Influenza Vaccination

Question 1

When should influenza vaccinations occur?

Answer 1

September and early November

Question 2

What are the types of influenza virus and which ones account for most of the disease?

Answer 2

Influenza A, B & C.

A&B account for most of the clinical disease.

Question 3

What are the 4 things to remember about the children’s vaccine?

Answer 3

• It is given intranasally
• The first dose is given at 2-3 years, then annually after that
• It is a live vaccine.
• It is more effective than the injectable vaccine

Question 4

What are some other points to remember about the child influenza vaccine?

Answer 4

• Children who were traditionally offered the flu vaccine (e.g. asthmatics) will now be given intranasal vaccine.
• If a live vaccine is inappropriate, (e.g. immunosuppressed) inactivated, injectable vaccine should be given.
• Only children aged 2-9 years who have not received an influenza vaccine before need 2 doses.

Question 5

What are the contraindications of the child influenza vaccination?

Answer 5

• Immunocompromised
• Aged < 2 years
• Current febrile illness or cold (blocked nose/rhinorrhoea)
• Current wheeze (e.g. ongoing viral-induced wheeze/asthma) or history of severe asthma (BTS step 4)
• Egg allergy
• Pregnancy/breastfeeding
• If the child is taking aspirin (e.g. for Kawasaki disease) due to a risk of Reye’s syndrome

Question 6

What are the side effects of the child influenza vaccine?

Answer 6

• Blocked-nose/rhonorrhoea
• Headache
• Anorexia

Question 7

The adult vaccines are trivalent. What does this mean?

Answer 7

The vaccine consists of two subtypes of influenza A and one subtype of influenza B.

Question 8

There is a quadrivalent flu vaccine called Fluarix Tetra. What does it contain?

Answer 8

Protection against two B subtypes, as well as two A subtypes.

Question 9

When does the DoH recommend an annual influenza vaccine?

Answer 9

1. All people older than 65 years.
2. Those older than 6 months if they have:
   
   • Chronic respiratory disease (including asthmatics who use inhaled steroids)
   • Chronic heart disease (heart failure, ischaemic heart disease, including hypertension if associated with cardiac complications)
   • Chronic kidney disease
   • Chronic liver disease: cirrhosis, biliary atresia, chronic hepatitis
   • Chronic neurological disease: (e.g. Stroke/TIAs)
   • Diabetes mellitus (including diet controlled)
   • Immunosuppression due to disease or treatment (e.g. HIV)
   • Asplenia or splenic dysfunction
   • Pregnant women
3. Health and social care staff directly involved in patient care (e.g. NHS staff)
4. Those living in long-stay residential care homes
5. Carers of the elderly or disabled person whose welfare may be at risk if the carer becomes ill (at the GP’s discretion).

Question 10

Is the adult injectable vaccine live or inactivated?

Answer 10

Inactivated and so cannot cause flu

Question 11

A minority of patients will gets symptoms. What are these symptoms & how long do they last for?

Answer 11

Fever and malaise

1-2 days

Question 12

How should the adult inactivated vaccine be stored?

Answer 12

Away from light

And between +2 and +8 C

Question 13

How effective is the adult vaccine?

Answer 13

75%

(But this decreases in the elderly)

Question 14

What are the contraindication of the adult vaccine?

Answer 14

Hypersensitivity to egg protein

Question 15

How long does it take after immunisation for the inactivated adult vaccine to be effective?

Answer 15

It takes around 10-14 days after immunisation before antibody levels are at protective levels