Practice Alert

CDC: Older kids should get annual flu vaccine, too

J Fam Pract. 2008 October;57(10):658-660
Author and Disclosure Information
PDF Download

 

References

TABLE 3
Which vaccines contain thimerosal—and how much?

VACCINETRADE NAMEMANUFACTURERHOW SUPPLIEDMERCURY CONTENT (MCG HG/0.5 ML DOSE)
TIVFluzoneSanofi Pasteur0.25-mL prefilled syringe0
0.5-mL prefilled syringe0
0.5-mL vial0
5-mL multidose vial25
TIVFluvirinNovartis Vaccines5-mL multidose vial25
0.5-mL prefilled syringe≤1
TIVFluarixGlaxoSmithKline0.5-mL prefilled syringe≤1
TIVFluLavalGlaxoSmithKline5-mL multidose vial25
TIVAfluriaCSL Biotherapies0.5-mL prefilled syringe0
5-mL multidose vial24.5
LAIVFluMistMedImmune0.2-mL sprayer0

Make use of antivirals

Two antiviral medications are licensed and approved for the treatment and prevention of influenza: oseltamivir (Tamiflu) and zanamivir (Relenza). Two others (amantadine and rimantadine) are licensed but not currently recommended due to the high rates of resistance that influenza has developed against them.

Oseltamivir is approved for the treatment and prophylaxis of influenza starting at 1 year of age.

Zanamivir is approved for the treatment of influenza starting at 7 years of age and for prophylaxis starting at 5 years of age.

Treatment, if started within 48 hours of symptom onset, reduces the severity and length of infection and the length of infectiousness. Antiviral prophylaxis should be considered when there is increased influenza activity for those listed in TABLE 4.

TABLE 4
Increased flu activity in the community? Consider antiviral prophylaxis

  • Individuals at high risk during the 2 weeks after influenza vaccination (after the second dose for children ages <9 years who have not previously been vaccinated)
  • Individuals at high risk for whom influenza vaccine is contraindicated
  • Family members or health care providers who are unvaccinated and are likely to have ongoing, close exposure to individuals at high risk, unvaccinated people, or infants who are <6 months of age
  • High-risk individuals and their family members and close contacts, as well as health care workers, when circulating strains of influenza virus in the community are not matched with vaccine strains
  • Individuals with immune deficiencies or those who might not respond to vaccination (eg, individuals infected with human immunodeficiency virus or with other immunosuppressed conditions, or those who are receiving immunosuppressive medications)
  • Unvaccinated staff members and other individuals during a response to an outbreak in a closed institutional setting with residents at high risk (eg, extended-care facilities).
Note: Recommended antiviral medications (neuraminidase inhibitors) are not licensed for prophylaxis of children <1 year of age (oseltamivir) or <5 years of age (zanamivir).

Every bit helps

Each year, influenza kills, on average, 36,000 Americans and hospitalizes another 200,000. Much of this morbidity and mortality could be avoided with full utilization of influenza vaccines and antiviral medications. You can contribute to improved public health by assuring that your patients and staff are fully immunized, that office infection control practices are adhered to, and that antiviral prophylaxis is used when indicated.

Pages

Next Article:

MEASLES HITS HOME: Sobering lessons from 2 travel-related outbreaks