Technically Speaking: Do You Know the Answers to These Questions About 2021-2022 Influenza Vaccination Recommendations?
Published on in Vaccine Update for Healthcare Providers
Published on in Vaccine Update for Healthcare Providers
Parents may be more excited this year to have their child vaccinated against influenza. This is not only because influenza vaccine will prevent serious medical complications of influenza disease, but because it is one more way to prevent even mild symptoms of influenza at a time when every febrile illness presents families with logistical complications (e.g., COVID-19 testing, home schooling during quarantine).
The updated influenza vaccination recommendations were published in the August 27, 2021, issue of the Morbidity and Mortality Weekly Report (MMWR) with a significant amount of information to absorb. To test yourself on your influenza vaccination knowledge, try to answer each of the following questions.
In September, on his 6-month birthday, Teddy presents to your office for routine vaccination. Which of the following are TRUE?
Only answer B is true. The correct dose for Afluria is 0.25 ml. Dosing for patients ages 6 through 35 months is 0.5 ml intramuscularly (IM) for all injectable influenza vaccines in the U.S. except Afluria (Seqirus; 0.25 mL) and Fluzone® (Sanofi Pasteur; 0.25 mL or 0.5 mL, although the 0.25-ml prefilled syringes are not expected to be available for the 2021–22 influenza season).
Here is why the other answers are false:
*Cell culture–based inactivated influenza vaccine (ccIIV4)
** Recombinant influenza vaccine (RIV4)
Riley, age 17 years, presented in the clinic this September for influenza vaccination. Riley has a history of anaphylaxis following receipt of ccIIV4. Which of the following are TRUE?
Answers A, B, and C are true. Here is why:
Answer D was false. Children of any age who require only one dose for the season may be vaccinated as soon as vaccine is available. Waning immunity among children has not been identified to be as much of a concern as it is for adults.
Your influenza vaccine supply arrived in August this year. Each of the following patients attends their scheduled appointments faithfully. Which of them should have been vaccinated during their August visit?
The pregnant patient in answer “B” is the only one who should have been vaccinated in August. While pregnant individuals in any trimester may receive influenza vaccine, the CDC recommends that those in their third trimester receive influenza vaccine early, i.e., in July or August. In this manner, maternal antibodies, passively transferred before birth, can help protect the baby against influenza in the months after birth, but before infant vaccination.
CDC states, “For nonpregnant adults, vaccination in July and August should be avoided unless there is concern that later vaccination might not be possible.” The current recommendation is to start vaccinating all nonpregnant adults in September with the goal of having everyone vaccinated by the end of October. Giving influenza vaccination during this window (rather than in July or August) might result in greater immunity later in the season while still giving adults time to receive the vaccine before arrival of the virus in the United States. We should expect a similar timing recommendation in future years.
Assume that your healthcare facility is mandating influenza vaccine. Which of the following reasons for declining vaccination is based on evidence?
Answer “D” is correct: None of these statements are based on recommendations or scientific facts.
You would think it could go without saying, “Be sure all healthcare personnel in your circle of influence are vaccinated and understand why influenza vaccination is important.” But, it cannot. Often people who work in healthcare have the same unscientific misunderstandings that the public has, and the corrosive effect of their inaccurate statements spreads like … well, like influenza.
Contributed by: Sharon G. Humiston, MD, MPH, FAAP
Categories: Vaccine Update September 2021, Technically Speaking
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