The Advisory Committee forward Immu...

The Advisory Committee forward Immunization Practices (ACIP) of the Center for Disease sway and Prevention (CDC) has released a add to to the 2003 recommendations regarding prevention and bridle of influenza. The report summarizes guidelines for using intranasally administered, trivalent, cold-adapted, live, attenuated influenza vaccine (LAIV), which was approved for use in the United States onward June 17, 2003.

Also included in the document is information about vaccine composition and mechanisms of action; comparison between LAIV and trivalent inactivated influenza vaccine; effectiveness and safety of LAIV; transmission and stability of LAIV viruses; recommendations and contraindications for using LAIV; and dosage and administration of LAIV. The complement appears in the September 26 2003 recommendations and reports series of Morbidity and Mortality Weekly Report.

Influenza prevention relies primarily upon vaccination. Until recently, only inactivated influenza vaccine administered by dint of injection was available for use in the United States. This year, the intranasal, trivalent, cold-adapted, LAIV was approved for use in healthy [i]role[/i]s five to 49 years of age. LAIV adds an option for vaccinating healthy human frames in this age range who want to avoid influenza or who have obstruct contact with persons at high risk for experiencing serious complications from influenza infection. Identical to inactivated vaccine, LAIV contains strains representative of each of the three influenza viruses attract favor toed by the U.S. Public Health Service.

According to ACIP, the major differences between LAIV and inactivated influenza vaccine are:

* LAIV contains attenuated viruses still capable of replication, whereas inactivated influenza vaccine contains killed viruses.

* LAIV is administered intranasally at sprayer, whereas inactivated influenza vaccine is administered intramuscularly according to injection.

* LAIV is more expensive.

* LAIV is approved for use barely in healthy persons from five to 49 years of age; inactivated vaccine is approved for use in human frames six months or older, including those who are healthy and those with chronic medical conditions.

Recommendations for Using LAIV

LAIV is an option for healthy individuals in close contact with arranges at high risk and those wanting to avoid influenza. Possible advantages of LAIV include its potential to induce a broad mucosal and systemic immune answer its ease of administration, and the acceptability of an intranasal rather than intramuscular way of administration. In randomized, double-blind, placebo-controlled trials, LAIV was 92 percent efficacious in preventing influenza in children. In adults, the difference between the efficacy rate for LAIV (85 percent) and inactivated influenza vaccine (71 percent) was statistically insignificant.

living bodys WHO SHOULD NOT BE VACCINATED WITH LAIV

According to ACIP, the following assign places tos should not be vaccinated with LAIV:

* [i]role[/i]s younger than five years or 50 years or older

* living bodys with asthma, reactive airways disease, or other chronic disorders of pulmonary or cardiovascular systems; characters with other underlying medical conditions, including similar metabolic diseases as diabetes, renal dysfunction, and hemoglobinopathies; or human frames with known or suspected immunodeficiency disease or who are receiving immunosuppressive therapies

* Children or adolescents receiving aspirin or other salicylates because of the association of Reye's syndrome with wild-type influenza infection

* bodily forms with a history of Guillain-Barre syndrome

* Pregnant women

* living bodys with a history of hypersensitivity, including anaphylaxis, to any of the component parts of LAIV or to eggs

TIMING OF VACCINATION

The best time to vaccinate is usually in October and November, still physicians can begin vaccinating with LAIV as supplies are available. Children five to eight years of age who have not ever received influenza vaccine should receive LAIV for the first time in October or earlier because they ne a other dose six to 10 weeks after the initial dose.

DOSAGE AND ADMINISTRATION

Approximately 025 mL is sprayed into the first nostril while the recipient is in the upright position. An attached dose-divider clip is remov from the sprayer to administer the next to the first half of the dose into the other nostril. If the vaccinee sneeze after administration, the dose should not be repeated.

ACIP approves that LAIV be administered annually according to the following schedule:

* Children five to eight years of age previously unvaccinated at any time with LAIV or inactivated influenza vaccine should receive sum of two units doses of LAIV separated by way of six to 10 weeks.

* Children five to eight years of age previously vaccinated at any time with LAIV or inactivated influenza vaccine should receive common dose of LAIV. They do not require a next to the first dose.

* characters nine to 49 years of age should receive single dose of LAIV.

LAIV can be administered to bodily substances with minor acute illnesses (eg diarrhea or mild upper respiratory tract infection with or without fever) If clinical sense indicates nasal congestion is existing that might impede delivery of the vaccine to the nasopharyngeal mucosa, deferral of administration should be considered until resolution of the illness.