2009 Novel H1N1 Influenza Vaccine Key Points

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1 General Information 2009 Novel H1N1 Influenza Vaccine Key Points Messages: Please be patient. Vaccine will be coming. Meanwhile, use other prevention methods such as hand washing, covering coughs and sneezes, staying home when sick, and avoiding sick people. These measures may seem simple, but they really can help reduce sickness. Locate a seasonal or H1N1 influenza vaccine at or call Call the clinic BEFORE you travel to check vaccine availability. Vaccine Supply: The H1N1 vaccine is delivered directly to local health departments or designated providers in Utah from the central vaccine distributor. The Utah Department of Health does not control the supply of the vaccine. Because vaccine shipments arrive weekly in limited amounts, local health departments may be targeting certain people within the priority groups listed below based on the needs for their county. Check with your local health department or designated provider to find out what type of vaccine they have available and to whom they are giving it. Vaccine Fees: The H1N1 vaccine is free of charge. However, some providers may charge a fee up to $19.59 to give the vaccine. Check with your local health department or designated provider. Medicare Part B will cover the cost for providers to give the H1N1 vaccine. The Veteran s Administration (VA) will provide the H1N1 vaccine to Veterans who are enrolled in the VA health care system. There will be no charge to eligible Veterans. Some insurance plans may cover the H1N1 vaccine. Check with your insurance plan. TRICARE will cover the H1N1 vaccine for TRICARE beneficiaries. This coverage applies to beneficiaries served both in Military Treatment Facilities and in private provider offices that are authorized to treat TRICARE beneficiaries. H1N1 Vaccination Recommendations Priority groups: The 2009 novel H1N1 influenza vaccine is recommended for the following priority groups: Household and caregiver contacts of children younger than 6 months of age (e.g. parents, siblings, and daycare providers) Health care and emergency medical services personnel Persons from 6 months through 24 years of age Persons aged 25 through 64 years who have medical conditions associated with a higher risk of influenza complications Once providers meet the demand for vaccine among persons in these initial target groups, vaccination is recommended for all persons 25 through 64 years of age. Once vaccine demand among younger age groups has been met, programs and providers should offer vaccination to people 65 or older. 1

2 Who should NOT get vaccinated with any type of H1N1 influenza vaccine: People who have a severe allergy to chicken eggs People who have had a severe reaction to an influenza vaccination People who developed Guillain-Barré syndrome (GBS) within 6 weeks of getting an influenza vaccine previously Children younger than 6 months of age (influenza vaccine is not approved for this age group) People who have a moderate-to-severe illness with a fever (they should wait until they recover to get vaccinated). H1N1 Influenza Vaccines Vaccine Types: There are two types of 2009 novel H1N1 influenza vaccines: o Nasal spray made from a weakened live virus o Inactivated injectable (shot) made from a dead virus Live-virus nasal spray vaccine: The 2009 H1N1 live-virus nasal spray vaccine is approved and recommended for the following healthy people: 2-49 years of age who are not pregnant and in one of these priority groups: o Household and caregiver contacts of infants younger than 6 months o Health care and emergency medical services personnel o Persons with medical conditions that place them at higher risk of influenza complications The 2009 H1N1 live-virus nasal spray vaccine should NOT be given to the following groups: People with a severe (life threatening allergy to eggs or to any other substance in the vaccine Children younger than 2 and adults 50 years and older Anyone with a weakened immune system Anyone with a long-term health problem, such as o Heart disease o Kidney disease o Liver disease o Lung disease o Metabolic diseases, such as diabetes o Asthma o Anemia and other blood disorders Children younger than 5 years with asthma or one or more episodes of wheezing during the past year Anyone with certain muscle or nerve disorders (such as cerebral palsy) that can lead to breathing or swallowing problems Anyone in close contact with a person with a severely weakened immune system (requiring care in a protected environment, such as a bone marrow transplant unit) Children or adolescents on long-term aspirin treatment 2

3 Side effects of live-virus nasal spray vaccine: Children: Adults: Runny nose Runny nose Headache Headache Wheezing Sore throat Vomiting or diarrhea Cough Muscle aches Fever is not a common side effect in adults Fever receiving the nasal spray influenza vaccine. Inactivated influenza vaccine (shot): The 2009 H1N1 inactivated influenza vaccine (shot) is approved and recommended for the following groups: People 6 months of age and older Healthy people People with chronic medical conditions Side effects of inactivated influenza vaccine (shot): If these problems occur, they usually begin soon after the shot and last 1-2 days. Soreness, redness, tenderness or swelling where the shot was given Fainting (mainly adolescents) Headache Muscle aches Fever Nausea Severe side effects or allergic reactions from either vaccine: Life-threatening allergic reactions to vaccines are very rare. If they do occur, it is usually within a few minutes to a few hours after the vaccination and you should get medical attention immediately. Any unusual condition, such as a high fever or behavior changes Difficulty breathing Hoarseness or wheezing Hives Paleness Weakness Fast heart beat Dizziness Vaccine Information Vaccine Safety: The H1N1 influenza vaccine is made the same way the seasonal influenza vaccine has been made for many, many years and has a good safety record. It is simply a different type of virus. If the H1N1 virus had been circulating before the seasonal influenza vaccine was made, it would have been included in the seasonal influenza vaccine. The seasonal influenza vaccine contains the three most common types of influenza viruses that are circulating. The H1N1 outbreak appeared after manufacturing for the seasonal influenza vaccine began. For those who are concerned about the preservative thimerosal, preservative-free vaccines will be available. 3

4 Vaccine Timing/Spacing: The two inactivated 2009 H1N1 vaccines can be given at any time before, after, or at the same visit as each other. The 2009 H1N1 live-virus nasal spray vaccine can be given at the same visit as any other live or inactivated vaccine EXCEPT the seasonal live-virus nasal spray vaccine (FluMist). The seasonal live-virus nasal spray vaccine (FluMist) and the 2009 H1N1 live-virus nasal spray vaccine should not be given during the same visit, and should be separated by at least 4 weeks or 28 days. However, if the interval between the seasonal FluMist and 2009 H1N1 live-virus nasal spray vaccine is less than 4 weeks, neither vaccine needs to be repeated. Children younger than 10 years of age should receive two doses of either type of the 2009 H1N1 influenza vaccine separated by 4 weeks. However, if the second dose is separated from the first dose by at least 21 days, the second dose can be considered valid. If the vaccine doses are separated by less than 21 days, the second dose should be repeated four weeks after the first dose was given. Pregnant/Breastfeeding Women and Vaccination: Seasonal influenza vaccine has been recommended for all pregnant women at any time during pregnancy for years, and has not been shown to cause harm to a pregnant woman or her baby. The inactivated H1N1 influenza vaccine (shot) is also recommended for all pregnant women at any time during pregnancy. should not get the live-virus nasal spray. Live-virus vaccines are generally not recommended for pregnant women because of the theoretical or possible risk to the fetus. Both seasonal influenza and 2009 H1N1 influenza vaccines should be given to breastfeeding mothers. Vaccination for breastfeeding women is especially important for infants less than 6 months old because they cannot get the influenza vaccine. Protection against influenza is transferred by breastfeeding and further reduces the infant s chances of getting sick with the influenza. Breastfeeding women can get either the live-virus nasal spray or the injectable influenza vaccine (shot). There is no evidence that the preservative thimerosal is harmful to a pregnant woman or a fetus. However, because some women are concerned about exposure to preservatives during pregnancy, manufacturers are producing preservative-free seasonal influenza vaccine and 2009 H1N1 influenza vaccine in single dose syringes. Pregnant women receive either influenza vaccine with or without thimerosal. Immunocompromised Individuals and Vaccination: People who are in contact with others with severely weakened immune systems when they are being cared for in a protective environment (for example, people with stem cell transplants) should not get the nasal spray vaccine, including the 2009 H1N1 nasal spray vaccine if they will come into contact with the severely immunocompromised person within 7 days of vaccination. People who have contact with others with lesser degrees of immunosuppression (for example, people with diabetes, people with asthma taking corticosteroids, or people infected with HIV) can get the nasal spray vaccine. Transmission of virus from a person vaccinated with the live-virus nasal spray vaccine: The current estimated risk of getting infected with vaccine virus after close contact with a person vaccinated with the nasal-spray flu vaccine is low (0.6%-2.4%). Because the viruses are weakened, infection is unlikely to result in influenza symptoms since the vaccine viruses have not been shown to change into the natural influenza virus infection. 4

5 Sickness and Vaccination: If you are moderately or severely ill, you might be advised to wait until you recover before getting the H1N1 influenza vaccine. If you have a mild cold or other illness, there is usually no need to wait. The nasal-spray influenza vaccine can be given to people with minor illnesses (e.g., diarrhea or mild upper respiratory tract infection with or without fever). However, if nasal congestion is present, that might reduce the effectiveness of the nasal spray vaccine. Delaying vaccination with the nasal spray until the nasal congestion is reduced should be considered. Immunity from H1N1 Infection versus Vaccination: People who had an H1N1 influenza illness confirmed by a specific laboratory test (rrt-pcr) earlier in 2009 can be considered immune and do not need to be vaccinated this year. If the illness was not confirmed by that specific test, people in the priority groups should get vaccinated. Check with your health care provider to find out if you need the H1N1 vaccine. Tell your health care provider if you had: A life-threatening allergic reaction after a dose of seasonal flu vaccine Guillain-Barré syndrome (a severe paralytic illness also called GBS) Any influenza vaccine (seasonal or H1N1) this year Utah Department of Health Immunization Program 10/14/09 5