Flu Vac 2018/19 - Clinical FAQ's
How is the injectable flu vaccine given?
- The inactivated influenza vaccine should be administered as an intramuscular injection using a 25mm needle
- For infants aged six months to one year, the anterolateral aspect of the thigh should be used.
- For those aged one year and over, the deltoid muscle in the upper arm is the preferred muscle.
Fluad is being supplied with an orange hub 25mm needle and should not confuse this needle with the shorter orange (16mm) needle used to give subcutaneous injections.
The needle is suitable for use with patients taking anticoagulants or with a bleeding disorder.
Fluad will be in syringes that are pre-filled and the needle will be supplied separately (Luer Lock Presentation) which means the needle will have to be attached to the syringe before administration.
Can you give the vaccine subcutaneously?
Fluarix Tetra and Fluad® are not licensed for subcutaneous administration so should only be administered intramuscularly.
What about vaccination of patients taking anticoagulants or with a bleeding disorder?
Individuals on stable anticoagulation therapy, including individuals on warfarin who are up-to-date with their scheduled INR testing and whose latest INR was below the upper threshold of their therapeutic range can receive intramuscular vaccination. If in any doubt, consult with the clinician responsible for prescribing or monitoring the individual’s anticoagulant therapy. https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/special-situations.html
What if you are unsure if a patient has already had a flu vaccination?
If there is nothing documented, then the patient should be offered a flu vaccination. An additional dose is unlikely to cause them any harm. Any adverse reactions are likely to be similar to any other person receiving one dose of the vaccine.
What about patients who have recently been diagnosed with the flu?
These patients should be offered the vaccine. Both the inactivated flu vaccine and the LAIV can be given at any time following recovery providing there are no contraindications to vaccination and the patient is not acutely unwell.
Can the flu vaccine (LAIV) be given with other vaccines?
Although it was previously recommended that, where vaccines cannot be administered simultaneously, a four-week interval should be observed between live viral vaccines. JCVI has now advised that no specific intervals need to be observed between the live attenuated intranasal flu vaccine and other live vaccines.
What about patients who have an existing medical condition?
Egg Allergies – Adults
- Most flu vaccines are prepared from flu viruses grown in embryonated hen’s eggs – the final vaccine products contain varying amounts of egg protein as ovalbumin
- Adults with egg allergy can be immunised in any setting using an inactivated flu vaccine with an ovalbumin content less than 0.12 µg/ml (equivalent to <0.06 µg for 0.5ml dose)
- Adults with a severe anaphylaxis to egg that has previously required intensive care should be referred to specialists for immunisation in hospital
- There is no ovalbumin-free vaccine available for the 2018/19 flu season
- Ovalbumin content for the 2018/19 flu vaccines is published on PHE Annual flu programme webpage .
Egg Allergies – Children
- Please see our web page - Childhood flu vaccination programme