With flu season just around the corner, it is important for pharmacists to be up-to-date on the latest recommendations. Influenza can result in serious complications including hospitalization and death. Routine annual vaccination is recommended by the end of October for all individuals at least 6 months of age and older who do not have contraindications.

Pharmacists can play an important role in patient education and administering influenza vaccines. Many pharmacies across the country have already received vaccines and have started administering them to patients.  

The ACIP does not give a preference for 1 influenza vaccine product over another when there are multiple licensed, recommended, and age-appropriate immunizations available.1 

The FDA approved an expanded age indication for Afluria Quadrivalent (Seqirus), which is now licensed for individuals 6 months and older. Afluria dosing is 0.25 mL per dose for children 6 through 35 months and 0.5 mL per dose for all individuals 36 months and older.1 

Ina addition, there was a recent change in dosing for the Fluzone Quadrivalent (Sanofi), and children 6-35 months can receive either 0.25 mL or 0.5 mL per dose. Children at least 36 months and adults should receive 0.5 mL per dose.1

Children ages 6 months-8 years receiving their influenza vaccine for the first time should be administered 2 doses separated by at least 4 weeks.1 Pharmacists should educate parents to make sure that children receiving the influenza vaccine for the first time get it early since it becomes effective 2 weeks after the second dose.1

The live attenuated influenza vaccine FluMist (AstraZeneca) nasal spray also is an option this season for individuals 2-49 years.1 However, this nasal spray may be limited during the 2019-2020 season due to manufacturing constraints.2 

The following influenza vaccine products are available for children:1
  • Afluria Quadrivalent 0.25 mL or 0.5 mL per dose depending upon age
  • Fluarix Quadrivalent (GSK) 0.5 mL per dose
  • FluLaval Quadrivalent (GSK) 0.5 mL per dose
  • Fluzone Quadrivalent 0.25 mL or 0.5 mL per dose
  • Flucelvax Quadrivalent (Seqirus) 0.5 mL per dose
  • FluMist 0.2 mL per dose
Pharmacists should remind patients that once administered, the influenza vaccine takes about 2 weeks for it to become effective. Remind patients that an annual influenza vaccine is the best form of protection from the flu. Other flu prevention strategies that should be exercised along with vaccination include frequent handwashing with soap and water, and avoiding close contact with sick individuals.

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REFERENCES
  1. Grohskopf LA, Alyanak E, Broder KR, Walter EB, Fry AM, Jernigan DB. Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices-United States, 2019-20 Influenza Season. MMWR Recomm Rep 2019;68(No. RR-3):1-21. DOI: http://dx.doi.org/10.15585/mmwr.rr6803a1. Accessed August 24, 2019. 
  2. ACIP approves recommendations on MenB, HepA, flu vaccines. AAP website. https://www.aappublications.org/news/2019/06/28/acip062819. Published June 28, 2019.  Accessed August 24, 2019.