Working With The H1N1 Influenza Vaccine The single most effective way to prevent influenza disease is with influenza vaccine! Carolee’s Corner November 2009 MPCA [email_address]
• This power point is very limited in space - It covers only a small portion of the information available - Please check these websites frequently for updated information www.cdc.gov/flu www.michigan.gov/flu
Don’t let yourself become confused: Similarities between H1N1 Influenza Vaccine and Seasonal Flu vaccine Administration of both vaccines - if 6-35 mos old -- give 0.25mL per dose - if 3 yrs and older --give 0.5mL per dose Dosage Both vaccines packaged by manufacturer as - Pre-filled 0.25mL syringes - Pre-filled 0.5mL syringes - Multi-dose vials Presentations TIV of both vaccines given IM LAIV of both vaccines given intranasally Route of administration All influenza vaccine is to be stored in frig at 35 ° -46 ° F (2°-8°C) Label ALL flu vaccine very carefully in frig Storage Both vaccines come as - TIV (inactivated) - LAIV (live, attenuated) Types
Don’t let yourself become confused: (cont) Similarities between H1N1 Influenza Vaccine and Seasonal Flu vaccine YOU need to get both influenza vaccines to protect - Yourself - Your patients - Your family and friends Need for Health Care Personnel to give vaccinated Some are licensed for - only 6-35 mos old children - only 6 mos and older - only 2-49 years old - only 3 yrs and older - only 4 yrs and older - only 18 years and older Check very carefully that the person to whom you are giving a vaccine fits into the licensed age group for that vaccine! Influenza vaccines from all manufacturers are licensed only for specific age groups !!
Don’t let yourself become confused: (cont) Differences between H1N1 Influenza Vaccine and Seasonal Flu vaccine - All H1N1 vaccine is public vaccine. You do not need to assess for VFC qualifications - Seasonal Flu is available on VFC for children who qualify Vaccines for Children ( VFC ) vaccine - H1N1 vaccine : Unless contraindicated, ALL children 6 mos through 9 years of age automatically need two doses - Seasonal Flu vaccine : All children 6 mos through 8 years need to be evaluated for two doses Who gets two doses There are differences. See next slide for priority groups for H1N1 vaccine Groups of people who initially need vaccine
H1N1 vaccine ONLY protects against disease caused by H1N1 virus
Seasonal flu vaccine ONLY protects against Seasonal flu viruses
Priority Target Groups for H1N1 vaccine when vaccine is in limited supply • Remember: - Priority groups may change - As vaccine supply increases or decreases Yes, if 2 yrs of age and older, healthy, not preg. Yes Health care and emergency medical services personnel No Yes Persons 25 thru 64 yrs old with medical condition that puts them at high risk Yes, if 2 -49 yrs of age, healthy, not preg. Yes Persons living with or caring for infants less than 6 mos old Yes, if 2 yrs of age and older, healthy, not preg. Yes Persons 6 mos thru 24 yrs old No Yes Pregnant women Give LAIV? Give TIV? Priority Group
Which Seasonal Vaccines & H1N1 Vaccines can you give to a patient during the same visit? When giving Seasonal TIV and H1N1 TIV flu vaccines at the same time, administer vaccines in different sites Yes One inactivated and one live, attenuated vaccine: H1N1 TIV and Seasonal LAIV? No Two LAIV vaccines: Seasonal LAIV and H1N1 LAIV? Remember the Live-Live rule: If two live vaccines are not given at the same time, they must be separated by 28 days Yes One inactivated and one live, attenuated vaccine: Seasonal TIV and H1N1 LAIV? Yes Two inactivated vaccines: Seasonal TIV & H1N1 TIV ? Can these vaccines be given at the same time?
Many of your patients will be wondering: How safe is H1N1Influenza Vaccine?
Reassure your patients that
This vaccine is made just like Seasonal Flu Vaccine
With use of different influenza virus
By a method that has been used for many years
H1N1 vaccine will be watched very closely for problems
Vaccine Adverse Event Reporting System (VAERS) will be used
We are encouraged to report any clinically significant adverse event after H1N1 vaccine to VAERS
OK to submit a report even if the reporter is not certain that the vaccine caused the event
Reports may be completed on line, faxed or mailed
For more information: www.vaers.hhs.gov
Do influenza vaccines contain Thimerosal?
Thimerosal is a preservative in some vaccines
Used in multi-dose flu vials to prevent growth of bacteria
TIV single-dose vials and syringes are either
Thimerosal free (Preservative Free – PF)
Contain only a trace amount of thimerosal
LAIV (nasal sprayers) do not contain thimerosal
Studies have NOT shown that thimerosal-containing flu vaccine has evidence of harm to anyone, including pregnant women and children
Benefits of flu vaccine outweigh any hypothetical risks posed by thimerosal
Influenza Vaccine and Antiviral Medications
Some of your patients may be taking antiviral meds
If a patient has had influenza antiviral medication, wait 48 hours to give H1N1 LAIV (live, attenuated vaccine)
If patient has had H1N1 LAIV (live, attenuated vaccine) wait 2 weeks to give influenza antiviral medication
Patient Education about H1N1 Vaccine
• There are FOUR Vaccine Information Statements (VIS)
Make certain you print the Michigan-specific VIS
These contain the paragraph about MCIR
This is how patients are informed that their vaccines are entered into MCIR
Give correct VIS to each patient
Differentiate between H1N1 and Seasonal Influenza VIS
Publication Date of H1N1 Flu Vaccine VIS
10-2-09 for both TIV and LAIV
Do not confuse with Seasonal Flu Vaccine VIS
Publication date 8-11-09 for both TIV and LAIV
Differentiate between TIV and LAIV Influenza VIS
TIV – identified as inactivated influenza vaccine
LAIV – identified as live (attenuated, nasal ) influenza vaccine
Documentation of Influenza Vaccine
Very carefully document the specifics about which vaccine you gave
Make certain you are very clear
Did you give H1N1 influenza vaccine?
OR was it Seasonal influenza vaccine?
Was it TIV vaccine?
OR was it LAIV vaccine?
Document in three places
1) In your medical charts/EMR
Follow all the routine documentation requirements
2) In MCIR
ALL doses of H1N1 vaccine MUST go into MCIR
AND for adults!!
Documentation in MCIR for VFC vaccine is never optional