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  • Children between the ages of 6 months and 8 years who are receiving the influenza vaccination for the first time require a booster vaccination at least 4 weeks after their initial influenza vaccination.
  • Because of the novelty of the 2009(H1N1) influenza virus, which is again expected to circulate in 2012-2013 and is included in the current trivalent vaccine, only children who received 2 or more doses of influenza vaccine since July 1, 2010, should receive 1 dose this year. This ensures that children who have previously only had 1 exposure to the H1N1 antigen receive a booster.
  • New intradermal preparations of the influenza vaccine include a dose of 9 µg of hemagglutinin per vaccine virus strain with an indication for adults 18 to 64 years old, and a high-dose vaccine featuring 60 µg of hemagglutinin per vaccine virus strain for patients 65 years and older.
  • The ACIP does not recommend one form of TIV vaccine vs another.
  • The intranasally administered live-attenuated influenza vaccine is indicated for healthy, nonpregnant persons between the 2 and 49 years old. There is generally no preference for live vs inactivated vaccines among this age group, although persons with a history of egg allergy should receive the inactivated vaccine.
  • Febrile seizures have an overall prevalence of 2% to 5% among children. The 2010-2011 influenza season was remarkable for the first time in that the influenza vaccine was associated with a higher risk for febrile seizures. This risk was limited to children between the ages of 6 months and 4 years, and it occurred during the 24 hours after receipt of the vaccine. Concomitant administration of the PVC13 vaccine increased the risk for febrile seizure associated with the influenza vaccine.
  • Reports of a higher risk for febrile seizures associated with the vaccine Afluria have led the CDC to recommend against the use of this specific product among children younger than 9 years.
  • Among persons with a history of egg allergy, those who report only hives after exposure to eggs may receive TIV, provided that the healthcare practice is familiar with the potential manifestations of egg allergy and can monitor the patient for at least 30 minutes after administration of the vaccine.
  • Measures such as splitting the vaccine into 2 separate injections or skin testing with the vaccine are unnecessary among patients with egg allergy.
  • If clinicians wish to administer the influenza vaccine to patients with more severe symptoms of egg allergy (ie, anaphylaxis), they should refer these patients to an allergy specialist for consultation.
  • Predicting the predominant circulating strain of influenza B in a given year is a challenge. Therefore, several quadrivalent influenza vaccines are being developed, including a live attenuated vaccine.

 

CLINICAL IMPLICATIONS

 

  • The influenza vaccine is recommended for all individuals 6 months and older. Children who received 2 or more doses of influenza vaccine since July 1, 2010, should receive 1 dose this year. Otherwise, children younger than 8 years should receive a booster vaccination at least 1 month after primary vaccination.
  • Persons who report only hives after exposure to eggs may receive TIV, provided that the healthcare practice is familiar with the potential manifestations of egg allergy and can monitor the patient for at least 30 minutes after administration of the vaccine.

Fonte: Medscape Pharmacist

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