.hhs.gov, or by calling 1-800-822-7967. VAERS does not provide medical advice.
7 The National Vaccine Injury Compensation Program
The National Vaccine Injury Compensation Program (VICP) was created in 1986. People who believe they may have been injured by a vaccine can learn about the program and about fi ling a claim by calling 1-800-338-2382, or visiting the VICP website at http://www.hrsa.gov/vaccinecompensation.
8 How can I learn more?
•
Ask your healthcare provider. They can give you the vaccine package insert or suggest other sources of information.
•
Call your local or state health department.
•
Contact the Centers for Disease Control and Prevention (CDC):
-Call 1-800-232-4636 (1-800-CDC-INFO) or
-Visit CDC’s website at http://www.cdc.gov/flu
DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention
Vaccine Information Statement (Interim)
Inactivated Infl uenza Vaccine (8/10/10) 42 U.S.C. §300aa-26