2009 H1N1 Influenza Vaccine


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  • __________________________________________________ FYI
  • _________________________________________________________________________ FYI From the IAC Ask the Experts Q and A on Novel H1N1 Vaccine   Q: Will we be able to administer both the seasonal and H1N1 influenza vaccines at the same visit?    A: You can in most cases. See the points below.  * You can administer both the inactivated seasonal and the inactivated H1N1 influenza vaccines at the same visit (using separate syringes and sites) or at any time before or after each other.     * You can administer the inactivated seasonal and live H1N1 influenza vaccines together or at any time before or after each other.     * You can administer the live seasonal and inactivated H1N1 influenza vaccines together or at any time before or after each other.     * Administering both the live attenuated seasonal and the live attenuated H1N1 influenza vaccines at the same visit is NOT recommended because of concerns about competition between the two vaccine viruses. If you have only live vaccines for both seasonal and H1N1 influenza available, you should separate the doses of the two live vaccines by at least 4 weeks.
  • Reporting clinically significant adverse events following vaccination is true for all vaccines not just H1N1 _____________________________________________________ FYI VAERS website: www.vaers.hhs.gov
  • The risks associated with influenza are greater than any hypothetical risks associated with vaccine ______________________________________________________ FYI No scientific evidence indicates that thimerosal in vaccines, including influenza vaccines, is a cause of adverse events in vaccine recipients or to children born to women who received vaccine during pregnancy. In fact, evidence is accumulating that supports the absence of any risk for neurodevelopment disorders or other harm resulting from exposure to thimerosal-containing vaccines. The benefits of influenza vaccination for all recommended groups, including pregnant women and young children, outweigh the unproven risk from thimerosal exposure through vaccination. The risks for severe illness from influenza virus infection are elevated among both young children and pregnant women, and vaccination has been demonstrated to reduce the risk for severe influenza illness and subsequent medical complications. In contrast, no scientifically conclusive evidence has demonstrated harm from exposure to vaccine containing thimerosal preservative. For these reasons, persons recommended to receive TIV may receive any age- and risk factor–appropriate vaccine preparation, depending on availability. ACIP and other federal agencies and professional medical organizations continue to support efforts to provide thimerosal preservative–free vaccine options. Prevention and Control of Influenza Recommendations of the ACIP MMWR August 8, 2008 .
  • ________________________________________________________ FYI Information current as of Sept 2, 2009 from the CDC website www.cdc.gov/h1n1flu- vaccine Q and A
  • 2009 H1N1 Influenza Vaccine

    1. 1. 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]
    2. 2. • 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
    3. 3. 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
    4. 4. 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 !!
    5. 5. 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 <ul><li>H1N1 vaccine ONLY protects against disease caused by H1N1 virus </li></ul><ul><li>Seasonal flu vaccine ONLY protects against Seasonal flu viruses </li></ul>Diseases
    6. 6. 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
    7. 7. 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?
    8. 8. Many of your patients will be wondering: How safe is H1N1Influenza Vaccine? <ul><li>Reassure your patients that </li></ul><ul><ul><li>This vaccine is made just like Seasonal Flu Vaccine </li></ul></ul><ul><ul><ul><li>With use of different influenza virus </li></ul></ul></ul><ul><ul><ul><li>By a method that has been used for many years </li></ul></ul></ul><ul><ul><li>H1N1 vaccine will be watched very closely for problems </li></ul></ul><ul><ul><ul><li>Vaccine Adverse Event Reporting System (VAERS) will be used </li></ul></ul></ul><ul><ul><ul><li>We are encouraged to report any clinically significant adverse event after H1N1 vaccine to VAERS </li></ul></ul></ul><ul><ul><ul><li>OK to submit a report even if the reporter is not certain that the vaccine caused the event </li></ul></ul></ul><ul><ul><ul><li>Reports may be completed on line, faxed or mailed </li></ul></ul></ul><ul><ul><ul><li>For more information: www.vaers.hhs.gov </li></ul></ul></ul>
    9. 9. Do influenza vaccines contain Thimerosal? <ul><li>Thimerosal is a preservative in some vaccines </li></ul><ul><ul><li>Used in multi-dose flu vials to prevent growth of bacteria </li></ul></ul><ul><li>TIV single-dose vials and syringes are either </li></ul><ul><ul><li>Thimerosal free (Preservative Free – PF) </li></ul></ul><ul><ul><li>or </li></ul></ul><ul><ul><li>Contain only a trace amount of thimerosal </li></ul></ul><ul><li>LAIV (nasal sprayers) do not contain thimerosal </li></ul><ul><li>Studies have NOT shown that thimerosal-containing flu vaccine has evidence of harm to anyone, including pregnant women and children </li></ul><ul><li>Benefits of flu vaccine outweigh any hypothetical risks posed by thimerosal </li></ul>
    10. 10. Influenza Vaccine and Antiviral Medications <ul><li>Some of your patients may be taking antiviral meds </li></ul><ul><li>If a patient has had influenza antiviral medication, wait 48 hours to give H1N1 LAIV (live, attenuated vaccine) </li></ul><ul><li>If patient has had H1N1 LAIV (live, attenuated vaccine) wait 2 weeks to give influenza antiviral medication </li></ul>
    11. 11. Patient Education about H1N1 Vaccine <ul><li>• There are FOUR Vaccine Information Statements (VIS) </li></ul><ul><ul><li>Make certain you print the Michigan-specific VIS </li></ul></ul><ul><ul><ul><li>These contain the paragraph about MCIR </li></ul></ul></ul><ul><ul><ul><li>This is how patients are informed that their vaccines are entered into MCIR </li></ul></ul></ul><ul><ul><li>Give correct VIS to each patient </li></ul></ul><ul><ul><ul><li>Differentiate between H1N1 and Seasonal Influenza VIS </li></ul></ul></ul><ul><ul><ul><ul><li>Publication Date of H1N1 Flu Vaccine VIS </li></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>10-2-09 for both TIV and LAIV </li></ul></ul></ul></ul></ul><ul><ul><ul><ul><li>Do not confuse with Seasonal Flu Vaccine VIS </li></ul></ul></ul></ul><ul><ul><ul><ul><ul><li>Publication date 8-11-09 for both TIV and LAIV </li></ul></ul></ul></ul></ul><ul><ul><ul><li>Differentiate between TIV and LAIV Influenza VIS </li></ul></ul></ul><ul><ul><ul><ul><li>TIV – identified as inactivated influenza vaccine </li></ul></ul></ul></ul><ul><ul><ul><ul><li>LAIV – identified as live (attenuated, nasal ) influenza vaccine </li></ul></ul></ul></ul>
    12. 12. Documentation of Influenza Vaccine <ul><li>Very carefully document the specifics about which vaccine you gave </li></ul><ul><ul><li>Make certain you are very clear </li></ul></ul><ul><ul><ul><li>Did you give H1N1 influenza vaccine? </li></ul></ul></ul><ul><ul><ul><li>OR was it Seasonal influenza vaccine? </li></ul></ul></ul><ul><ul><ul><li>Was it TIV vaccine? </li></ul></ul></ul><ul><ul><ul><li>OR was it LAIV vaccine? </li></ul></ul></ul><ul><li>Document in three places </li></ul><ul><ul><li>1) In your medical charts/EMR </li></ul></ul><ul><ul><ul><li>Follow all the routine documentation requirements </li></ul></ul></ul><ul><ul><li>2) In MCIR </li></ul></ul><ul><ul><ul><li>ALL doses of H1N1 vaccine MUST go into MCIR </li></ul></ul></ul><ul><ul><ul><ul><li>For children </li></ul></ul></ul></ul><ul><ul><ul><ul><li>For adolescents </li></ul></ul></ul></ul><ul><ul><ul><ul><li>AND for adults!! </li></ul></ul></ul></ul><ul><ul><ul><li>Documentation in MCIR for VFC vaccine is never optional </li></ul></ul></ul><ul><ul><li>3) On a record card which you give to the patient </li></ul></ul><ul><ul><li>Thank you </li></ul></ul>