A Closer Look at Flu Vaccine
What's trending? 2016-2017 flu season review
New influenza guidelines on patients with egg allergies and flu vaccine1
The CDC and the Advisory Committee on Immunization Practices (ACIP) have updated their guidelines as of 2016 to recommend:
- Those who have only experienced hives after exposure to eggs can and should receive influenza vaccine. Any licensed flu vaccine recommended for the recipient's age may be used
- Those who have experienced symptoms other than hives after being exposed to eggs (such as angioedema, respiratory distress, lightheadedness or recurrent emesis) may still receive any licensed and recommended vaccine. However, the vaccine should be administered in a medical setting and supervised by a healthcare practitioner who is able to recognize and manage several allergic conditions
FDA approves FluMist® for the 2016-2017 season
The FDA has approved FluMist® Quadrivalent for the 2016-2017 season2. This decision comes after the ACIP voted on June 22, 2016 that FluMist® Quadrivalent should not be used in the 2016-2017 season3.
Most common place of flu vaccination in 20164
What's coming? 2017-2018 influenza outlook
FluLaval® Quadrivalent receives expanded age indication approval
Manufacturer GSK has received FDA approval for expanded indication for FluLaval® Quadrivalent for infants 6 months and older.
When are 2017-2018 influenza shipments anticipated to begin?
- Before the new flu season begins, typically around February, the FDA makes a recommendation on the different strains of influenza viruses that should be included in vaccines being produced for the upcoming U.S. influenza season, which triggers production
- In addition, the Center for Biologics Evaluation and Research (CBER), which is responsible for regulating vaccines in the U.S., must undergo a multi-step approval process for each vaccine
- For these factors and several others, it is difficult to predict with accuracy when shipments will begin. However, customers who pre-book with McKesson Medical-Surgical will be notified before the release of their shipments and they can contact the Flu Team directly at any time for the latest updates
Flu year-round: A look at flu vaccine activities by season
The chart below breaks down your major flu activities - ordering flu vaccine, preparing for the season, vaccinating and treating patients - by when these activities occur within the year.
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Influenza Vaccine Frequently Asked Questions
Types of flu vaccine
Are all flu vaccines the same?
Different flu vaccine preparations have different indications as approved by the FDA.5 Click here to see the CDC's flu vaccine table for an overview of these indications.
What are some of the differences between Trivalent (TIV) and Quadrivalent (QIV)?
Trivalent contains three strains of influenza virus (two "A" strains and one "B" strain). Quadrivalent contains four strains (two "A" and two "B").6
What is the difference between Quadrivalent and high-dose vaccines?
Quadrivalent refers to the number of strains of influenza virus contained in the vaccine - four strains - two "A" and two "B". High dose is a type of vaccine that provides a more robust immune response in patients 65 years and older.
Are there any thimerosal-free or preservative-free influenza vaccines?
Yes. Most pre-filled single-dose syringes are preservative-free (FLUVIRIN® PFS contains 1 mcg or less mercury per 0.5ml dose).
When should I learn about the different flu vaccines offered and the strains they protect against?
Look for the season's strains in late February/early March. The World Health Organization (WHO) consults with various experts and partners each year in February, before making recommendations for the composition of the seasonal influenza vaccine. Shortly thereafter, the Food and Drug Administration (FDA) likely endorses this recommendation and announces which strains the season's vaccine will protect against.7
Ordering flu vaccine
When should I order my flu vaccine?
Because of the lengthy flu vaccine manufacturing and distribution periods, as well as limited quantities, it's best to pre-book and order your vaccine as early as possible. Typically, you would want to order your vaccine in the spring, shortly after the season's vaccines and strains are announced by the FDA and CDC.
How much flu vaccine should I order?
Assess your last year's vaccine usage and make adjustments as necessary. Take into consideration any expected flu surges in your area, as well as your patient population. Certain persons are at a higher risk of medical complications attributable to severe flu, so you should assess your patient population for these persons and include these numbers in your vaccine ordering. Persons at risk include:8
- All children aged 6-59 months
- All persons aged 50 years and older
- Adults and children who have chronic pulmonary (including asthma) or cardiovascular (except isolated hypertension), renal, hepatic, neurologic, hematologic, or metabolic disorders (including diabetes mellitus)
- Persons who have immunosuppression (including immunosuppression caused by medications or by HIV infection)
- Women who are or will be pregnant during the influenza season
- Children and adolescents (aged 6 months through 18 years) who are receiving long-term aspirin therapy and who might be at risk for experiencing Reye's syndrome after influenza virus infection
- Residents of nursing homes and other long-term care facilities
- American Indians/Alaska Natives
- Persons who are obese, with a body mass index of 40 or greater
Why is pre-booking important?
Because production begins so early (it takes at least six months to produce large quantities of influenza vaccine), pre-booking can be helpful to ensure you get the appropriate amount of vaccine for your needs.9 In addition, historical data shows that manufacturers typically waitlist certain vaccines in March. Once a product is waitlisted, there is no guarantee of the delivery date or even that more vaccines will be available. Product may not be readily available to providers who did not take advantage of the pre-book period.
Why isn't my flu vaccine shipped all at once and delivered at the beginning of the season?
It's difficult for manufacturers to produce sufficient flu vaccine supply all at once, due to the early start and phased approach to vaccine production. According to the CDC, flu vaccine production begins as early as six to nine months before the beginning of vaccine distribution, and yet, even with this early start, it isn't possible to complete the entire production and distribution process prior to flu season. In addition, the limited number of manufacturing plants in the US, all producing high volumes of vaccine, further contributes to the difficulty of supply. These factors, as well as others including the unpredictability of the flu season, often affect the vaccine distribution process and make it extremely difficult to provide all flu vaccine at once.10
Unless otherwise noted, the recommendations in this document were obtained from: Centers for Disease Control and Prevention. Be advised that information contained herein is intended to serve as a useful reference for informational purposes only and is not complete clinical information. This information is intended for use only by competent healthcare professionals exercising judgment in providing care. McKesson cannot be held responsible for the continued currency of or for any errors or omissions in the information.
2017 McKesson Medical-Surgical Inc.