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IAC Express: Issue 1271
October 21, 2016
Ask the Experts: CDC Experts Answer Your Questions

The questions and answers about influenza vaccination in this edition of IAC Express first appeared in the October 2016 issues of Needle Tips and Vaccinate Adults.

IAC extends thanks to our experts, medical officer Andrew T. Kroger, MD, MPH, and nurse educator Donna L. Weaver, RN, MN. Both are with the National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention (CDC).
Q: Which influenza vaccines will be available during the 2016–17 influenza season?
Q: Why did CDC’s Advisory Committee on Immunization Practices (ACIP) recommend that LAIV not be used during the 2016–17 season?
Q: With the ACIP recommendation to not use LAIV during the 2016–17 season, will there be enough inactivated influenza vaccine (IIV) to meet the demand for the upcoming season?
Q: I know that LAIV is not recommended to be used this season. If a dose of LAIV is administered this season, is it a valid dose, or should we repeat it with IIV?
Q: Please tell me about Fluad, the new influenza vaccine for people age 65 years and older.
Q: Who is recommended to receive vaccination against influenza?
Q: When should influenza vaccine be administered?
Q: Is influenza vaccine recommended for pregnant women?
Q: We have noticed that ACIP recommends that we begin vaccinating with seasonal influenza vaccine in September or even earlier. Does protection from seasonal influenza vaccine decline or wane within 3 or 4 months of vaccination? Should I wait until later in the year to vaccinate my elderly or medically frail patients?
Q: Some of my patients refuse influenza vaccination because they insist they “got the flu” after receiving the injectable vaccine in the past. What can I tell them?
Q: Is a Vaccine Information Statement (VIS) only recommended or is it mandatory when administering influenza vaccine?
Q: We are trying to provide influenza vaccination to all eligible patients during their stay in our hospital. If a patient does not remember if he or she has already received the vaccine this season, should we go ahead and vaccinate?
Q: Which children younger than age 9 years will need 2 doses of influenza vaccine in this influenza season?
Q: When determining whether a child age 2 through 8 years needs one or two doses of influenza vaccine this season, can we count doses of LAIV administered in past years? We were not sure because LAIV is not recommended this year.
Q: If a child receives influenza vaccine at age 34 or 35 months for the first time (0.25 mL dose) and then returns for the second dose at age 37 months, should we give another 0.25 mL dose or should we give the 0.5 mL dose that is indicated for ages 3 and older?
Q: What is the latest ACIP guidance on influenza vaccination and egg allergy?
Q: Does the ACIP prefer that healthcare personnel administer high-dose or adjuvanted influenza vaccine to people age 65 years and older, or is standard-dose influenza vaccine acceptable?
Q: May Fluzone High-Dose or Fluad be administered to patients younger than age 65 years?
Q: Some of our patients believe that they have had reactions to influenza vaccine in the past, and request the dose to be split into 2 doses administered on different days. Is this an acceptable practice?
Q: The pneumococcal conjugate vaccine (PCV13, Prevnar, Pfizer) package insert says that in adults, antibody responses to PCV13 were diminished when given with inactivated influenza vaccine. Does this mean we should not give PCV13 and influenza vaccine at the same visit?
Q: We inadvertently administered a 0.5 mL dose of Fluvirin (IIV3, Seqirus) to a 2-year-old before realizing that the vaccine is only licensed for use in people age 4 years and older. Do we need to repeat the dose with an age-appropriate product?
Q: How should influenza vaccines (IIV and LAIV) be stored?
Q: What are the ACIP recommendations for influenza vaccination of healthcare personnel (HCP)?
Q: Is it okay to draw up vaccine into syringes at the beginning of the day? If it isn't, how much in advance can this be done?
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Editor: Deborah L. Wexler, MD
Managing Editor: Teresa Anderson, DDS, MPH
Consulting Editor: Marian Deegan, JD
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