influenza h1n1 vaccine

Absorption: Vaccine is absorbed following intramuscular and intranasal administration.

Distribution: Unknown.

Metabolism/Excretion: Unknown.

Half-Life: Unknown.

Time/Action Profile ⬆ ⬇

(antibody production)

ROUTE	ONSET	PEAK	DURATION
IM, Intranasal	within days	within weeks	unknown

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Severe hypersensitivity to egg protein or previous life-threatening reaction from influenza vaccination;
Hypersensitivity to eggs, egg protein, gentamicin, gelatin, arginine or previous life-threatening reaction from influenza vaccination;
Concurrent aspirin therapy in children/adolescents 2–17 yr (↑ risk of Reye's Syndrome);
Children <24 mo (↑ risk of wheezing/hospitalization);
Children <5 yr with recurrent wheezing (↑ risk of wheezing post-vaccination).

Use Cautiously in:

Immunosuppressed patients (may have ↓ antibody response);
Recent (within 6 wk) Guillian-Barré Syndrome; consider risks and benefits;
Geri: Elderly patients may have ↓ antibody response;
OB: Use in pregnancy only if clearly needed;
Lactation: Use cautiously during breastfeeding; consider possible shedding of virus in milk and proximity during breastfeeding for intranasal form;
Pedi: Safe and effective use in children <6 mo not established for IM dose form, safe use in children <2 yr not established for intranasal form;
Underlying medical conditions that predispose to wild-type influenza infection complications.

Adv. Reactions/Side Effects ⬆ ⬇

Intramuscular

Local: pain, soreness, swelling, tenderness

MS: myalgia

Intranasal

EENT: nasal congestion, runny nose, sore throat

Neuro: headache, malaise, headache, weakness

Resp: cough

MS: muscle aches

Misc: fever, chills

Interactions ⬆ ⬇

Drug-drug:

IM: Concurrent immunosuppressants or radiation therapy may ↓ antibody response.
The use of antivirals active against influenza A or B will ↓ effectiveness; avoid immunization within 48 hours of discontinuing; treatment with antivirus should not be initiated for 2 wk following immunization.

Route/Dosage ⬆ ⬇

IM (Adults ): 0.5 mL single dose.
IM (Children >10 yr): 0.5 mL single dose.
IM (Children 3–9 yr): 0.5 mL, repeat one mo later.
IM (Children 6–35 mo): 0.25 mL, repeat one mo later.
(Children 2–9 yr): 0.2 mL, repeat one mo later.
(Adults and Children 10–49 yr): 0.2 mL single dose.

Availability ⬆ ⬇

Sterile suspension for IM injection (prefilled syringes preservative-free): 0.25 mL, 0.5 mL
Sterile suspension for IM injection (single dose vial preservative-free): 0.5 mL
Sterile suspension for IM injection (multidose vial-thimerosal preservative): 5 mL (contains 25 mcg mercury/0.5 mL dose)
Suspension for intranasal use (prefilled intranasal sprayer): 0.2 mL

Assessment ⬆ ⬇

Monitor patient for signs of allergic reaction (rash, pruritus, laryngeal edema, wheezing) following administration. Keep epinephrine, an antihistamine, and resuscitation equipment close by in case of an anaphylactic reaction.

Lab Test Considerations:

May cause thrombocytopenia.

Implementation ⬆ ⬇

IM: Shake well before administering single dose and before withdrawing dose from multi-dose vial. Administer IM.
- Do not mix with other vaccines in the same syringe or vial.
To administer, remove rubber tip protector. Do not remove dose-divider clip at the other end of sprayer. With patient in an upright position, place tip just inside nostril. Depress plunger as rapidly as possible with a single motion until dose-divider clip prevents from going further. Pinch and remove dose-divider clip and repeat procedure in other nostril until remaining vaccine is administered. Dispose of sprayer at completion of procedure. Store in refrigerator; do not freeze.

Patient/Family Teaching ⬆ ⬇

Explain to patient and parent the purpose of the vaccination. Inform patient that there are two vaccine formulations for this influenza season, the H1N1 vaccine and the seasonal trivalent influenza vaccine.
Advise female patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.
Advise patient to avoid contact with patients who are immunocompromised for at least 21 days.

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇

Action ⬆ ⬇

Pharmacokinetics ⬆ ⬇