Influenza A (H1N1) Monovalent Nasal-Spray Flu Vaccine (Live Attenuated
Influenza Vaccine [LAIV]
What is the nasal spray flu vaccine?
There are two types of flu vaccine: the
flu shot and the nasal spray vaccine. Both types of vaccine are being made
against 2009 H1N1. The nasal spray flu vaccine (sometimes called LAIV for Live
Attenuated Influenza Vaccine) is a vaccine made with live, weakened viruses that
cannot grow at normal body temperature and is given via a nasal sprayer.
This
vaccine was approved for seasonal influenza viruses in 2003 and tens of millions
of doses of the vaccine have been given in the United States.
How is the 2009 H1N1 nasal spray vaccine different from the seasonal nasal
spray vaccine?
The 2009 H1N1 nasal spray vaccine is being made in the same way as the
seasonal nasal spray vaccine, but instead of containing three weakened live flu
viruses, it only contains weakened 2009 H1N1 virus. (That is why it' is called a
"monovalent" vaccine.). The recommendations for who can get the 2009 H1N1 nasal
spray vaccine are the same as for seasonal nasal spray vaccine. LAIV is
recommended for use in healthy* people 2 years to 49 years of age who are not
pregnant.
Who can be vaccinated with the 2009 H1N1 nasal-spray flu vaccine (LAIV)?
The 2009 H1N1 nasal spray vaccine is recommended for use in healthy people 2
years Through 49 years of age who are not pregnant. See below
Can health care providers get the live attenuated influenza vaccine?
Yes. LAIV is a very good option for most health care providers who are
healthy, younger than 50 years old, and not pregnant. However, health care
providers should not get LAIV if they are providing medical care for patients
who require special environments in the hospital because they are profoundly
immunocompromised (e.g., those who work in bone marrow transplant units).
Although no immunocompromised patient has been shown to be harmed by use of LAIV
among health care workers, the recommendation against the use of LAIV in health
care workers with this type of patient contact is intended as an extra
precaution for fragile immunocompromised patients. Health care workers with this
type of patient contact can get LAIV, but if they do, they should wait 7 days
after being vaccinated before returning to duties that include care of severely
immunocompromised patients in special environments.
Who should not be vaccinated with the 2009 H1N1 nasal-spray flu vaccine LAIV?
Certain people should not get a nasal spray flu vaccine, including the 2009
H1N1 nasal spray vaccine. This includes:
- People younger than 2 years of age;
- Pregnant women;
- People 50 years of age and older;
- People with a medical condition that places them at higher risk for
complications from influenza, including those with chronic heart or lung
disease, such as asthma or reactive airways disease; people with medical
conditions such as diabetes or
kidney failure; or people with illnesses that
weaken the immune system, or who take medications that can weaken the immune
system;
- Children younger than 5 years old with a history of recurrent wheezing;
- Children or adolescents receiving
aspirin therapy;
- People who have had Guillain-Barré syndrome (GBS), a rare disorder of the
nervous system, within 6 weeks of getting a flu vaccine,
- People who have a severe allergy to chicken eggs or who are
allergic to any of the nasal
spray vaccine components.
Should the nasal-spray flu vaccine be given to patients with chronic diseases other than those specifically listed above?
No. The nasal-spray flu vaccine is approved for use only in healthy* people 2
years to 49 years of age who are not pregnant.
Breastfeeding mothers and pregnant women and the H1N1
nasal-spray flu vaccine
Are there any contraindications to giving breastfeeding mothers the 2009 H1N1
vaccine?
Breastfeeding is not a contraindication for the nasal spray flu vaccine.
Women who are breastfeeding can get the nasal spray vaccine, including 2009 H1N1
vaccine.
Can pregnant women be in contact with someone who has gotten the nasal spray vaccine (LAIV)?
Yes. A pregnant woman can be in close contact with someone who has gotten the
nasal spray flu vaccine (LAIV). A pregnant woman can also administer (give) a
nasal spray vaccine (LAIV). Because the viruses in the nasal spray vaccine are
attenuated or weakened, vaccine viruses are unlikely to cause any illness
symptoms, even if an unvaccinated person inadvertently gets vaccine viruses in
their nose. The nasal spray vaccine against seasonal influenza viruses has been
used in millions of school children and healthy adults since it was licensed,
and there have been no reports of pregnant women becoming ill after exposure to
their vaccinated children or other family members.
While it's OK for her contacts to get the nasal spray vaccine, this vaccine
should not be given to pregnant women. While LAIV is not known to be a safety
risk for pregnant women, there have not been studies of LAIV among pregnant
women to assess safety and effectiveness for use in this group. LAIV can be
given to women after they have delivered, even if they are nursing.
CDC recommends that pregnant woman get both the 2009 H1N1 flu shot and the
seasonal flu shot. Flu shots are made with a killed virus, and have not been
shown to cause harm to pregnant women or their babies.
Nasal-spray flu vaccine, ill patients, passing the
vaccine virus to others, and immunocompromised patients
Can the nasal-spray flu vaccine be given to patients when they are ill?
The nasal-spray flu 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 limit delivery of the
vaccine to the nasal lining, then delaying of vaccination until the nasal
congestion is reduced should be considered.
Can people receiving the nasal-spray flu vaccine LAIV pass the vaccine viruses to others?
In clinical studies, transmission of vaccine viruses to close contacts
occurred only rarely. 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 illness symptoms since the vaccine viruses have
not been shown change into typical or naturally occurring influenza viruses.
Can contacts of people with weakened immune systems get the nasal-spray flu vaccine?
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 hematopoietic 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.
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