Can Live Attenuated Influenza Vaccine Be Given At The Same Time As Other Vaccines
Live, attenuated influenza vaccine may be administered simultaneously with other live or inactivated vaccines. However, if two live, attenuated vaccines are not given during the same clinical visit, they should be separated by at least 4 weeks to minimize the potential risk for interference. For example, if live, attenuated influenza vaccine was given, at least 4 weeks should pass before MMR is administered.
Iv1 Inactivated Influenza Vaccine
IIVs contain standardized amounts of the HA protein from representative seed strains of the two human influenza A subtypes and either one or both of the two influenza B lineages . IIVs currently authorized for use in Canada are a mix of split virus and subunit vaccines, both consisting of disrupted virus particles. Split virus vaccines contain whole inactivated viruses split with detergent, ether, or both, while subunit vaccines are made of purified HA and NA. The amount of NA in the vaccines is not standardized. HA-based serum antibody produced to one influenza A subtype is anticipated to provide little or no protection against strains belonging to the other subtype. The potential for trivalent vaccine to stimulate antibody protection across B lineages requires further evaluation and may be dependent upon factors such as age and prior antigenic experience with the two B lineagesFootnote 79,Footnote 80,Footnote 81,Footnote 82,Footnote 83,Footnote 84.
Because of potential changes in the circulating influenza virus from year to year and waning immunity in vaccine recipients, annual influenza vaccination is recommended. Although NACI is aware of some recent studies that suggest that vaccine induced protection may be greater in individuals who have no recent vaccine history, optimal protection against influenza, season after season, is best achieved through annual influenza vaccinationFootnote 85,Footnote 86. NACI will continue to monitor this issue.
Efficacy and effectiveness
Whats The Difference Between The Third Covid
Technically there is no difference as of now. Both are simply an additional administration of the same dose of the currently available COVID-19 vaccine, similar to the second shot of the mRNA vaccines you receive. However, they are referred to differently because of their purpose.
Booster vaccines are given when immunity lapses, to rebuild COVID-19 antibodies eight months after the last vaccine, says Daniel Arkfeld, MD, a rheumatologist with Keck Medicine of USC. In immunocompromised patients, we give an additional vaccine to help build more immunity .
In short, people who are immunocompromised including those who are on treatment for cancer, have organ transplants, and have immunocompromising conditions or are on immunosuppressive medications may not receive an adequate immune response to the initial COVID-19 vaccine and, therefore, need an additional dose to build more of the response.
Research has shown that vaccine effectiveness may be 59 to 72 percent among immunocompromised people versus 90 to 94 percent in non-immunocompromised people after two doses, per the CDC.
The purpose of a third dose is to try to accomplish in these individuals what two doses accomplished in everybody else, says Dr. Aronoff. Its essentially saying, Because your immune system is suppressed, you may not respond normally to this vaccine. So for you, the normal regiment is a three-dose regimen, not a two-dose regimen.
Don’t Miss: Flu Shot Cause Heart Problems
Ii5 Choice Of Seasonal Influenza Vaccine
The decision to include specific influenza vaccines as part of publicly funded provincial and territorial programs depends on several factors, such as cost-effectiveness evaluation and other programmatic and operational factors, such as implementation strategies. Not all products will be made available in all jurisdictions and availability of some products may be limited therefore, officials in individual provinces and territories should be consulted regarding the products available in individual jurisdictions.
With the availability of influenza vaccines that are designed to enhance immunogenicity in specific age groups or given through a different route of administration, the choice of product has become more complex.
Choice of influenza vaccine by age group
Recommendations for individual-level decision making
- NACI recommends that influenza vaccine should be offered annually to anyone 6 months of age and older who does not have contraindications to the vaccine. Table 2 provides age group-specific recommendations for the age-appropriate influenza vaccine types authorized for use in Canada.
Recommendations for public health program-level decision making
- NACI recommends that any of the age-appropriate influenza vaccine types available for use may be considered for people without contraindications to the vaccine. Table 2 provides age group-specific recommendations for the age-appropriate influenza vaccine types authorized in Canada.
What’s In This Year’s Flu Vaccines

The composition of the 2021-2022 flu shot will be different from last season’s flu shot. Specifically, the two influenza A components of the flu shot differ from those in last year’s shot. In addition, all flu shots for the 2021-2022 season will be quadrivalent, meaning they will contain four strains of flu viruses.
According to the CDC, the 2021-2022 quadrivalent egg-based flu shot will contain the following strains of the flu virus:
- A/Victoria/2570/2019 pdm09-like virus This H1N1 component differs from last year’s flu shot.
- A/Cambodia/e0826360/2020 -like virus This is the H3N2 component that is different from last year’s flu shot.
- B/Washington/02/2019- like virus This influenza B strain component is the same as the one in last year’s shot.
- B/Phuket/3073/2013-like virus This influenza B strain component was also in last year’s shot.
Then, there are two types of flu vaccines that dont involve eggs: cell-based and recombinant-based flu vaccines. In cell-based flu vaccines, the inactivated flu virus is grown in cultured cells from mammals rather than in hens eggs. And recombinant flu vaccines are created synthetically. To make this type of vaccine, scientists combine a lab-made antigen specific to the flu virus with a baculovirus .
Don’t Miss: Schedule Flu Shot Rite Aid
What If The High
Manufacturers have increased flu shot production to meet the high demand for the 2020-2021 season. According to the CDC, between 188 million and 200 million doses will be distributed. All vaccines will be quadrivalent , most will be thimerosal-free or thimerosal-reduced vaccines and about 18% of flu vaccines will be free of eggs.
What Is The Recommended Site And Needle Length For Giving Influenza Vaccine To Adults By Intramuscular Injection
- Use a – to 1-inch needle for men and women who weigh less than 130 pounds . Insert the needle at a 90-degree angle and stretch the skin flat between thumb and forefinger.
- Use a 1-inch needle for men and women who weigh 130152 pounds .
- Use a 1- to 1½-inch needle for women who weigh 152200 pounds and men who weigh 152260 pounds .
- Use a 1½-inch needle for women who weigh more than 200 pounds and men who weigh more than 260 pounds .
CDC has vaccine administration resources for clinicians administering influenza vaccine, including a needle length and gauge chart and demonstration videos for intramuscular injection and intranasal administration.
Additional information on vaccine administration and safe injection practices can be found in the following resources:
Recommended Reading: Rite Aid Flu Shot Record
Can Inactivated Influenza Vaccine Be Given At The Same Time As Other Vaccines Such As Pneumococcal Polysaccharide Or Zoster Vaccines
Yes if other vaccines are indicated, they can be administered during the same clinical encounter as inactivated influenza vaccine. When giving several injections at a single visit, administer each vaccine at a separate injection site. The injection sites should be separated by 1 inch or more, if possible, so that any local reactions can be differentiated.
Pharmacies Ready To Go
Harpell, who also owns Medicine Shoppe, a pharmacy in Dartmouth, said pharmacists across the province are ready to go once Health Canada gives the go-ahead.
“We are already making sure that we move towards having the supplies on hand. So having a few extra of those shorter needles on hand if we need it,” she explained.
In terms of staffing, she admitted that pharmacists are particularly taxed now due to COVID-19 vaccinations and annual flu shots.
“Folks are tired, but fortunately, we do have options. We’ve got students that we’ve been working with. We’ve had retired pharmacists come back. We have other health-care practitioners that have dispensed or are providing vaccine in our pharmacies as well,” she said.
“Folks just remember to be kind and to be patient because we’re working through a lot of things at once.”
Recommended Reading: Sanofi High Dose Flu Vaccine
If You’re Ages 50 To 64
The choices include the regular flu shot, the new quadrivalent flu shot, the tiny-needle shot and the egg-free Flucelvax.
Should I get the quadrivalent vaccine?
For somewhat younger adults, the quadrivalent shot may be ideal in terms of protection against flu. But here as well, studies have yet to prove superior performance over regular vaccine. And because it’s brand new this year, supplies are limited. Zimmerman says that if all the alternatives were offered at the same price, for people 50 to 64 he’d choose the quadrivalent vaccine. “However, I would not travel an extra 20 minutes for it,” he adds.
Is the tiny-needle shot a good option?
Those wary of needles can also opt for the tiny-needle or “intradermal” shot, which deposits the medicine under the skin rather than in the muscle, as a standard shot does. It’s been approved for people ages 18 to 64 and protects against three viral strains, same as the standard flu shot. It also can be harder to find than the standard flu shot.
What about the egg-free vaccine?
Anyone 18 or older who is hypersensitive to eggs a problem that’s actually far more common in young children can choose a vaccine whose virus is grown in mammalian cells rather than chicken eggs.
Katharine Greider is a freelance writer.
What To Know About Flu Shots For Older Adults
Q: Is the flu vaccine effective for older adults?
A: You may have heard people say that the flu shot doesnt work in older people. This is not entirely correct.
Now, its true that flu vaccine is usually less effective in older adults because aging immune systems tend to not respond as vigorously to the vaccine. In other words, older adults tend to create fewer antibodies in response to vaccination. So if they are later exposed to flu virus, they have a higher chance of falling ill, compared to younger adults.
But less effective doesnt mean not at all effective. For the 2017-2018 flu season, the CDC estimates that vaccination prevented about 700,000 influenza cases and 65,000 hospitalizations, for adults aged 65 and older.
For more on the effectiveness of influenza vaccination in older adults, see:
To provide more effective vaccination to aging immune systems, vaccine makers have developed stronger vaccines against the flu, which I explain in the next section.
Q: Are there flu shots specifically designed for older adults?
Yes, over the past several years, vaccine makers have developed vaccines that are designed to work better with an aging immune system. Most research studies to date show that these stimulate aging immune systems to produce more antibodies to influenza. Theres also some evidence that these vaccines reduce the risk of being hospitalized for influenza.
Recommended Reading: What Vitamin Is Good For The Flu
If An Inactivated Influenza Vaccine Approved For Adult Use Is Inadvertently Administered To A Child Is This Considered A Valid Dose
If an inactivated influenza formulation approved for adults is inadvertently administered to a child, this should be counted as a single valid dose for the child. However, this is considered a vaccine administration error. Healthcare personnel should take steps to determine how the error occurred and put strategies in place to prevent it from happening in the future. In addition, we encourage providers to report all vaccine administration errorseven those not associated with an adverse eventto the Vaccine Adverse Event Reporting System external icon. A discussion of strategies to prevent errors can be found in the Vaccine Administration chapter of Epidemiology and Prevention of Vaccine-Preventable Diseases . Additional resources can be found on CDCs vaccine administration web page.
Flu Vaccine Recommendations And Dosages

Virtual Mentor.
About 10 to 20 percent of US residents contract the influenza virus each year, resulting in an average of 114,000 hospitalizations and 36,000 deaths annually . The influenza virus causes flu, a serious respiratory disease that may present with symptoms similar to those of the common cold but is caused by a different virus. Common flu symptoms are:
- Fever,
- Sore throat,
- Nasal congestion and body aches.
The flu is most common during the winter months for North America the flu season is from November to March. Although anyone may get the flu, some people are more vulnerable to serious complications from contracting the virus. It is recommended that people at high risk for flu-related complications get an influenza vaccine each year in October or November .
Read Also: Time Of Year To Get Flu Shot
Common And Local Adverse Events
Univalent varicella vaccine
Reactions to univalent varicella vaccine are generally mild and include injection site pain, swelling and redness in 10% to 20% of recipients. A low-grade fever has been documented in 10% to 15% of vaccine recipients. A varicella-like rash occurs at the injection site or is generalized in 3% to 5% of vaccine recipients after the first dose. The rash usually appears within 5 to 26 days after immunization. As varicella-like rashes that occur within the first 2 weeks after immunization may be caused by wild-type virus , health care providers should obtain specimens from the vaccine recipient to determine whether or not the rash is due to a natural varicella infection or to the vaccine-derived strain.
The safety profile of a 2 dose regimen is comparable to that of a single dose with slightly higher incidence of injection site reactions observed within 3 days after vaccination and slightly lower incidence of fever and varicella-like rash after dose 2 compared to dose 1.
Measles-Mumps-Rubella-Vaccine vaccine
Varicella zoster immunoglobulin
Reactions to VarIg are rare. The most frequent treatment related adverse events are pain at the injection site , headache , and rash .
Rubella-containing vaccines
What We Know About Covid
Q: How are COVID-19 and influenza similar and how are they different?
A: COVID-19 and influenza have many similarities, but also many differences.
The main similarities are:
- Both viruses are mostly spread through an airborne route. This means that steps you take to protect yourself from COVID-19, such as social distancing measures and avoiding crowded indoor spaces, will likely reduce your risk of catching influenza as well.
- The initial symptoms of infection have a lot in common. Namely, both often start with upper respiratory symptoms such as cough, runny nose, fatigue, fever, and body aches. This means it will be difficult to tell the two conditions apart, unless laboratory testing is used.
- Both are more likely to cause severe illness in people who are older or frail.
Even though both viruses often cause viral pneumonia, there are significant differences between the two. They are actually quite different types of viruses. The differences include:
In short, influenza and COVID-19 are similar in terms of how they spread and common initial symptoms. But COVID-19 has so far caused more serious disease, and at this time, remains harder to treat, in part because it seems to affect the body in more significant ways than influenza usually does.
For more on the similarities and differences between influenza and COVID-19:
Q: Is it possible to get influenza and COVID-19 at the same time? How do they affect each other?
Also Check: When Is Flu Season In Arkansas
Guidance On Reporting Adverse Events Following Immunization
Vaccine providers are asked to report the following AEFI in particular, through local public health officials:
- Varicella that is moderate or severe and occurs within 7 to 21 days of vaccination with varicella-containing vaccine.
- Any serious or unexpected adverse event temporally related to vaccination. An unexpected AEFI is an event that is not listed in available product information but may be due to the immunization, or a change in the frequency of a known AEFI.
Refer to Reporting Adverse Events Following Immunization in Canada and Adverse Events Following Immunization in Part 2 for additional information about AEFI reporting.
Persons New To Canada
Health care providers who see persons newly arrived in Canada should review the immunization status and update immunization for these individuals as necessary. People from tropical regions are more likely to be susceptible to varicella and should be a priority for varicella immunization. Refer to Immunization of Persons New to Canada in Part 3 for additional information about varicella vaccination of people who are new to Canada.
Recommended Reading: Mgh Occupational Health Flu Shot
So It Offers More Protection From The Flu
Exactly. A 2014 study published in The New England Journal of Clinical Medicine, which involved more than 30,000 adults aged 65 and older, found that participants who received the high-dose flu vaccine had 24% fewer flu illnesses compared to those who got the standard flu vaccine.
Another study, carried out during the 2013-2014 flu season and published in The Lancet Respiratory Medicine in 2017, found that the high-dose flu shot was associated with a lower risk of hospital admissions compared with the regular flu shot in people age 65 and over. This was particularly true for those living in long-term care facilities.
How Is The Flu Vaccine Given
- Kids younger than 9 years old will get two doses of flu vaccine, spaced at least 1 month apart, if they’ve had fewer than two doses before July 2019. This includes kids who are getting the flu vaccine for the first time.
- Those younger than 9 who had at least two doses of flu vaccine will only need one dose.
- Kids older than 9 need only one dose of the vaccine.
Talk to your doctor about how many doses your child needs.
Don’t Miss: Flu Symptoms For 2 Weeks