Dosing & Uses
Dosage Forms & Strengths
intranasal suspension
- 0.2mL (prefilled single use sprayer)
Influenza Prophylaxis
Indicated for prevention of influenza A and B infection in individuals aged 2-49 years
2-49 years: 0.2 mL/dose (0.1 mL/nostril); 1 dose/season
Intranasal administration for age ≥50 years: Safety and efficacy not established
ALERT: ACIP states intranasal flu vaccine should NOT be used for 2016-2017 season
- June 22, 2016: CDC’s Advisory Committee on Immunization Practices (ACIP) voted that live attenuated influenza vaccine (LAIV), also known as the “nasal spray” flu vaccine, should not be used during the 2016-2017 flu season
- This ACIP vote is based on data showing poor or relatively lower effectiveness of LAIV from 2013 through 2016
- In late May 2016, preliminary data on the effectiveness of LAIV among children aged 2-17 yr during 2015-2016 season became available from the U.S. Influenza Vaccine Effectiveness Network
- That data showed the estimate for LAIV VE among study participants in that age group against any flu virus was 3% (with a 95% Confidence Interval (CI) of -49% to 37%); this 3% estimate means no protective benefit could be measured
- In comparison, IIV (flu shots) had a VE estimate of 63% (with a 95% CI of 52-72%) against any flu virus among children aged 2-17 yr
- http://www.cdc.gov/media/releases/2016/s0622-laiv-flu.html
Dosing Considerations
Contains the following 4 viral strains for 2016-2017 northern hemisphere season:
A/California/7/2009 (H1N1)-like (same strain as was used for 2009 H1N1 monovalent vaccines)
A/Hong Kong/4801/2014 (H3N2)-like virus (new for 2016-2017)
B/Phuket/3073/2013-like virus (B/Yamagata lineage)
B/Brisbane/60/2008-like (B/Victoria lineage vaccine virus)
Dosage Forms & Strengths
intranasal suspension
- 0.2mL (prefilled single use sprayer)
Influenza Prophylaxis
Indicated for prevention of influenza A and B infection individuals aged 2-49 years
<2 year: Safety and efficacy not established
2-8 years: 0.2 mL/dose (0.1 mL in each nostril) x1-2 doses/season (see Administration)
≥9 years: As in adults; 0.2 mL/dose (0.1 mL/nostril); 1 dose/season
ALERT: ACIP states intranasal flu vaccine should NOT be used for 2016-2017 season
- June 22, 2016: CDC’s Advisory Committee on Immunization Practices (ACIP) voted that live attenuated influenza vaccine (LAIV), also known as the “nasal spray” flu vaccine, should not be used during the 2016-2017 flu season
- This ACIP vote is based on data showing poor or relatively lower effectiveness of LAIV from 2013 through 2016
- In late May 2016, preliminary data on the effectiveness of LAIV among children aged 2-17 yr during 2015-2016 season became available from the U.S. Influenza Vaccine Effectiveness Network
- That data showed the estimate for LAIV VE among study participants in that age group against any flu virus was 3% (with a 95% Confidence Interval (CI) of -49% to 37%); this 3% estimate means no protective benefit could be measured
- In comparison, IIV (flu shots) had a VE estimate of 63% (with a 95% CI of 52-72%) against any flu virus among children aged 2-17 yr
- http://www.cdc.gov/media/releases/2016/s0622-laiv-flu.html
Dosing Considerations
Contains the following 4 viral strains for 2016-2017 northern hemisphere season:
A/California/7/2009 (H1N1)-like (same strain as was used for 2009 H1N1 monovalent vaccines)
A/Hong Kong/4801/2014 (H3N2)-like virus (new for 2016-2017)
B/Phuket/3073/2013-like virus (B/Yamagata lineage)
B/Brisbane/60/2008-like (B/Victoria lineage vaccine virus)
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Adverse Effects
>10%
Adults
- Runny nose (41-45%)
- Headache (41-45%)
- Sore throat (26-30%)
- Weakness (26-30%)
- Myalgia (16-20%)
- Cough (11-15%)
Children
- Runny nose/nasal congestion (46-50%)
- Cough (36-40%)
- Irritability (16-20%)
- Headache (16-20%)
1-10%
Adults
- Chills (6-10%)
- Nasal congestion (6-10%)
- Sinusitis (2-5%)
Warnings
Suspected adverse events after administration of any vaccine may be reported to Vaccine Adverse Events Reporting System (VAERS), 1-800-822-7967
Contraindications
Hypersensitivity to eggs, sulfites
IV/IM administration
Children/adolescents receiving aspirin
Asthma, reactive airway disease
Diabetes, renal dysfunction
Hemoglobinopathies
Immunodeficiency diseases
Patients on immunosuppressants
Any chronic pulmonary/cardivascular disorder
Cautions
Do not administer within 2 wk of inactivated vaccine or 4 week of live virus vaccine
Treatment for anaphylactoid and/or hypersensitivity reactions must be present during vaccine use
Use caution in patients with history of Guillain-Barre
Nasal congestion may impair delivery of vaccine (avoid use)
Not recommended in patients with neurologic or neuromuscular disorders
Avoid use in children aged 2 through 4 years who had wheezing in the past 12 months, or those who have any other underlying medical conditions that predispose them to influenza complications
Pregnancy & Lactation
Pregnancy Category: C
Live virus vaccine; indicated for nonpregnant adolescents and adults
Lactation: unknown; avoid intranasal live vaccine while breastfeeding newborn
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.
Pharmacology
Mechanism of Action
Vaccine; vaccines convey active immunity via stimulation of production of endogenously produced antibodies
Pharmacokinetics
Onset: Three weeks after vaccination
Duration: 6 months or more
Distribution: Nasal cavity, stomach, brain, and lungs
Administration
Instructions
Administer at beginning of influenza season
Dosing algorithm for children aged 2 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 and if no or don’t know, give 2 doses
- From ACIP recommendations: MMWR 2014 Aug 15 / 63(32);691-697
Images
Patient Handout
Formulary
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To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
