INFLUENZA STANDING ORDERS FOR VOLUNTEER FIRST …



Delaware Health & Social Services

Division of Public Health

IMMUNIZATION

STANDING

ORDERS

2017-2018

SEASONAL INFLUENZA

VACCINATION

Delaware Division of Public Health

2017-2018 Seasonal Influenza Standing Orders

2017-2018 Seasonal Influenza Vaccine Formula:

Vaccine viruses included in the 2017-18 Quadrivalent Vaccines are:

▪ A/Michigan/45/2015 (H1N1) pdm09-like virus

▪ A/Hong Kong/4801/2014 (H3N2)-like virus

▪ B/Brisbane/60/2008-like virus (B/Victoria lineage)

▪ B/Phuket/3073/2013-like virus (B/Yamagata lineage) (only in quadrivalent vaccine)

Trivalent vaccines for this season will contain the first three but not the fourth vaccine virus above.

Vaccine prepared for a previous influenza season should NOT be administered to provide protection for the current season.

All persons aged > 6 months and who have no contraindications should be vaccinated annually. Influenza vaccination should not be delayed to procure a specific vaccine preparation if an appropriate one is already available. An age-appropriate formulation of vaccine should be used.

When vaccine supply is limited vaccination efforts should focus on delivering vaccination to persons who:

▪ are aged 6 months to less than 5 years ( 40);

▪ are health care personnel*;

▪ are household contacts and caregivers of children aged 50 years, with particular emphasis on vaccinating contacts of children aged 50% of recipients), redness and/or swelling at the vaccination site are the most frequent side effects of vaccination. Other mild problems include headache, lethargy, sore throat, red itchy eyes, cough, fever and muscle aches. If these problems occur, they usually begin soon after the injection and last 1-2 days.

▪ Other possible infrequent, but severe problems include immediate responses such as hives, angioedema, allergic asthma, or systemic anaphylaxis (severe allergic reaction is estimated at less than 1 in a million doses.)

GUIDELINES FOR INACTIVATED INFLUENZA VACCINE (IIV) VACCINATION OF CHILDREN AND ADULTS

|CIRCUMSTANCE |ACTION |

|Well individual, eligible for vaccine as indicated above |Immunize |

|Moderate or severe acute illness |Defer immunization until symptoms have abated |

|History of anaphylactic reaction or hypersensitivity to |Do NOT immunize. Refer to primary care provider |

|eggs | |

|HIV infected persons |Immunize with IIV preparation |

|Pregnant and Lactating Women |Immunize at any gestation with IIV |

|Simultaneous administration |Can receive influenza vaccine at the same time they receive other vaccinations |

| |Give 2 doses this season |

|Infant/Child 6 months through 8 years of age who has | |

|received: | |

| | |

|No (zero) or one dose trivalent or quadrivalent influenza| |

|vaccine before July 1, 2017 | |

| | |

|OR | |

| | |

|Infant/Child 6 months through 8 years of age for whom | |

|vaccine history before July 1, 2017 cannot be determined | |

| |Give 1 dose this season |

|Infant/Child 6 months through 8 years of age who has | |

|received: | |

| | |

|Two or more doses of trivalent or quadrivalent influenza | |

|vaccine prior to July 1, 2017 | |

| |Immunize |

|Well individual, eligible for vaccine, who received a | |

|2016-2017 seasonal vaccine | |

Vaccine Excipient & Media Summary

Excipients Included in Influenza Vaccines Purchased by DPH, by Vaccine

This table includes not only vaccine ingredients (e.g., adjuvants and preservatives), but also substances used during the manufacturing process, including vaccine-production media, that are removed from the final product and present only in trace quantities. In addition to the substances listed, most vaccines contain Sodium Chloride (table salt).

All reasonable efforts have been made to ensure the accuracy of this information. If in doubt, check the manufacturer’s package insert. See links below.

|Vaccine |Contains |Source: Manufacturer’s P.I. |

| | |Dated |

|Influenza (Fluarix Quadrivalent) |octoxynol-10 (Triton X-100), α-tocopheryl hydrogen succinate, |Revised: 4/2017 |

| |polysorbate 80 (Tween 80), hydrocortisone, gentamicin sulfate, | |

| |ovalbumin (egg protein), sodium deoxycholate, and formaldehyde | |

|Influenza (Fluzone: Quadrivalent) |ovalbumin(egg protein), sodium phosphate-buffered isotonic sodium |July 7 |

| |chloride solution, formaldehyde, octylphenol ethoxylate (Triton | |

| |X-100), and thimerosal/mercury (multi-dose vial only) | |

GlaxoSmithKline Fluarix® Quadrivalent Influenza Vaccine Suspension for Intramuscular Injection. Highlights of Prescribing Information, 2017-2018 Formula, Revised: 4/2017, Accessed: 8/16/16.

.

Sanofi Pasteur 450/477 Fluzone® Quadrivalent, Highlights of Prescribing Information, 2017-2018 Formula, Revised: July 2017, Accessed: 8/16/17.

.

References and Resources:

Center for Disease Control and Prevention. MMWR Weekly. Prevention and Control of Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices, United States, 2017–18 Influenza Season 66(2); 1-20.

Centers for Disease Control and Prevention. Vaccine Information Statement, Flu Vaccine, Inactivated (8/7/15) 42 U.S.C. §300aa-26.

GlaxoSmithKline Fluarix® Quadrivalent Influenza Vaccine Suspension for Intramuscular Injection. Highlights of Prescribing Information, 2017-2018 Formula, Revised: 4/2017, Accessed: 8/16/16.

.

Sanofi Pasteur 450/477 Fluzone® Quadrivalent, Highlights of Prescribing Information, 2017-2018 Formula, Revised: July 2017, Accessed: 8/16/17.

.

THE PRECEDING PROCEDURES, GUIDELINES AND INFLUENZA STANDING ORDERS ARE APPROVED FOR USE BY DIVISION OF PUBLIC HEALTH REGISTERED NURSES AND REGISTERED NURSES WORKING UNDER THE DIRECTION OF THE DIVISION OF PUBLIC HEALTH.

____________________________________________

EFFECTIVE DATES: September 9, 2017 – June 30, 2018

____________________________________________

| | |9/8/2017 |

|Awele Maduka-Ezeh MD, MPH | |Date |

|Medical Director | | |

|Division of Public Health | | |

|Delaware Health and Social Services | | |

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Inactivated Influenza Vaccine (IIV)

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