Infectious Disease Book


Live Attenuated Influenza Vaccine

Aka: Live Attenuated Influenza Vaccine, Flumist
  1. See Also
    1. Influenza
    2. Influenza Vaccine
  2. Indications
    1. See Influenza Vaccine for indications
    2. Was NOT recommended by CDC in 2016 due to lower efficacy
    3. Alternative option in 2018 for Influenza Vaccine age 2 years to 49 years old who refuse Influenza Vaccine injection
      1. Flumist was previously thought to have higher efficacy than the injection and was preferred ages 2-8 years
      2. Later was thought to have equivalent efficacy as injection, but that is in question as of 2016
  3. Contraindications
    1. Includes Influenza Vaccine Contraindications (including severe egg allergy)
    2. Pregnancy
    3. Concurrent Aspirin therapy in age under 18 years (Reye's Syndrome Risk)
    4. Recurrent Wheezing or Asthma
    5. Immuodeficiency
    6. Chronic disease (lung, cardiac, renal, liver, neurologic, hematologic, metabolic)
    7. Exercise caution in severe congestion or acute illness
  4. Preparation
    1. Quadrivalent Vaccine only as of 2013 (covers an additional B strain)
  5. Dosing
    1. Timing
      1. Same as for TIV Vaccine
      2. May be given as early as July
    2. Dose
      1. One half vial in each nostril
      2. Divider is removed after first half is instilled
    3. Indications for a second dose
      1. First Immunization season
      2. Give second dose before December and at least 28 days after the first
  6. Safety
    1. Contains no thimerosol
  7. Efficacy
    1. Efficacy expected to be equivalent to inactivated Vaccine against strains in 2019
      1. (2019) Presc Lett 26(10): 55-6
      2. (2018) Presc Lett 25(8)
    2. In 2016 U.S., intranasal flu Vaccine efficacy has been as low as 3% in children and teens
      1. ACIP did not recommend the intranasal Influenza Vaccine in U.S., 2016
    3. Initial studies: Moderately more effective than the Inactivated Influenza Vaccine (TIV Vaccine)
      1. Belshe (2007) N Engl J Med 356(7):685-96 [PubMed]
    4. Later observational studies did not demonstrate superiority of Live Vaccine over TIV
  8. References
    1. (2015) Presc Lett 22(9):49-50

FluMist (C1311943)

Concepts Pharmacologic Substance (T121) , Immunologic Factor (T129)
MSH D007252
French Vaccin intranasal FluMist, Vaccin antigrippal CAIV-T, Vaccin antigrippal intranasal trivalent à virus atténué, Vaccin antigrippal trivalent atténué de MedImmune
English flumist, FluMist (obsolete), CAIV-T vaccine, MedImmune Vaccines Brand of Trivalent Live Attenuated Influenza Vaccine, FluMist
Derived from the NIH UMLS (Unified Medical Language System)

Trivalent Live Attenuated Influenza Vaccine (C1456404)

Definition (NCI) A weakened live virus vaccine containing three seasonal influenza reassortants with prophylactic activity against influenza subtypes A and B. The trivalent live-attenuated influenza vaccine (LAIV) contains 2 strains of the influenza subtype A, one for H1N1 and one for H3N2, and one strain of subtype B. Upon intranasal administration by sprayer of the trivalent LAIV, the live viruses replicate in the upper respiratory tract and induce an immune response leading to active immunization against influenza subtypes A and B.
Concepts Pharmacologic Substance (T121) , Organic Chemical (T109) , Immunologic Factor (T129)
MSH D007252
French Vaccin antigrippal trivalent à virus atténué, Vaccin antigrippal trivalent à virus vivant atténué
German Trivalente lebende attenuierte Influenza-Vakzine
English Trivalent Live-Attenuated Influenza Vaccine, Trivalent Intranasal Influenza Vaccine, Live, LAIV vaccine, vaccine, LAIV, Trivalent Live Attenuated Influenza Vaccine
Derived from the NIH UMLS (Unified Medical Language System)

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