FAQ's Flu & Pneumonia   |   Post Your Clinic

Flu & Pneumonia

o         Children aged 6–59 months,

o         Pregnant women,

o         People 50 years of age and older, and

o         People of any age with certain chronic medical conditions;

o         People who live in nursing homes and other long term care facilities.

2.       People who live with or care for those at high risk for complications from flu, including:

o         Household contacts of persons at high risk for complications from the flu (see above)

o         Household contacts and out of home caregivers of children less than 6 months of age (these children are too young to be vaccinated)

o         Healthcare workers.

Use of the Nasal Spray Flu Vaccine
It should be noted that vaccination with the nasal-spray flu vaccine is always an option for healthy persons aged 5-49 years who are not pregnant.

What is the make up of the influenza vaccine for the 2006-07 influenza season?

FDA's Vaccines and Related Biological Products Advisory Committee (VRBPAC) met in Bethesda, Maryland, on February 17, 2006, to select the influenza virus strains for the composition of the influenza vaccine for use in the 2006–07 U.S. influenza season. During this meeting, the advisory panel reviewed and evaluated the surveillance data related to epidemiology and antigenic characteristics, serological responses to 2005/2006 vaccines, and the availability of candidate strains and reagents.

The panel recommended that vaccines to be used in the 2006-07 season in the U.S. contain the following:

·          an A/New Caledonia/20/99 (H1N1)-like virus;

·          an A/Wisconsin/67/2005 (H3N2)-like virus (A/Wisconsin/67/2005 and A/Hiroshima/52/2005 strains);

·          a B/Malaysia/2506/2004-like virus (B/Malaysia/2506/2004 and B/Ohio/1/2005 strains)

The influenza vaccine composition to be used in the 2006-07 season in the U.S. is identical to that recommended by the World Health Organization on February 15, 2006.

The following is the recommended dosing schedule of the ACIP.  You can download a copy of the dosing schedule at http://www.cdc.gov/flu/professionals/dosagechart.htm

Who should receive the pneumococcal polysaccharide vaccine?

The pneumococcal polysaccharide vaccine is recommended for:

• All adults ≥65 years of age;
• Anyone over 2 years of age who has a long-term health problem such as; heart disease, sickle cell disease, alcoholism, lung disease, diabetes, cirrhosis, leaks of cerebrospinal fluid;
• Anyone over 2 years of age who has a disease or condition that lowers the body’s resistance to infection such as: Hodgkin’s disease, kidney failure, lymphoma, leukemia, multiple myeloma, nephritic syndrome, HIV infection or AIDS, damaged spleen or no spleen,  or organ transplant;
• Anyone over 2 years of age who is taking any drug or treatment that lowers the body’s resistance to infection such as; long-term steroids, certain cancer drugs, radiation therapy.

Where can I get more information about influenza and pneumonia?

The Centers for Disease Control and Prevention have great resources for patients and providers at their website, www.cdc.gov/flu.

How much influenza vaccine is projected to be available for the 2006-07 influenza season?

At the current time, influenza vaccine manufacturers are projecting that approximately 100 million doses of influenza vaccine will be available in the U.S. for use during the 2006-07 influenza season. This amount represents approximately 16% more doses than were available for the 2005-06 season. An additional 15 million to 20 million doses may be available if a new vaccine is licensed in 2006.

At the current time, sanofi pasteur is projecting that 8 million to 9 million doses of thimerosal-free vaccine in pre-filled syringes or vials will be produced for the 2006-07 influenza season. The majority of this vaccine will be in 0.25 mL syringes (indicated for ages 6-35 months) with the remainder in 0.5 mL vials or syringes (indicated for ages 36 months and older). In addition, GSK’s influenza vaccine for adults 18 years of age and older is preservative-free vaccine and Novartis (formerly Chiron) has a preservative-free preparation for persons 4 years of age and older.  The nasal influenza vaccine, FluMist, also is thimerosal-free.

For the 2006-07 season, CDC projects that thimerosal-free vaccine supplies will be adequate for children ages 6-23 months. There is also likely to be sufficient preservative-free influenza vaccine for four year olds.  Thimerosal-free vaccine doses licensed for three year olds, however, are limited in supply and CDC anticipates that there will be insufficient vaccine for this age group.  Thimerosal-containing vaccine can also be used to vaccinate children if the product’s age indication is appropriate.

Can I still buy influenza vaccine for the 2006-07 season?

Much of the influenza vaccine was pre-booked early this year.  Providers should contact distributors and local vendors about remaining supply.  Additional doses may be available if a new vaccine is licensed in 2006.

Are any shortages or delays in influenza vaccine supply expected?

CDC anticipates that many providers will be unable to obtain sufficient vaccine to vaccinate all children who are 3 years of age.  Because sanofi pasteur is the only supplier of vaccine that can be administered to 3-year-old children and all of sanofi pasteur’s vaccine for use in ages 3 years and above was pre-booked in January 2006 (prior to the ACIP recommendation to expand annual vaccination to children 24 to 59 months of age), providers are unable to make additional purchases of this vaccine.  Vaccines for children less than 3 years of age and for those 4 years of age and older are still available for purchase; children younger than 3 years of age can be vaccinated with the 0.25 ml preparation from sanofi pasteur and children 4 years of age and older can be vaccinated with Novartis vaccine.  In addition, another vaccine that can be used in healthy children 5 years of age and older is the intranasal vaccine produced by MedImmune.
  
In general, the annual supply of influenza vaccine and the timing of its distribution cannot be guaranteed in any year.  At the current time, we have no information to suggest that production problems will result in a delay of vaccine that has been ordered.  CDC anticipates adequate supplies of vaccines for older children and adults.  However, influenza vaccine distribution delays or vaccine shortages remain possible in part because of the inherent critical time constraints in manufacturing the vaccine given the annual updating of the influenza vaccine strains.

What should I do if I don’t have enough influenza vaccine to support the new recommendation to routinely vaccinate all children 6-59 months of age?

In February 2006, the Advisory Committee on Immunization Practices (ACIP) voted to extend routine vaccination recommendations to include all healthy children aged 6-59 months. During this transition year, all providers may not have sufficient vaccine supply in the preparations indicated for this age group.  If a provider has insufficient vaccine for this age group, CDC recommends that healthy children aged 6-23 months should be prioritized for receiving vaccine because they are at increased risk for hospitalization compared with children over 24 months of age.

Are all influenza vaccines the same?

Different influenza vaccine preparations have different indications as licensed by the FDA.  See the table below for an overview of these indications.

Last revised: September 6, 2006