Vaccine

Availability

Who is making the 2009 H1N1 vaccine?

The five manufacturers that make seasonal vaccine are in the process of manufacturing the 2009 H1N1 influenza vaccine. The five manufacturers that are producing vaccine for the U.S. are: Sanofi Pasteur, CSL Limited, MedImmune LLC, Novartis Vaccines and Diagnostics Limited, and Glaxo Smith Kline (GSK).

When will the vaccine be available?

Initial shipments to the state arrived the week of October 5, 2009. Appreciable supplies are expected by late fall/early winter.

Where can I get the 2009 H1N1 vaccine?

Vaccine will be available in a variety of settings, such as health care provider offices, vaccination clinics organized by local health departments, health care facilities, school based clinics, pharmacies, and other private settings such as certain workplaces. You should check with your own primary care provider first to determine if you can get your vaccine there. Please also keep in mind, that not all locations will get the vaccine at the same time. You may wish to check for information on the NYSDOH website regarding where to get vaccine.

My health care provider doesn't seem to have seasonal vaccine available. Why?

The number of doses of seasonal influenza vaccine that will be available is very close (97%) to the number of doses originally anticipated for the 2009-2010 seasonal influenza season and the vaccine has been made available earlier this season than ever before. People have been responding to vaccine availability by getting immunized earlier in the season.

Because the total number of doses that will be made this year is approximately the same as the number of doses that were actually administered last year, an increase in demand cannot be met this season. Manufacturers are not able to produce more seasonal influenza vaccine for this season because their facilities are currently being used for H1N1 vaccine production.

Some manufacturers fell short of their planned number of doses, and took orders that exceed the number of doses they now expect to make. In addition, some manufacturers have had a delay in the availability of vaccine, and this is resulting in orders that won't be completed until November. However, there are many millions of doses of flu vaccine yet to be distributed this season. You may be able to obtain vaccine from your usual provider, or you may have to obtain the vaccine from an alternative location. You can find a location to get vaccinated by checking the American Lung Association web site that identifies clinics that have seasonal flu vaccine available: http://www.flucliniclocator.org/

We are still early in flu season; there is still time to get vaccinated to protect yourself from becoming ill.

Seasonal vs. 2009 H1N1 Flu Vaccines

When should I get the seasonal flu and H1N1 flu vaccines?

You should get the seasonal flu vaccine as soon as possible and if you are in one of the target groups, you should get the 2009 H1N1 flu vaccine as soon as it becomes available to you.

What makes the H1N1 flu vaccine different from the seasonal flu vaccine?

The seasonal flu vaccine always covers three different flu viruses in the shot and nasal spray. The H1N1 vaccine will cover only the one virus, H1N1. Otherwise the manufacturing process is exactly the same.

Will the seasonal flu vaccine also protect against the H1N1 flu?

No, the seasonal flu vaccine is not expected to protect against the H1N1 flu.

1970's H1N1 Flu vs. 2009 H1N1 Flu Vaccines

What makes the 1976 H1N1 influenza vaccine different from the 2009 H1N1 influenza vaccine that is being released now?

The type of H1N1 that existed in the 1970's is not the same as the H1N1 that is currently circulating in the population. The vaccine that was created in the 1970's was made in a different way than the current H1N1 vaccine.

Do you expect an increased rate of Guillain Barre cases with the 2009 H1N1 vaccine?

No. In 1976, a different type of H1N1 flu vaccine was felt to be associated with an increased number of cases of a severe paralytic illness called Guillain-Barre Syndrome (GBS). Some studies done since 1976 have shown a small risk of GBS, no more than 1 case per 1 million persons vaccinated. Since then, flu vaccines have not been clearly linked to GBS. GBS has a number of different causes, and GBS usually occurs in people who have never received an influenza vaccine. The potential benefits of influenza vaccination in preventing serious illness, hospitalization, and death substantially outweigh the potential risk for vaccine-associated GBS.

The H1N1 Vaccine

Can I get the flu from receiving the 2009 H1N1 vaccine?

No. Those who are vaccinated cannot get the flu from the vaccine.

Is the vaccine a live vaccine?

Like the seasonal flu shot, the new H1N1 flu shot does not contain a live virus. To make the vaccine, the virus is killed and then broken up, so the injection contains only certain parts of the virus. The nasal spray form of both the seasonal and H1N1 vaccines is made from a live virus but that virus is changed so that it can NOT cause disease.

How will the vaccine be administered?

It will be available as both a flu shot and as a nasal spray.

Will my doctor have both types of vaccine (e.g. flu shot and nasal spray)? Can I choose which one I get?

The vaccine you receive will be based on what your provider has available, your age, and whether or not you have any underlying medical conditions.

How many doses do I need?

One dose of the vaccine is needed for those older than 9 years of age. For those 9 years and younger, 2 doses of the vaccine will be required and should be given at least 4 weeks or 28 days apart, according to current CDC recommendations. Although vaccine supply is limited, it is important for those 9 years and younger to receive 2 doses in order to be fully immunized against the 2009 H1N1 flu.

Why do children 6 months through 9 years old require two doses of the H1N1 vaccine?

Young children are especially susceptible to disease because their immune systems have not built up the necessary defenses to fight infections. Vaccine effectiveness studies for seasonal flu have shown that 2 doses are needed to provide adequate protection during the first season that young children are vaccinated. The same study results can be applied to the H1N1 vaccine for children 9 years and younger.

How long will it take for the vaccine to provide protection?

If one dose is required, immunity should develop about 3 weeks after the dose. If two doses are required, then immunity should have developed by about two weeks after the second shot.

Can I get the seasonal flu and H1N1 flu vaccines at the same time?

It depends on the type of vaccine you are getting.

  • Inactivated 2009 H1N1 influenza vaccine (shot) and the inactivated seasonal flu vaccine (shot): the shots can be given at the same time and should be placed at 2 different sites (e.g. left arm and right arm). It is also allowable to give them in the same location but at least 1 inch apart.
  • Inactivated 2009 H1N1 influenza vaccine(shot) and the live, attenuated seasonal flu vaccine (nasal spray): can be given at the same time.
  • Live, attenuated 2009 H1N1 vaccine(nasal spray) and inactivated seasonal vaccine (shot): can be given at the same time.
  • Live, attenuated 2009 H1N1 vaccine (nasal spray) and live attenuated seasonal vaccine (nasal spray): a patient should NOT receive them during the same visit. If a person is eligible and prefers the LAIV formulation of seasonal and 2009 H1N1 vaccine, the CDC currently recommends that these vaccines be separated by a minimum of four weeks/28 days.

For those who require more than 1 dose of 2009 H1N1 vaccine, can the first dose be given as a shot and the second as a nasal spray? Or vice versa?

Yes. Ideally they should be the same type of vaccine, but you should not wait to get the second dose until a certain product is available.

How close together can the live, attenuated 2009 H1N1 vaccine be given with another live, attenuated vaccine (other than the seasonal flu nasal spray vaccine)?

The live H1N1 vaccine can be given at the same visit as another live vaccine (for example, measles, mumps, rubella or varicella vaccine), except for the live seasonal flu vaccine (nasal spray).

If I am on influenza antivirals, can I get the 2009 H1N1 nasal vaccine (LAIV)?

You need to be off of antivirals for at least 48 hours before receiving the LAIV. If you then go on to receive antivirals within 2 weeks of receiving the vaccine, the vaccine would need to be given again.

If I am immunocompromised, can I receive the live, attenuated 2009 H1N1 vaccine or be in the vicinity of those who have?

You should not get the 2009 H1N1 LAIV but it is safe for you to be in contact with those who have received it, unless you are a recent bone marrow transplant recipient or have another condition that makes you severely immunosuppressed.

Who should not receive the live, attenuated 2009 H1N1 nasal spray vaccine?

The following groups are not recommended to receive nasal spray flu vaccines, including the 2009 H1N1 vaccine:

  • Children younger than 2 years of age
  • Pregnant women
  • People 50 years of age and older
  • Children under 5 years of age with a history of recurrent wheezing
  • Children or adolescents receiving long term aspirin therapy
  • People who have had Guillain-Barre Syndrome (GBS), a rare nervous system disorder, within 6 weeks of getting a flu vaccine
  • People who have a severe allergy to eggs
  • People with a medical condition that puts them at a higher risk for developing complications from the flu, such as those with chronic heart or lung disease (e.g. asthma, chronic obstructive pulmonary disease); people with kidney disease or diabetes; people with medical conditions that weaken the immune system, such as HIV or persons who take medications that can weaken the immune system
  • Anyone with certain muscle or nerve disorders, such as cerebral palsy, that can lead to breathing or swallowing problems

If I am vaccinated outside of my regular doctor's practice how will that information be included in my permanent medical record?

All those who receive the 2009 H1N1 vaccine will be provided with a hand-held card to serve as a record of vaccination and a source of information. Vaccine recipients will be encouraged to bring the hand-held card to their next visit to their primary care provider so that vaccination information can be transcribed into their permanent medical record. Records of vaccination will be available in the New York State Immunization Information System (NYSIIS) for all persons 18 years of age or younger.

Adjuvants/Additives

What is an adjuvant?

An adjuvant is an immune booster that allows a vaccine to be more protective while using less of the active component. These agents modify the effect of other agents (e.g. vaccines) while having few if any direct effects when given by themselves.

Will an adjuvant be added to the H1N1 flu vaccine?

No, not at this time.

Are there additives, like thimerosal, in the vaccine?

Some of the vaccine shots will contain thimerosal. Thimerosal is a mercury-containing preservative used in some vaccines and other products since the 1930s. There is no scientific evidence of harm caused by the low doses of thimerosal in vaccines, except for minor reactions like redness and swelling at the injection site. Because some women are concerned about exposure to preservatives during pregnancy, those making the vaccine will produce preservative-free seasonal and H1N1 flu vaccines in single dose syringes for pregnant women and small children. There is no thimerosal in the nasal spray vaccine.

Can thimerosal free vaccine be provided to anyone who wishes to receive it?

Not at this time. 2009 H1N1 vaccine is currently in short supply and thimerosal-free vaccine, available in pre-filled syringes, is indicated for priority use in pregnant women and children ages 6 months-3 years. In the future, after priority groups have been vaccinated, additional preservative free vaccine can be made freely available for groups other than pregnant women and children.

Can I have an allergic or anaphylactic reaction to thimerosal?

An allergic or anaphylactic reaction to thimerosal is extremely rare. In the very rare instances where patients report previous anaphylactic (severe allergic response such as trouble breathing) reactions to thimerosal, they should also be provided preservative free vaccine.

Will there be enough preservative-free H1N1 vaccine for me or my child to get one?

For children and pregnant women, there will be a limited amount of thimerosal-free H1N1 vaccine available. The CDC recommends that pregnant women and all children may receive influenza vaccine with or without thimerosal. New York State has a law that requires that children under 3 and pregnant women be offered vaccine without thimerosal. If there is not enough preservative-free vaccine, your vaccine provider can give you the other vaccine as long as you provide consent. Pregnant women and young children should not wait for a preservative-free vaccine if none is available to them.

Target Population

Who can get the 2009 H1N1 vaccine when it comes out?

The Advisory Committee on Immunization Practices at CDC has indicated that the target populations for initial H1N1 vaccination include:

Pregnant women. Pregnant women are at higher risk of complications from 2009 H1N1 flu. By vaccinating pregnant women, you can also potentially provide protection to infants who cannot be vaccinated.

Household contacts and caregivers for children younger than 6 months of age. Younger infants cannot be vaccinated and are already at higher risk of flu-related problems. The best way to protect children younger than 6 months old is to make sure members of their household and their caregivers are vaccinated.

Healthcare and emergency medical services personnel. Infections among healthcare workers can be a potential source of infection for vulnerable patients. Also, increased absenteeism in this population could reduce health care system capacity.

All people from 6 months - 24 years of age

  1. Children from 6 months - 18 years of age. There have been many cases of 2009 H1N1 flu in children. They are in close contact with each other in school and day care settings, which increases the chances that they will spread the flu more easily.
  2. Young adults 19- 24 years of age. There have been many cases of 2009 H1N1 flu in healthy young adults because of the fact that they often live, work, and study in close proximity, and they are a frequently mobile population.

Persons aged 25 - 64 years who have health conditions associated with higher risk of medical complications from flu including:

  • cancer,
  • blood disorders (including sickle cell disease),
  • chronic lung disease (including asthma or chronic obstructive pulmonary disease),
  • diabetes,
  • heart disease,
  • kidney disorders,
  • liver disorders,
  • neurological disorders (including nervous system, brain or spinal cord),
  • neuromuscular disorders (including muscular dystrophy and multiple sclerosis), and
  • people with weakened immune systems (including people with AIDS or those who are receiving chemotherapy).

Why are there target groups?

The Advisory Committee on Immunization Practices / CDC created these groups based on the following considerations:

  1. Groups that had the most severe illness and risk for complications during the 2009 H1N1 outbreak
  2. Groups that had the greatest frequency of illness during the 2009 H1N1 outbreak
  3. The contribution of particular groups to the overall burden of severe illness
  4. Protection of health care system functions
  5. Reduction of societal impact
  6. The potential for indirect protection of more vulnerable contacts.

Once the vaccine has been distributed among the priority groups, people from the ages of 25 through 64 years should be vaccinated. Current studies indicate that the risk for infection among persons age 65 or older is less than the risk for younger age groups. However, once vaccine demand among younger age groups has been met, programs and providers should offer vaccination to people 65 or older.

What if I am not in the target groups? When will I be able to obtain the vaccine?

After target groups are vaccinated. This will depend on how vaccine distribution unfolds in the coming weeks.

Why aren't adults age 65 years and older included as a priority group for the 2009 H1N1 vaccination as they are for seasonal influenza?

The Advisory Committee on Immunization Practices did not prioritize this group because current studies indicate that the risk of infection, hospitalization, and death from the 2009 H1N1 flu virus among persons age 65 years and older is less than is the risk for younger age groups. People age 65 years and older are included as a priority group if they live with or care for infants younger than age 6 months or are a healthcare or emergency services provider. Once the target groups for 2009 H1N1 have been vaccinated, you will be able to get the vaccine.

Who should NOT get the 2009 H1N1 flu vaccine?

The following groups of people have been identified by the Advisory Committee on Immunization Practices as those who should NOT receive the vaccine:

  • Those who are <6 months old
  • Those who have a severe egg allergy
  • Those who have had an allergic reaction to previous flu vaccination
  • Those with current moderate-severe illness (delay vaccine until you are feeling better)
  • Those with a history of Guillain-Barre syndrome (a form of paralysis – check with your doctor about whether you should still be vaccinated)

Are there precautions for receiving the 2009 H1N1 flu vaccine?

The Advisory Committee on Immunization Practices indicates that patients with a history of Guillain-Barre syndrome (sudden weakness/paralysis of the extremities) from previous flu vaccination (estimated at 1-2 cases per 1 million vaccinated patients) are under a precaution for receipt of the H1N1 vaccine. A precaution is a condition in a recipient that might increase the risk for a serious adverse reaction or that might compromise the ability of the vaccine to produce immunity. Injury could result, or a person might experience a more severe reaction to the vaccine than would have otherwise been expected; however, the risk for this happening is less than expected with a contraindication. Under normal circumstances, vaccinations should be deferred when a precaution is present. However, a vaccination might be indicated in the presence of a precaution because the benefit of protection from the vaccine outweighs the risk for an adverse reaction. This is a matter of medical judgment on the part of your provider.

Can I get the H1N1 flu vaccine if I currently have an influenza-like illness?

If you are sick with influenza-like illness (defined as having a fever of 100° (37.8°C) or greater AND a cough and/or a sore throat without another known cause) AND your medical provider decides you have a moderate to severe illness, you should wait to be vaccinated until after your symptoms have lessened or disappeared

Mothers/Pregnant Women

Why does the CDC recommend that pregnant women receive the 2009 H1N1 flu vaccine?

A pregnant woman who gets any type of flu is at risk for serious complications and hospitalization. Pregnant women who are otherwise healthy have been severely impacted by the 2009 H1N1 flu virus. In comparison to the general population, a greater number of pregnant women infected with the 2009 H1N1 flu virus have been hospitalized. In addition, severe illness and death have occurred in pregnant women. To date, 6% of confirmed deaths from 2009 H1N1 flu have been in pregnant women while only about 1% of the general population is pregnant. Vaccination is the single best way to protect against the 2009 H1N1 flu.

Is the H1N1 influenza vaccine safe for pregnant women?

Influenza vaccines have not been shown to cause harm to a pregnant woman or her baby.

Can pregnant women receive the 2009 H1N1 vaccine that contains thimerosal?

There is no evidence that thimerosal (used as a preservative in vaccine packaged in multi-dose vials) is harmful to a pregnant woman or a fetus. However, because some women are concerned about exposure to preservatives during pregnancy, manufacturers will produce preservative-free seasonal and 2009 H1N1 flu vaccines in single dose syringes for pregnant women and small children. CDC recommends that pregnant women may receive flu vaccine with or without thimerosal.

How many doses of the H1N1 flu vaccine will pregnant women need to get?

The U.S. Food and Drug Administration (FDA) has approved the use of one dose of H1N1 flu vaccine for persons 10 years of age and older.

Is there a particular kind of H1N1 flu vaccine that pregnant women should get? Are there flu vaccines that pregnant women should not get?

Pregnant women should get the "flu shot"— an inactivated vaccine (containing fragments of killed influenza virus) that is given with a needle, usually in the arm. The flu shot is approved for use in pregnant women. The other type of flu vaccine — nasal-spray flu vaccine, is not currently approved for use in pregnant women. This vaccine is made with live, weakened flu viruses that do not cause the flu.

Can pregnant women get the seasonal flu vaccine and the 2009 H1N1 flu vaccine at the same time?

Yes. The seasonal flu shot and 2009 H1N1 vaccine shot may be administered on the same day but should ideally be given at different sites (e.g. one shot in the left arm and the other shot in the right arm). However, we expect the seasonal vaccine to be available earlier than the H1N1 flu vaccine. Pregnant women and others at increased risk of complications of influenza are encouraged to get their seasonal flu vaccine as soon as it is available.

What safety studies have been done on the H1N1 flu vaccine and have any been done in pregnant women?

Studies of H1N1 flu vaccine in pregnant women are ongoing. However, the safety profile for the H1N1 vaccine is expected to be similar to the seasonal flu vaccine safety profile in women.

Can the H1N1 flu vaccine be given at any time during pregnancy?

Yes, the vaccine is safe to be administered during any trimester of pregnancy.

Can the family members of a pregnant woman receive the nasal spray vaccine?

Pregnant women should not receive the live nasal spray influenza vaccine but family and household members and other close contacts of pregnant women (including healthcare personnel) who have no contraindications may receive live nasal spray vaccine.

Is it okay to breastfeed after receiving the H1N1 vaccine?

Yes

I didn't get the H1N1 vaccine while I was pregnant, should I get it now, after I have delivered my baby?

Yes. This will protect both you and your infant.

Past Infections

Do I need to be vaccinated if I had Influenza A (swine flu) in 1976?

Yes. The 1976 swine flu virus and the 2009 H1N1 virus are different. It's unlikely a person vaccinated in 1976 will have full protection from the 2009 H1N1 virus. People vaccinated in 1976 should still be given the H1N1 vaccine now if they are in the target groups specified by the CDC.

Do I need to have the H1N1 vaccine if I had laboratory confirmed H1N1 flu this year?

No, however, if you are given the H1N1 flu vaccine by accident, no adverse outcomes are to be expected.

Should the 2009 H1N1 flu vaccine be given to someone who has had an influenza-like illness between April and now? Do I need a test to know if I need the vaccine or not?

People for whom influenza vaccine is recommended should receive the 2009 H1N1 vaccine, even if they had an influenza-like illness previously. It is not necessary to test a person who previously had an influenza-like illness. People for whom the 2009 H1N1 flu vaccine is recommended should receive it, even if they have had an influenza-like illness previously, unless they can be certain they had H1N1 flu based on a laboratory test that can specifically detect 2009 H1N1 viruses. CDC recommends that persons who were tested for H1N1 flu discuss this issue with a healthcare provider to see if the test they had (either an RT-PCR or a viral culture) specifically detected 2009 H1N1 flu. There is no harm in being vaccinated if you had H1N1 flu in the past.

Safety/Side Effects

Is the vaccine safe?

It is anticipated that the safety of the H1N1 flu vaccine will be similar to seasonal flu vaccine since it is made in the same way. Despite the fact that seasonal flu vaccine changes each year with regards to the strains of viruses it contains, clinical trials are not performed each year because these vaccines have an excellent safety record and are made in the same way year after year. In comparison, the H1N1 flu vaccine has been tested in thousands of volunteers, including children and pregnant women. No safety issues have been found. Most people had no side effects at all. The benefits of flu vaccination far outweigh the risks.

What are preservatives and why are they used in vaccines?

Preservatives are used to prevent the growth of bacteria and fungi in vaccines. Contamination by germs in a vaccine could cause serious illness or death. Thimerosal is a mercury based preservative that has been used for decades in the United States to prevent the growth of microorganisms.

Will the 2009 H1N1 flu vaccine contain thimerosal?

The 2009 H1N1 flu vaccines that the FDA has approved, will be manufactured in several formulations. Some will come in multi-dose vials and will contain thimerosal as a preservative to prevent potential contamination after the vial is opened.

Some vaccine manufacturers will be producing 2009 H1N1 flu vaccine in single-dose units, which will not require the use of thimerosal as a preservative. In addition, the live-attenuated version of the vaccine, which is administered through the nose, is produced in single-units and will not contain thimerosal.

What are the possible side effects of the H1N1 flu vaccine?

The side effects from H1N1 flu vaccine are expected to be similar to those from seasonal flu vaccines. The most common side effects following vaccination are expected to be mild, such as soreness, redness, tenderness or swelling where the shot was given. Some people might experience headache, muscle aches, fever, nausea and fainting. If these problems occur, they usually begin soon after the shot and may last as long as 1-2 days. Like any medicines, vaccines can cause serious problems like severe allergic reactions. However life-threatening allergic reactions to vaccines are very rare.

What is Guillain Barre Syndrome (GBS) and do we expect an increased number of cases following H1N1 vaccination?

GBS is a sudden weakness/paralysis of the limbs that may also affect breathing and other muscles in your body. GBS occurs worldwide at an annual incidence of 1-2 cases per 100,000. The death rate for GBS is about 4-15%. In most cases, the weakness is worst between 12 hours and 28 days, followed by subsequent improvement. Despite modern treatment, up to 20% of survivors are disabled after one year.

In February 1976, influenza virus isolates from two Army recruits at Fort Dix, New Jersey were identified as a new influenza A strain, the "swine flu". Eventually 45 million Americans received the swine flu vaccine in 1976. Following vaccination, there was a small increased chance of GBS of about 1 more case per 100,000 people vaccinated.

Since 1976, many studies have been done to see if other flu vaccines may cause GBS. Two studies showed one additional case of GBS per 1,000,000 persons vaccinated, while other studies showed no increase in GBS cases after flu vaccination.

Multiple infectious illnesses are associated with GBS. It is important to remember that influenza infection itself may trigger GBS. One study estimated that influenza-related GBS was four to seven times higher than the risk of 1976 swine flu vaccine-associated GBS.

The risk of GBS following pandemic H1N1 vaccine is unknown, but there is no evidence to suggest risk will be higher than with seasonal influenza vaccine.

Adverse Events

Will any organization be tracking the number of adverse events experienced by those who get the H1N1 flu vaccine?

In the U.S. tracking for adverse events following immunization is done through the Vaccine Adverse Event Reporting System (VAERS). Events that may be associated with vaccination can be reported on paper forms, by telephone, or electronically by health care providers, patients, health departments, or vaccine manufacturers. Reports of serious adverse events are analyzed to determine whether such events are reported more frequently than expected. In addition, VAERS will be supplemented by additional surveillance and studies to rapidly evaluate the safety of the vaccination program. CDC has stated that adverse events reported to VAERS will be supplied to the NYSDOH on a weekly basis.

What should I do if I think I am having an adverse reaction after receiving the 2009 H1N1 flu vaccine?

If you feel that you are experiencing abnormal symptoms after vaccination or if you are concerned about a possible adverse event that you attribute to receiving the H1N1 vaccine, you should contact a health care provider or go to the local emergency department for medical evaluation. A medical provider can assist you in determining if the reaction you are experiencing is possibly due to flu vaccination. In addition, you can consider reporting this event to the Vaccine Adverse Event Reporting System (VAERS) via one of the following ways:

What information should be reported to VAERS?

The following information should be reported to VAERS:

  • Adverse events after vaccine administration
  • Administration errors if associated with adverse events
  • LAIV (nasal spray) used in a non-approved population

What should I do if I received the nasal spray vaccine, but I am over the age of 49?

You should immediately notify your medical provider. The 2009 H1N1 nasal spray vaccine is recommended for use in healthy people 2 years through 49 years of age who are not pregnant. However, if the LAIV is accidentally administered to someone over the age of 49, the vaccine should be considered valid. You do not need to be re-vaccinated. Ultimately, your medical provider can provide you with the best guidance on what to do in this situation.

What should I do if I received the nasal spray vaccine and I am pregnant?

There is no known risk from the nasal spray vaccine to you or your baby; the risk for adverse events is theoretical. You should notify your medical provider and the error should still be reported to VAERS. You do not need to receive antiviral medication and you do not need to be revaccinated.

Miscellaneous

How much will the vaccine cost?

Both the vaccine and the supplies required to give the vaccine will be provided by the Federal government at no charge. Reimbursement for vaccine administration is likely to be covered by most private health insurers and will be covered by public health insurance (Medicaid/Medicare) plans.

What is the difference between a vaccine and an antiviral medication (for example Tamiflu®)?

Antivirals are drugs that can treat people who have already been infected by a virus. They also can be used to prevent infection when given before or shortly after exposure and before illness occurs. They interfere with the life cycle of the influenza virus in the body and prevent it from multiplying thus preventing or lessening the infection. A key difference between a vaccine and antiviral drug is that the antiviral drug will prevent infection only when administered within a certain time frame before or after exposure and is effective during the time that the drug is being taken. A vaccine can be given long before exposure to the virus and can provide protection over a long period of time.

Vaccines are the best way to prevent disease. Flu vaccines are made from either pieces of the killed flu virus or weakened versions of the live virus that will not lead to disease. When vaccinated, the body's immune system makes antibodies which will fight off infection if exposure to the virus occurs.

Will vaccination against H1N1 flu be mandatory?

No, not at this time.

Where can I get more information on H1N1 and seasonal influenza?

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