influenza virus vaccine (nasal)

(in flue EN za VYE rus)
FluMist

What is the most important information I should know about influenza virus vaccine?

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People with minor illnesses, such as a cold, may be vaccinated. Those who are moderately or severely ill or have a fever should usually wait until they recover before getting influenza vaccine.

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The viruses used in the nasal influenza vaccine are live and can cause infection in individuals with decreased immune system response such as those with hereditary immune system disorders, HIV/AIDS, some types of cancer, and those receiving radiation or cancer chemotherapy. These individuals should not receive the nasal form of influenza virus vaccine. Household contacts of people with immune system problems should also not receive the nasal form of influenza virus vaccine unless they can avoid close contact (e.g., within the same household) for at least 21 days to prevent possible transmission of the virus.

What is influenza virus vaccine?

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Influenza virus ("flu") is a serious disease caused by a virus. Influenza virus spreads from an infected person to the nose or throat of others. Intranasal influenza vaccine exposes the individual to a small dose of active virus and causes the body to develop immunity to the disease.

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Influenza virus infection can cause fever, cough, sore throat, headache, chills, and muscle aches. Anyone can get influenza. Most people are ill with influenza for only a few days, but some get much sicker and may need to be hospitalized. Influenza causes thousands of deaths each year, mostly among the elderly.

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Intranasal influenza vaccine is recommended for healthy children and adults (5 to 49 years of age).

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Influenza virus vaccine can help prevent the disease. Many more people would get the disease if vaccination did not occur.

What should I discuss with my healthcare provider before receiving influenza virus vaccine?

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Anyone who has had a life-threatening allergic reaction to eggs or after receiving a dose of influenza vaccine should not get another dose. Anyone who has a history of Guillain-Barre Syndrome (GBS) should not receive influenza vaccine.

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Before using intranasal influenza virus vaccine, talk to your doctor if you have

a breathing or respiratory disorder such as asthma;

heart problems;

diabetes or another metabolic disorder;

kidney problems;

blood problems; or

immune suppression due to a disorder, disease, or medication or live in the same house as someone with immune suppression.

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You may not be able to use intranasal influenza virus vaccine, or you may require a dosage adjustment or special monitoring during treatment.

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People with minor illnesses, such as a cold, may be vaccinated. Those who are moderately or severely ill or have a fever should usually wait until they recover before getting influenza vaccine.

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Nasal influenza virus vaccine is in the FDA pregnancy category C. This means that it is not known whether it will be harmful to an unborn baby. Intranasal influenza vaccine is not recommended for use by pregnant women. Do not use nasal influenza virus vaccine without first talking to your doctor if you are pregnant. If influenza virus vaccine is needed during pregnancy, your doctor may recommend use of the injectable form which may be used by pregnant women past the first trimester.

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It is not known whether influenza virus vaccine passes into breast milk and if it will affect a nursing baby. Do not use influenza virus vaccine without first talking to your doctor if you are breast-feeding a baby.

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Influenza virus vaccine should not be administered to children and adolescents (younger than 18 years of age) who are taking aspirin. Influenza virus and aspirin increase the risk of Reye syndrome, a rare but often fatal disorder, in children.

How is influenza virus vaccine administered?

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Your doctor, nurse, or healthcare provider will administer the influenza virus vaccine as a nasal spray.

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Most people need only one dose each year to prevent influenza. Some children getting flu vaccine for the first time may need 2 doses.

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The best time to get the flu vaccine is in October or November. But because the flu season typically peaks between January and March, vaccination in December, or even later can be beneficial in most years.

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What happens if I miss a dose?

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Since only one dose of the vaccine is usually given, missing a dose should not occur.

What happens if I overdose?

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An overdose of influenza vaccine is unlikely to occur.

What should I avoid before or after getting influenza virus vaccine?

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There are no restrictions on food, beverages, or activity following vaccination with influenza virus vaccine unless otherwise directed by your healthcare provider.

What are the possible side effects of influenza virus vaccine?

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Getting the flu is much riskier than getting influenza vaccine. However, a vaccine, like any medicine, is capable of causing serious problems, such as severe allergic reactions. The risk of influenza vaccine causing serious harm, or death, is extremely small.

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Seek emergency medical attention or contact your doctor immediately if any of the following rare but serious side effects from influenza vaccine are experienced:

a serious allergic reaction including swelling of the lips, tongue, or face; difficulty breathing; closing of the throat; hives; paleness; weakness; dizziness; or a fast heart beat within a few minutes to a few hours after a dose; or

Guillain-Barre Syndrome (GBS) (muscle pain, weakness, or paralysis) (very rare).

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Other less serious side effects may be more likely to occur. Talk to your doctor if you experience:

slight fever;

headache;

tiredness;

muscle aches; or

nasal congestion or sore throat.

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Side effects other than those listed here may also occur. Contact your doctor about any side effect that seems unusual or that is especially bothersome.

What other drugs will affect influenza virus vaccine?

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Antiviral medications used to treat influenza [e.g., oseltamivir (Tamiflu), zanamivir (Relenza)] should not be used for 48 hours before or 2 weeks after a dose of intranasal influenza virus vaccine.

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Other nasal medications should not be used at the same time as nasal influenza virus vaccine unless otherwise directed by your doctor.

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Talk to your doctor before receiving influenza vaccine if you are taking any of the following medications that may affect the immune system:

an oral or injectable steroid medication such as betamethasone (Celestone), cortisone (Cortone), dexamethasone (Decadron, Dexone), hydrocortisone (Cortef, Hydrocortone), methylprednisolone (Medrol), prednisolone (Prelone, Pediapred), prednisone (Orasone, Deltasone, others), or triamcinolone (Aristocort);

an inhaled or nasal steroid such as beclomethasone (Qvar, Beclovent, Beconase, Vanceril, Vancenase), budesonide (Pulmicort, Rhinocort), flunisolide (Aerobid, Nasalide, Nasarel), fluticasone (Flovent, Flonase), mometasone (Nasonex), or triamcinolone (Azmacort, Nasacort);

treatment for cancer with chemotherapy (medication), radiation, or x-rays;

azathioprine (Imuran);

basiliximab (Simulect);

cyclosporine (Sandimmune, Neoral, Gengraf);

etanercept (Enbrel);

leflunomide (Arava);

muromonab-CD3 (Orthoclone);

mycophenolate mofetil (CellCept);

sirolimus (Rapamune); or

tacrolimus (Prograf).

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Drugs other than those listed here may also interact with influenza virus vaccine. Do not receive influenza virus vaccine without first talking to your doctor if you take any other prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

Where can I get more information?

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Your doctor or pharmacist may have additional information or suggest additional resources regarding influenza vaccine.

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Remember, keep this and all other medicines out of the reach of children, never share medicines with others, and use this medication only for the indication prescribed.

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Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.