Flu and Pneumonia Vaccine Updates 10/2/14

October 2nd, 2014

October 2, 2014

Routine annual influenza vaccination is recommended for all persons aged ≥6 months who do not have contraindications. Vaccination optimally should occur before onset of influenza activity in the community.

Inactivated Influenza Vaccine

Inactivated influenza vaccine (IIV) is available as:

  • The old-fashioned standard shot;
  • An intradermal version using a really small, skinny needle only for adults up to age 64 years;
  • A high-dose version only for seniors 65 years or older
  • A new cell-cultured version (CCIIV) for adults of all ages.

These inactivated shots can be given to age-appropriate patients with hives-only egg allergy.

Also new for this season: needle-free flu shots. PharmaJet® needle-free injection technology has teamed up with flu vaccine manufacturer bioCSL. This needle-free injection system (brand name Stratis®) can be used to administer inactivated flu vaccine, Afluria®, to adults 18-64 years old.

Recombinant Influenza Vaccine

One of the newest flu vaccines on the market: the recombinant influenza vaccine (brand name Flublok®), abbreviated RIV3. The “3” means that it is trivalent. This is totally egg-free and can be given to patients aged 18-49 years, including those with egg allergy of any severity.

Live Attenuated Influenza Vaccine

The live attenuated influenza vaccine, abbreviated LAIV4; the “4” means that it is quadrivalent. It is made from live but weakened virus. It is only for healthy people aged 2-49 years, as long as they are not pregnant.

This year, LAIV got an additional heads-up from ACIP for use in young children. Evidence review found LAIV to be more efficacious than inactivated flu vaccine among younger children. ACIP now recommends LAIV for healthy children aged 2-8 years. There is a qualifier. Flu vaccination should not be delayed. If LAIV is not immediately available, it is fine to vaccinate with IIV, the inactivated vaccine. LAIV should not be given to anyone with a history of egg allergy of any severity.

Vaccine Components for 2014 – 2015 Season

For 2014–15, U.S.-licensed influenza vaccines will contain the same vaccine virus strains as those in the 2013–14 vaccine. Trivalent influenza vaccines will contain hemagglutinin (HA) derived from an A/California/7/2009 (H1N1)-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like (Yamagata lineage) virus. Quadrivalent influenza vaccines will contain these antigens, and also a B/Brisbane/60/2008-like (Victoria lineage) virus.

Pneumococcal Vaccine Update

On August 13, 2014, the ACIP recommended routine use of 13-valent pneumococcal conjugate vaccine (PCV13 [Prevnar 13, Wyeth Pharmaceuticals, Inc., a subsidiary of Pfizer Inc.]) among adults aged ≥65 years.

  • PCV13 should be administered in series with the 23-valent pneumococcal polysaccharide vaccine (PPSV23 [Pneumovax23, Merck & Co., Inc.]), the vaccine currently recommended for adults aged ≥65 years.
  • PCV13 was approved by the Food and Drug Administration (FDA) in late 2011 for use among adults aged ≥50 years.
  • On June 20, 2012, ACIP recommended routine use of PCV13 for adults aged ≥19 years with immunocompromising conditions, functional or anatomic asplenia, cerebrospinal fluid leak, or cochlear implants.

Questions call Deb McMahan, MD