Holliston Pediatrics will be following the Center for Disease Control (CDC) recommendations for Seasonal Flu and H1N1 Flu vaccination. Because the supply of the vaccines cannot yet meet demands, children with certain medical issues will be offered earlier supply of vaccine. Currently, the populations to be vaccinated first are:
*6 months to 4 year olds.
*siblings of babies under 6 mos.
*patients with certain chronic conditions that make them more at risk for flu complications.
The American Academy of Pediatrics (AAP) has outlined conditions which put patients at risk for complications from the flu:
*Neurological disorders - epilepsy, cerebral palsy, neurodevelopmental disabilities.
*Neuromuscular disorders with impaired respiratory function.
*Chronic respiratory diseases with impaired pulmonary function and/or difficulty
handling secretions - moderate/severe asthmatics, cystic fibrosis, patients requiring
oxygen/ventilators/tracheostomy.
*Immunodeficiency states.
*Congenital heart disease.
*Mitochondrial disease with respiratory impairment.
Seasonal Flu There are two vaccines available:
Nasal spray(3 strains of attenuated live virus) is approved for 2 yr to 49 yr.
Injectable(3 strains of killed virus) is approved for 6 mos and up.
*A patient under 9 yr will require 2 vaccine doses the first year that they are vaccinated (2 doses of the same vaccine 1 month apart).
H1N1 Flu There are two vaccines available: nasal spray and injectable
Nasal spray(1 strain of attenuated live virus) is approved for 2 yr to 49 yr.
Injectable(1 strain of killed virus) is approved for 6 mos and up.
*A patient under 10yo will require 2 vaccine doses this year (2 doses of the same vaccine 1 month apart).
Your child may get the injectable seasonal flu vaccine, or the injectable H1N1 flu vaccine, with any other live or killed vaccine on the same day, and with each other on the same day.
Your child may get the nasal spray seasonal flu vaccine, or the nasal spray H1N1 flu vaccine, with any other live vaccine or killed vaccine on the same day. One cannot administer the nasal spray seasonal flu vaccine and the nasal spray H1N1 flu vaccine on the same day, and one must wait at least 1 month before administering another live vaccine of any type.
Contraindications to the nasal spray
Nasal seasonal flu vaccine and the nasal spray H1N1 vaccine:
*Under 2 yr, or over 50 yr.
*Pregnant women.
*Allergy to egg or any of the other vaccine components (gelatin, gentamicin, arginine).
*Patients who have had Guillain-Barre syndrome.
*Patients who have had a life-threatening reaction to any previous flu vaccination.
*Acute febrile illness or severe nasal congestion.
*Household member who is severely immunocompromised. One must wait 7 days
after receiving nasal vaccine to visit immunocompromised people.
Contraindications to the injectable Seasonal Flu vaccine and the injectable H1N1 vaccine:
*Under 6 mos.
*Allergy to egg or any of the other vaccine components (gelatin, gentamicin,arginine).
*Patients who have had Guillan-Barre syndrome.
*Patients who have had a life-threatening reaction to any previous flu vaccination.
*Acute febrile illness.
If a patient is on anti-viral therapy, they should wait 48 hours to receive any flu vaccine. If a patient takes anti-viral therapy within 2 weeks of being vaccinated for any flu, they need to repeat their vaccination 48 hours after the anti-viral medication is complete.
Women who are breast feeding may have the nasal or injectable vaccines and continue to breast feed.
A patient who has had a flu-like illness during 2009 should probably still receive the H1N1 Flu vaccine, and certainly should receive the seasonal flu vaccine.
School systems are expecting to get H1N1 vaccine to administer, and our patients should be encouraged to get vaccinated through their schools if/when available. We should encourage these patients to call us with the date and type of vaccine that is received so that we can update their vaccination record.
