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Influenza vaccine inactivated (split virion)
Before receiving the inactivated influenza vaccine (split virion), there are several precautions to consider:
- Allergy to Vaccine Components: Individuals who have a known allergy to any component of the vaccine, particularly egg proteins, should avoid receiving this vaccine. Although the inactivated flu vaccine contains minimal egg proteins, severe allergic reactions can still occur.
- Severe Allergic Reactions: If a person has had a severe allergic reaction (e.g., anaphylaxis) to a previous dose of the influenza vaccine, they should not receive another dose.
- History of Guillain-Barré Syndrome (GBS): Individuals with a history of Guillain-Barré Syndrome (a rare neurological disorder) within 6 weeks of a previous influenza vaccination should consult with a healthcare provider, as there is a slight increase in risk of recurrence following vaccination.
- Pregnancy and Breastfeeding: The inactivated influenza vaccine is considered safe during pregnancy and breastfeeding. However, it is always advisable for pregnant women to consult their healthcare provider prior to vaccination to ensure it is appropriate for their specific health situation.
- Illness: It is recommended to delay vaccination in individuals who are moderately or severely ill, including those with fever. The vaccine can be administered once the person has recovered from mild illness.
- Immune System Disorders: People with immunocompromised states (due to disease or medication) should consult their healthcare provider, although the inactivated vaccine is generally safe for most individuals with these conditions.
The inactivated influenza vaccine (split virion) is used for the prevention of influenza caused by influenza viruses, primarily during the flu season. It is indicated for:
- Seasonal Flu Prevention: The vaccine is designed to protect against the most common strains of the influenza virus circulating each flu season, typically strains of influenza A and influenza B.
- At-Risk Populations: It is particularly recommended for individuals who are at higher risk for complications from influenza, including:
- Children (especially those aged 6 months and older).
- Elderly individuals (65 years and older).
- Pregnant women.
- People with chronic health conditions (e.g., asthma, diabetes, heart disease).
- Healthcare workers and caregivers of those at risk.
- Immunocompromised individuals or those with neurological disorders.
The inactivated influenza vaccine (split virion) should not be administered in the following situations:
- Severe Allergic Reactions to Vaccine Components: Any person who has had a severe allergic reaction (e.g., anaphylaxis) to any component of the vaccine, including eggs, gelatin, formaldehyde, or any previous flu shot, should not receive the vaccine.
- History of Guillain-Barré Syndrome (GBS): If an individual has previously experienced Guillain-Barré Syndrome following a flu vaccination, they should consult their doctor before receiving another dose. Some studies have suggested a very small increased risk of GBS after vaccination, although it remains rare.
- Severe Acute Illness: If someone has an acute fever or severe illness, they should wait until they have recovered before getting vaccinated. Mild illness (without fever) is not a contraindication.
Most individuals tolerate the inactivated influenza vaccine (split virion) well, but some side effects are possible:
- Common and Mild Side Effects:
- Pain, redness, or swelling at the injection site.
- Low-grade fever or fatigue.
- Headache and muscle aches.
- Moderate Side Effects:
- Mild allergic reactions, such as hives or a rash.
- Swelling of the face or throat, which may indicate a mild allergic response and should be monitored.
- Severe Side Effects:
- Severe allergic reactions (anaphylaxis) are rare but possible, presenting with difficulty breathing, swelling of the face, and rapid heart rate.
- Guillain-Barré Syndrome (GBS): Though rare, GBS (a neurological disorder) has been associated with the influenza vaccine in some cases, primarily after previous vaccinations.
- Fainting: Especially in younger children or adolescents, fainting after receiving the vaccine is reported, but this is usually short-term and resolves quickly.
The inactivated influenza vaccine (split virion) works by stimulating the body’s immune system to produce an immune response to the influenza virus without causing illness. It contains inactivated (killed) influenza virus particles, which are split into fragments (split virion). These fragments are used to train the immune system to recognize and fight the virus in the future. When the body is exposed to the live virus later, it recognizes it and mounts an immune response, thus preventing or reducing the severity of the flu illness. The immune system produces antibodies that specifically target the hemagglutinin (HA) and neuraminidase (NA) proteins on the surface of the virus, which are essential for the virus to enter and spread in the body.
Several drug interactions may affect the inactivated influenza vaccine (split virion)'s efficacy or safety:
- Immunosuppressive Therapy: Medications that suppress the immune system, such as corticosteroids, chemotherapy drugs, or immunosuppressive biologics, may reduce the immune response to the vaccine. In some cases, these individuals may need additional vaccines or enhanced monitoring.
- Antiviral Drugs: The use of antiviral drugs like oseltamivir or zanamivir does not affect the inactivated influenza vaccine. However, antiviral medications can reduce the severity and duration of influenza symptoms, but should be used as adjunct therapy, not as a substitute for vaccination.
- Live Attenuated Influenza Vaccine (LAIV): This live vaccine, often given as a nasal spray, should not be given simultaneously with the inactivated vaccine. If both are required, they should be administered at least 4 weeks apart.
- Vaccination Schedule: The efficacy of the vaccine can be reduced if administered too soon after another vaccine. It’s generally recommended to space other vaccines by at least 14 days from the flu vaccine.
Use in pregnancy: Safety of use during pregnancy has not been established; benefits of vaccination should be weighed against potential risks. However, as an inactivated vaccine, it does not share the theoretical risks associated with live vaccines.
For adults and children aged 9 years and older, the typical dose of the inactivated influenza vaccine (split virion) is 0.5 mL administered via intramuscular injection (usually in the deltoid muscle of the upper arm). The vaccine should be given annually before the start of the flu season, typically in October or November.
- If someone is receiving the flu vaccine for the first time, they may require two doses of 0.5 mL, spaced at least 4 weeks apart, depending on the recommendation from their healthcare provider.
For children aged 6 months to 8 years, the dose of the inactivated influenza vaccine (split virion) is typically 0.25 mL for infants and toddlers aged 6 months to 35 months, and 0.5 mL for children 3 years and older. Children who are receiving the flu vaccine for the first time may require two doses of 0.5 mL, spaced at least 4 weeks apart, to ensure a full immune response.
- For children aged 6 months to 8 years, it's crucial to determine if they need one or two doses based on their vaccination history, particularly if they have never been vaccinated or have received fewer than two doses in the past.
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Important Note:
It is crucial for patients to consult their healthcare provider before receiving the inactivated influenza vaccine (split virion) to assess individual risks, especially in the case of allergies, underlying health conditions, or concerns about vaccine interactions. The annual flu vaccine is an important preventive measure in reducing flu-related morbidity and mortality, especially in high-risk populations.
There are no specific renal dose adjustments needed for the inactivated influenza vaccine (split virion) in patients with renal impairment. However, individuals with severe kidney disease should consult their healthcare provider to ensure it is appropriate for them to receive the vaccine, especially if they have other complicating factors such as immunocompromised conditions.
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