influenza virus vaccine (Rx) - Fluzone, Afluria, more..Fluarix, FluLaval, Fluvirin, Fluzone High-Dose, Fluzone Intradermal
- Class: Vaccines, Inactivated, Viral
Adult Dosing & Uses
Dosing Forms & Strengths
IM injection, regular strength
- 22.5mcg/0.25mL
- 45mcg/0.5mL
IM injection, high-dose
- 180mcg/0.5mL
ID injection
- 27mcg/0.1mL
Contains the following 3 influenza strains for 2011/2012 season
- A/California/7/2009 (H1N1)-like (same strain as was used for 2009 H1N1 monovalent vaccines)
- A/Perth/16/2009 (H3N2)-like
- B/Brisbane/60/2008-like
Influenza Prophylaxis
CDC's ACIP recommends that everyone 6 months of age and older receive an annual influenza vaccination
IM regular strength
- 0.5 mL IM x1 dose
Fluzone Intradermal
- 18-64 years: 0.1 mL ID x1 dose
Geriatrics
Fluzone High-Dose: 0.5 mL IM x1 dose for adults 65 yr or older
Administration
Administer at beginning of influenza season
Other Information
Healthcare workers are large reservoir for influenza, estimated only 60% currently immunized
Healthy children age 6-23 months are most likely to be hospitalized from influenza
Immunization of household contacts of young children prevent spreading influenza to infants/toddlers
Pregnant and breastfeeding women: Risk of serious cardiorespiratory complications of influenza include increased heart rate, stroke volume, and O2 consumption, and decreased lung capacity; vaccine safe in all 3 trimesters
Patients aged 49-64 years often have increased prevalence of high-risk conditions
65 years or older, or residents of nursing homes should be vaccinated and are at higher risk for mortality from influenza
Up-to-date vaccination schedules available at www.cdc.gov/nip/publications
Other Indications & Uses
For children and teens age 6 months through 18 years, as well as all household contacts of infants and children through age 59 months (ie, 4 years 11 months)
Patients >19 yo with risk factor (eg, pregnancy, heart or lung disease, renal, hepatic, hematologic, or metabolic disorder [including diabetes], immunosuppression, or have a condition that compromises respiratory function or the handling of respiratory secretions or that can increase the risk of aspiration) or live in a chronic-care facility;
Persons who live or work with at-risk people as listed above
Persons who want to reduce the likelihood of becoming ill with influenza or of spreading it to others
Pediatric Dosing & Uses
Dosing Forms & Strengths
injection, regular strength
- 22.5mcg/0.25mL
- 45mcg/0.5mL
Contains the following 3 influenza strains for 2011/2012 season
- A/California/7/2009 (H1N1)-like (same strain as was used for 2009 H1N1 monovalent vaccines)
- A/Perth/16/2009 (H3N2)-like
- B/Brisbane/60/2008-like
Influenza Prophylaxis
CDC's ACIP recommends that everyone 6 months of age and older receive an annual influenza vaccination
Fluzone
- Approved for children >6 months
- 6-18 months: 0.25 mL IM (anterolateral thigh) x1-2 doses/season
- 18-35 months: 0.25 mL IM (deltoid) x1-2 doses/season
- 3-9 years old: 0.5 mL IM (deltoid) x1-2 doses/season
- >9 years old: As in adults
- Children up to age 9 years old: If receiving influenza vaccine for first time, or vaccinated for the first time last year but only received 1 dose, give 2 doses at least 4 weeks apart
- Children previously vaccinated with 2 doses should receive only 1 dose
Fluvirin (Inactivated vaccine)
- <4 years old: Not approved
- 4-9 years old: 0.5 mL IM (deltoid) x1-2 doses/season
- >9 years old: As in adults
- Children up to age 9 years old: If receiving influenza vaccine for first time, or vaccinated for the first time last year but only received 1 dose, give 2 doses at least 4 weeks apart
- Children previously vaccinated with 2 doses should receive only 1 dose
Fluarix
- <3 years old: Not approved
- 3-9 years old: 0.5 mL IM (deltoid) x1-2 doses/season
- >9 years old: As in adults
- Children up to age 9 years old: If receiving influenza vaccine for first time, or vaccinated for the first time last year but only received 1 dose, give 2 doses at least 4 weeks apart
- Children previously vaccinated with 2 doses should receive only 1 dose
Afluria
- <5 years: Not approved
- 5-8 years: 0.5 mL IM (deltoid) x1-2 doses/season
- 9 years or older: As in adults
- Children up to age 9 years old: If receiving influenza vaccine for first time, or vaccinated for the first time last year but only received 1 dose, give 2 doses at least 4 weeks apart
- Children previously vaccinated with 2 doses should receive only 1 dose
Administration
Administer at beginning of influenza season
Drug Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Adverse Effects
Suspected adverse events after administration of any vaccine may be reported to Vaccine Adverse Events Reporting System (VAERS), 1-800-822-7967
>10%
Soreness at injection site (10-70%)
Frequency Not Defined
Fever
Malaise
Myalgia
Headache
Allergic reactions
Contraindications & Cautions
Contraindications
Hypersensitivity to eggs, sulfites
Cautions
Use split or purified surface antigen in children
Defer vaccine with febrile illnesses until illness is resolved; may administer vaccine with minor illnesses without fever (eg, URIs)
Expected immune response may not be obtained in immunocompromised individuals, including those receiving immunosuppressive therapy
Pregnancy & Lactation
Pregnancy Category: B/C (manufacturer specific)
CDC recommends Influenza vaccine be administered during pregnancy (all trimesters); vaccination during pregnancy shown to decrease risk of illness in the mother, as well as the risk of influenza and influenza hospitalization in their infants during the first 6 months of life (MMWR August 26, 2011;60[33]:1128-32)
Lactation: excretion in milk unknown; use with caution
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Pharmacology
Mechanism of Action
Inactivated influenza virus types A & B subunits
Convey active immunity via stimulation of production of endogenously produced antibodies
Pharmacokinetics
Onset: days
Duration: few months
Effectiveness: 70-90%
