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influenza virus vaccine trivalent (Rx)Brand and Other Names:Afluria, Fluzone, more...Agriflu, Flucelvax, Fluvirin, Fluzone High-Dose, Fluzone Intradermal

 
 
 

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

IM injection, regular strength

  • 22.5mcg/0.25mL
  • 45mcg/0.5mL
  • Flucelvax: New brand using mammalian culture instead of chicken embyros

IM injection, high-dose

  • 180mcg/0.5mL

ID injection

  • 27mcg/0.1mL
more...

Influenza Prophylaxis

CDC's ACIP recommends that everyone 6 months of age and older receive an annual influenza vaccination

For more vaccine information see http://www.cdc.gov/vaccines/schedules/hcp/index.html

IM regular strength

  • 0.5 mL IM x1 dose

Intradermal

  • Fluzone Intradermal (18-64 yr): 0.1 mL ID x1 dose

IM high-dose

  • Fluzone high dose (≥65 yr): 0.5 mL IM x1 dose

Dosing Considerations

Contains the following 3 viral strains for 2016-2017 northern hemisphere season:

A/California/7/2009 (H1N1)pdm09-like (same strain as was used for 2009 H1N1 monovalent vaccines)

A/Hong Kong/4801/2014 (H3N2)-like virus (new for 2016-2017)

B/Brisbane/60/2008-like virus (B/Victoria lineage vaccine virus) (new for the trivalent vaccine for 2016-2017)

Other Information

Up-to-date vaccination schedules available at http://www.cdc.gov/vaccines/schedules/hcp/index.html

Dosage Forms & Strengths

injection, regular strength

  • 22.5mcg/0.25mL
  • 45mcg/0.5mL
more...

Influenza Prophylaxis

CDC's ACIP recommends that everyone 6 months of age and older receive an annual influenza vaccination

See Administration section for information regarding if 1or 2 doses are required for the 2013/2014 vaccine in children aged 6 months through 8 years

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
  • 3-8 years: 0.5 mL IM (deltoid) x1-2 doses/season
  • 9 years or older: As in adults

Fluvirin

  • <4 years: Not approved
  • 4-8 years: 0.5 mL IM (deltoid) x1-2 doses/season
  • 9 years or older: As in adults

Fluarix

  • Fluarix available only as quadrivalent vaccine for 2015/2016 flu season
  • <3 years: Not approved
  • 3-8 years: 0.5 mL IM (deltoid) x1-2 doses/season
  • 9 years or older: As in adults

Afluria

  • <5 years: Not approved
  • 5-8 years: 0.5 mL IM (deltoid) x1-2 doses/season
  • 9 years or older: As in adults

Flucelvax

  • <18 years: Safety and efficacy not established

Dosing Considerations

Contains the following 3 viral strains for 2016-2017 northern hemisphere season:

A/California/7/2009 (H1N1)pdm09-like (same strain as was used for 2009 H1N1 monovalent vaccines)

A/Hong Kong/4801/2014 (H3N2)-like virus (new for 2016-2017)

B/Brisbane/60/2008-like virus (B/Victoria lineage vaccine virus) (new for the trivalent vaccine for 2016-2017)

Fluzone High-Dose: 0.5 mL IM x1 dose for adults 65 yr or older

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Interactions

Interaction Checker

influenza virus vaccine trivalent and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            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

            Presyncope

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            Warnings

            Contraindications

            Hypersensitivity to eggs, sulfites (persons with hives-only allergy to eggs, can receive the inactivated influenza vaccine)

            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

            Syncope (fainting) can occur in association with administration of injectable vaccines; can be accompanied by transient neurological signs such as visual disturbance, paresthesia, and tonic-clonic limb movements; procedures should be in place to avoid falling injury and to restore cerebral perfusion following syncope by maintaining a supine or Trendelenburg position

            Vaccination may not protect all vaccine recipients against influenza disease

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            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

            Pregnancy Categories

            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.

            more...
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            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%

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            Administration

            Instructions

            Administer at beginning of influenza season

            Should not be mixed with any other vaccine in the same syringe or vial

            Shake well before administration

            Adults and children >8 years

            • IM: Administer IM in deltoid muscle of upper arm
            • ID (18-64 yr): Administer ID in deltoid region of upper arm
            • Afluria
              • For IM injection only, by either needle and syringe (age ≥5 years) or by the PharmaJet Stratis Needle-Free Injection System (aged 18 through 64 years)
              • PharmaJet Stratis is a needleless injection device that delivers an IM injection

            Children aged 6 months through 8 years

            • IM (aged 6-35 months): Administer IM in anterolateral thigh; do not inject in the gluteal area or areas where there may be a major nerve trunk
            • IM (aged 3-8 years): Administer IM in deltoid muscle of upper arm
            • If child requires 2 doses, administer at least 4 weeks apart (see dosing algorithm)
            • Dosing algorithm for children aged 6 months through 8 years
              • Did the child receive at least 1 dose of the previous year’s seasonal influenza vaccine?
              • If yes, give 1 dose
              • If no or don’t know, did the child receive a total of at least 2 doses of seasonal influenza vaccine since July 1, 2010?
              • If yes, give 1 dose or if no or don’t know, give 2 doses
              • From ACIP recommendations: MMWR 2014 Aug 15 / 63(32);691-697
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            Images

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            Formulary

            FormularyPatient Discounts

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            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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