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Providers might consider consultation with a specialist concerning risk for persistent CSF leak if an age-appropriate inactivated or recombinant vaccine cannot be used. ACIP will continue to review data on the efficacy and effectiveness of these vaccines as more information emerges. Influenza vaccination of health-care personnel: recommendations of the Healthcare Infection Control Practices Advisory Committee (HICPAC) and the Advisory Committee on Immunization Practices (ACIP). Chambers CD, Johnson D, Xu R, et al; OTIS Collaborative Research Group. WHO Director-General’s opening remarks at the media briefing on COVID-19; March 11, 2020. How to find us Although increased prevalence of injection site or systemic adverse reactions has been noted with concurrent administration in some of these studies, these symptoms have generally been reported to be mild or moderate. Allison MA, Daley MF, Crane LA, et al. Quadrivalent influenza egg-culture vaccine (QIVe) should also be considered as an alternative to QIVc, subject to the JCVI considerations outlined in the NHSE&I letter. Since different types of flu viruses cause infection every flu season, usually a new vaccine is produced and given for each flu season. Timing of vaccination might be a consideration (e.g., vaccinating during some period either before or after an immunocompromising intervention). Ma F, Zhang L, Jiang R, et al. Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Protect from light. More information on influenza vaccines and travel is available at https://wwwnc.cdc.gov/travel/diseases/influenza-seasonal-zoonotic-and-pandemic. Since the publication of the previous season’s guidance, two new influenza vaccines have been licensed. Initial public health response and interim clinical guidance for the 2019 novel coronavirus outbreak—United States, December 31, 2019–February 4, 2020. Young-Xu Y, Van Aalst R, Mahmud SM, et al. Randomized, double-blind controlled phase 3 trial comparing the immunogenicity of high-dose and standard-dose influenza vaccine in adults 65 years of age and older. In the study of Shingrix and IIV4 (101), most reactogenicity symptoms resolved within 4 days. Falsey AR, Treanor JJ, Tornieporth N, Capellan J, Gorse GJ. However, ACIP recommends that vaccine providers consider observing patients (seated or supine) for 15 minutes after administration of any vaccine to decrease the risk for injury should syncope occur (74). Influenza Other Respir Viruses 2018;12:132–7. Adults and children aged ≥9 years need only 1 dose of influenza vaccine for the 2020–21 season. Trivalent inactivated influenza vaccine and spontaneous abortion. McMillan M, Porritt K, Kralik D, Costi L, Marshall H. Influenza vaccination during pregnancy: a systematic review of fetal death, spontaneous abortion, and congenital malformation safety outcomes. Both contain 15 μg of HA per vaccine virus in each 0.5-mL dose (45 μg total for Fluad and 60 μg total for Fluad Quadrivalent) (72,99). Telephone: 404-639-2552; E-mail: Lgrohskopf@cdc.gov. Two new influenza vaccine licensures are described: In November 2019, FDA licensed Fluzone High-Dose Quadrivalent (HD-IIV4). Gaithersburg, MD: MedImmune; 2020. The potential contributions of these factors among persons aged ≥65 years have been assessed using a simulated mathematical model examining various scenarios of vaccination timing, timing of onset of the influenza season, rate of waning, and VE (31). All rights reserved. The information is not intended to cover all possible uses, directions, precautions, drug interactions or adverse effects, nor should it be construed to indicate that use of a particular drug is safe, appropriate or effective for you or anyone else. Clinical review: Fluad Quadrivalent. Abbreviations: ACIP = Advisory Committee on Immunization Practices; FDA = Food and Drug Administration; HA = hemagglutinin; IIV3 = inactivated influenza vaccine, trivalent; IIV4 = inactivated influenza vaccine, quadrivalent; IM = intramuscular; LAIV4 = live attenuated influenza vaccine, quadrivalent; MDV = multidose vial; NAS = intranasal; PFS = prefilled syringe; RIV4 = recombinant influenza vaccine, quadrivalent; SDV = single-dose vial. Vaccine 2007;25:3464–74. Mullooly JP, Bridges CB, Thompson WW, et al; Vaccine Safety Datalink Adult Working Group. Vaccine 2008;26:6383–91. Summaries of the VRBPAC discussion of March 4, 2020, during which the composition of the 2020–21 U.S. influenza vaccines was discussed, are available at https://www.fda.gov/advisory-committees/advisory-committee-calendar/vaccines-and-related-biological-products-advisory-committee-march-4-2020-meeting-announcementexternal icon. To be eligible for compensation under VICP, a claim must be filed within 3 years after the first symptom of the vaccine injury. CDC recommends annual influenza vaccination for everyone 6 months and older with any licensed, age-appropriate flu vaccine (IIV, RIV4, or LAIV4) with no preference expressed for any one vaccine over another. RIV4 is indicated for persons aged ≥18 years. Prospective cohort study of the safety of an influenza A(H1N1) vaccine in pregnant Chinese women. Clin Vaccine Immunol 2012;19:1296–303. Effectiveness of the 2003–2004 influenza vaccine among children 6 months to 8 years of age, with 1 vs 2 doses. Vaccine 2013;31:6122–8. Various influenza vaccines will be available for the 2020–21 season (Table 1). Do not start, stop, or change the dosage of any medicines without your doctor's approval. ACIP recommends that persons with immunocompromising conditions (including but not limited to persons with congenital and acquired immunodeficiency states, persons who are immunocompromised due to medications, and persons with anatomic and functional asplenia) should receive an age-appropriate IIV or RIV4. CONDITIONS OF USE: The information in this database is intended to supplement, not substitute for, the expertise and judgment of healthcare professionals. An IIV or RIV4 (as appropriate for the recipient’s age) is suitable for persons in all risk groups. No preferential recommendation is made for one influenza vaccine product over another for persons for whom more than one licensed, recommended, and appropriate product is available. The flu shot vaccine does not match all the flu viruses that are currently spreading. quadrivalent (protects against four types of flu), People with health problems such as asthma, diabetes, heart disease, chronic lung disease and other chronic illnesses or conditions, Caregivers of infants or family members with health problems.

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