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New Flu Vaccination Recommendations

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The CDC has published new guidelines regarding this years flu vaccination.  They recommend everyone over 6 months get vaccinated with the vaccine – obviously this is not something new.  What is new, however, is they recommend that children aged 2-8 receive the intransal vaccine as apposed to the injection.  The nasal spray will be a quadrivalent vaccine.

The qaudravalent vaccine will protect against two influenza A (H1N1 and H3N2) and two influenza B strains. The trivalent only offers protection against one influenza B strain.

Per the CDC, they feel that the nasal spray works better in children aged 2-8.  There are contraindications to its use:

1. Asthma
2. Wheezing in the last 12 months
3. Immunosuppression
4. Egg allergy
5. Receiving aspirin therapy
6. Children who have taken antiviral medication in the last 48 hours

These children should be offered the injection.  It is also important to realize that if the nasal spray is not available, then the child should still receive the injection.

Don’t forget, if this is the first time the child will be vaccinated, they will require two doses separated by 4 weeks.  This recommendation is for children <8 years of age and only if it is their first year being vaccinated.

Fluzone is recommended (not by the CDC) for patients aged >65.  This vaccine contains four times the amount of antigen when compared to the regular vaccine.  Fluzone is a trivalent vaccine.

Most patients with egg allergy can safely receive the flu vaccine.  It is recommended that those with allergies receive RIV (recombinant influenza vaccine – egg free), but if unavailable, they may be given the IIV (inactivated influenza vaccine).  Those with severe egg allergy should be closely monitored by someone experienced in recognizing anaphylaxis.

Vaccination should start now (october).  It takes about two weeks for antibodies to develop, so starting the process before peak months is ideal.  In case you wondering, peak months start in january.

Andrew