MAGIC OF VACCINATIONS With the exception of clean drinking water, vaccines are the most effective intervention in reducing and preventing infectious diseases World Health Organisation (WHO),

1. SNAPSHOT ON INFLUENZA VACCINE
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Dr. Sharda Jain
Dr. Jyoti Agarwal
Dr. Jyoti Bhasker

2. MAGIC OF VACCINATIONS
With the exception of clean drinking water, vaccines are
the most effective intervention in reducing and
preventing infectious diseases
– World Health Organisation (WHO),
Clean Drinking Water Vaccination

3. IMPACT OF
VACCINES IN
THE US
Out of these small pox
has been eradicated
globally .
Polio is on the verge of
eradication .
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4. How did INFLUENZA got its NAME?
“It is the bad Influence of the
stars “is the old Italian belief which gives the
disease its name.
A disease which goes by the name of
INFLUENZA
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7. B

9. Pandemics of influenza
H7
H5
H9*
1980
1997
Recorded new avian influenzas
1996 2002
1999
2003
1955 1965 1975 1985 1995 2005
H1N1
H2N2
1889
Russian
influenza
H2N2
H2N2
1957
Asian
influenza
H2N2
H3N2
1968
Hong Kong
influenza
H3N2
H3N8
1900
Old Hong Kong
influenza
H3N8
1918
Spanish
influenza
H1N1
1915 1925 1955 1965 1975 1985 1995 20051895 1905 2010 2015
2009
Pandemic
influenza
H1N1
Reproduced and adapted (2009) with permission of Dr Masato Tashiro,
Director, Center for Influenza Virus Research,
National Institute of Infectious Diseases (NIID), Japan.
H1N1
Pandemic
H1N1
India’s
Scare

10. EVERY ONE AT RISK
≈100 million people infected every year in
northern hemisphere*
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11. FLU – DISEASE BURDEN
5–15 % of the population are affected with
influenza
Influenza leads to 3 to 5 million cases of
severe illness
Influenza leads to 250,000 to 500,000
deaths
Source: http://www.who.int/mediacentre/factsheets/fs211/en/index.html
As per WHO, every year in the world;

12. INFLUENZA IS A VIRUS
• Three types
– Type A- antigenic shifts as well as drifts
Type B- antigenic drifts
– Type C is a stable virus
• Only types A and B cause significant illness and epidemics
• Type A mutates easily ( commonly seen in India)
– 16 HA subtypes and 9 NA subtypes are known to exist
– The strain is named as per which subtype of HA and which subtype of NA
is present .
– HA ( Hemaglutinnin ) and NA ( Neuraminidase ) are surface proteins on
the Virus

13. • Most contagious first 3 - 4d
• Respiratory droplets
– Coughing
– Sneezing
– Touching respiratory droplets on persons or an object, then touching mucus
membranes (e.g., mouth, nose, eyes) without washing hands
SPREAD
High risk of spread
!!!
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14. FLU SYMPTOMS ARE DISRUPTIVE: IT IS NOT A
COMMON COLD !!
1-Center for disease control and Prevention. Key Facts About Seasonal Influenza (Flu), 2008.
Flu can induce symptoms that will stick your patients in bed1
fever (usually high)
• Fever can continue up to 5 days
• High fever that can go above 40°C
headache
severe cough
extreme tiredness
muscle aches and pain
runny or stuffy nose …..Caring hearts, healing hands

15. How can flu affect your pregnancy?

16. 1. Take time to get the flu vaccine
2. Take everyday preventive action to
stop the spread of germ
3. Take flu antiviral drugs if you
Doctor prescribes them
4. Don’t ignore flu in pregnancy
as it has very high mortality / morbidity
CDC ‘Take time to get the flu.

17. TREATMENT
1. You are already suffering from the disease which lasts for at least
4-5 days followed by a weakness lasting 10 days.
2. Even before you are having symptoms of Influenza , there is an
incubation period of 1-3 days . During this period you could pass on
the infection to family , friends , colleagues and others without
knowing it !!
3. If you or your contacts have other chronic conditions like diabetes ,
the recovery is slower and complications are higher .
Natural immunity is not provided since the virus
continuously changes every year .
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18. Influenza Vaccine
• Vaccine given at onset of winter season every year
• Licenced for > injection, high of deltoid muscle
• Antibodies take 10-14 days to develop suitable for most people
CONTRAINDICATED
• Anaphylaxis to previous dose or it constituents (other that
ovalbumin)
PRECAUTIONS
Acute severe febrile illness – defer vaccination
Egg allergy – if confirmed egg anaphylaxis or egg allergy can be given
influenza vaccine with ovelbumin content <0.1 micrograms per dose.
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19. WHO RECOMMENDATIONS FOR
INFLUENZA VACCINES
Recommended composition of influenza virus vaccines for
use for NH 2015 is:
• an A/California/7/2009 (H1N1)-like virus,
• an (H3N2) virus antigenically like the cell-propagated prototype
virus A/Switzerland/9715293/2013
• a B/Phuket/3-73/2013
Every year WHO recommends the strains to vaccine manufacturers:
1. NH strains in February
2. SH strains in September
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20. NASAL VS INTRAMUSCULAR VACCINE - SAFETY
COMPARISONS – CDC WEBSITE , US
Vaccine Contraindications Precautions
Influenza, live attenuated
(LAIV) – Nasal
• Severe allergic reaction (e.g., anaphylaxis) to any
component of the vaccine, or to a previous dose of any
influenza vaccine
• In addition, ACIP recommends that LAIV not be used in the
following populations:
• pregnant women
• immunosuppressed adults
• adults with egg allergy of any severity
• adults who have taken influenza antiviral
medications (amantadine, rimantadine, zanamivir,
or oseltamivir) within the previous 48 hours; avoid
use of these antiviral drugs for 14 days after
vaccination
•Moderate or severe acute illness with or
without fever.
•History of Guillain-Barré Syndrome within 6
weeks of previous influenza vaccination
•Asthma in persons aged 5 years and older
• chronic lung diseases,
•chronic cardiovascular disease
• diabetes,
•chronic renal or hepatic disease
• hematologic disease,
•neurologic disease, and
•metabolic disorders
Vaccine Contraindications Precautions
Inactivated
Influenza Vaccine
( IIV) – IM
Severe allergic reaction (e.g., anaphylaxis)
after previous dose of any influenza
vaccine; or to a vaccine component,
including egg protein
•Moderate or severe acute illness with
or without fever
•History of Guillain-Barré Syndrome
within 6 weeks of previous influenza
vaccination.
•Adults who experience only hives with
exposure to eggs may receive RIV or,
with additional safety precautions, IIV.

21. WHEN TO VACCINATE GENERALLY IN INDIA ?
Peak influenza season in India is the monsoon .
So vaccine should be given pre-monsoon i.e. April/May
The second peak is seen in Winter in Northern states i.e. J&K ,
Himachal , Delhi in Nov –Feb period.
Tamil Nadu which receives NE monsoon will show peak season in Nov-
Feb as well.
Please remember since 2009 flu & swine fle vaccine is same
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22. • Soreness redness at vaccination site in 1/3 of
people
• Fever, malaise and myalgia 6-12hrs after
immunisation and lasts for about 48hours
• Guillain barre syndrome very rare, risk of GBS
are higher following influenza like illness
• Anaphylaxis rare
• Please Remember Injection influenza vaccine
‘inactiveted cannot cause influenza.
Influenza Vaccine
Side effects
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23. Everyone
1 who needs a flu vaccine
a) You
b) You
c) You
d) All of the above
Who should get the influenza
vaccine
Anyone who dose not want to get
influenza

24. GETTING THE FLU VACCINE
IS
SAFER THAN GETTING THE
FLU