Influenza Guide for Pharmacists

Key Points for the Pharmacist

• For the 2016-2017 season, the influenza vaccine is recommended for all patients aged 6 months or older without contraindications to receiving the vaccine.
• Due to evidence of insufficient efficacy, the quadrivalent live influenza vaccine should not be used in any patient for the 2016-2017 season.
• Children aged 6 months through 8 years may require 2 doses of the influenza vaccine (separated by 28 days) if the child has not previously received 2 doses of any trivalent or quadrivalent influenza vaccine (including the live intranasal vaccine) at any time before July 1, 2016, regardless of whether the previous doses were administered during a single season, consecutive seasons, or 2 nonconsecutive seasons.
• In addition to quadrivalent and trivalent inactivated influenza vaccines, available formulations for the 2016 season include a recombinant trivalent influenza vaccine, an influenza vaccine manufactured in cell culture, and 2 vaccines for patients aged 65 years and older (an adjuvanted vaccine and a high-dose vaccine).
• For the 2016-2017 season, 1 vaccine—the recombinant trivalent influenza vaccine (trade name: Flublok)—is egg-free, and an inactivated vaccine produced through cell culture (trade name: Flucelvax) contains no more than one-half of 1 billionth of a microgram of total egg protein per dose.
• All influenza vaccines available in single-dose formulations (eg, single-dose 0.5-mL vials and prefilled syringes) are free of mercury (with the exception of prefilled syringes of Fluvirin, each of which contains less than 1 mcg of mercury).
• Pharmacists can administer influenza vaccines and can also act as advocates for vaccination.

The Importance of Vaccination of Health Care Professionals

Did you know? Transmission of influenza from health care professionals to patients may occur 24 hours before symptom onset and for approximately 1 week after symptom onset. Therefore, vaccination of health care professionals is an especially important measure for prevention of serious consequences in patients, many of whom may have chronic illnesses.

Risk of medical complications of severe influenza can occur if an individual is:

• A child age 6 months to 5 years
• Age 50 or older
• An adult or child with any of the following disorders: chronic pulmonary (including asthma) or cardiovascular (except isolated hypertension), renal, hepatic, neurologic, hematologic, or metabolic (including diabetes mellitus)
• Someone with immunosuppression (including immunosuppression caused by medications or by HIV infection)
• A woman who is or will be pregnant during the influenza season
• A child or adolescent (age 6 months to 18 years) who is receiving long-term aspirin therapy and who might be at risk for experiencing Reye syndrome after influenza virus infection
• A resident of a nursing home or other long-term care facility
• Of native American/Alaska native descent
• Anyone with severe obesity (body mass index ≥40)

Influenza Vaccination Guideline for the 2016-2017 Season

Who should get a flu shot? For the 2016-2017 flu season: consistent with recommendations from the past 5 influenza seasons, the Advisory Committee on Immunization Practices recommends an annual flu vaccine for everyone age 6 months and older (who does not have contraindications for the vaccine).