Influenza vaccination best prevention against disease

NEW YORK — Influenza vaccination remains the best way to prevent seasonal influenza, according to a presentation here at the 26th Annual Infectious Diseases in Children Symposium.

C. Buddy Creech, MD, MPH, assistant professor of pediatrics at Vanderbilt University and a member of the Infectious Diseases in Children Editorial Advisory Board, said there are numerous vaccine options available to account for age, presence of co-morbidities, and allergy history.

C. Buddy Creech

“The sheer number of choices we now have for influenza vaccination is remarkable,” Creech said.

According to the presentation, quadrivalent influenza vaccines will eventually replace trivalent vaccines. For people who are unable to get vaccinated, chemoprophylaxis is available.

Overall, vaccine efficacy is generally 70% against laboratory-confirmed influenza, but it does depend on how well the vaccine matches the circulating strains. Data is limited for children aged 6 to 23 months but efficacy has been shown to be lower. However, live-attenuated influenza vaccine (LAIV) efficacy appears to be higher in children than the inactivated influenza vaccine.

Patients aged younger than 6 months should not receive influenza vaccine along with patients who have a severe allergy to chicken eggs, a history of severe reaction to influenza vaccines, and those with a history of Guillain-Barre that occurred following influenza vaccination.

LAIV should not be used in the following:

People with a history of severe allergic reaction to gentamicin, gelatin, or arginine or those on concomitant aspirin therapy;
Children aged younger than 2 years;
Adults aged older than 50 years;
Children aged 2 to 4 with a history of wheezing or asthma in the last 12 months;
People with asthma or chronic co-morbidities;
Pregnant women; or
close contacts of immunocompromised hosts.

Chemoprophylaxis can be used for protection of high-risk patients who cannot be immunized or those who were immunized less than 2 weeks before influenza circulation began. It can also be used to protect in the event of a vaccine strain mismatch; to protect unimmunized contacts of high-risk children; and for control of influenza outbreaks in closed settings.

Creech addressed an audience question about how to address patients when they refuse influenza vaccination because they claim they ended up with influenza infection after their last influenza vaccination.

“I tell them that although it may have felt like you had the flu, it is impossible to get the flu from an inactivated vaccine,” he said. “I explain to them that it is a good thing because it is simply their body developing a robust immune response to the vaccine.”

For more information:

Creech CB. Presented at: IDC NY 2013; Nov. 16-17, 2013; New York.

Disclosure: Creech reports no relevant financial disclosures.