Fluvax

Generic Name: Inactivated influenza virus, split virion
Product Name: Fluvax

Indication

Fluvax is a medication used to prevent infection with influenza (the flu). It is suitable for individuals aged > 5 years. Fluvax can be used every year by individuals who want to prevent influenza infection.

Action

Fluvax contains particles of the influenza virus. The particles have been inactivated so they cannot cause an infection (you will not get the flu after having the vaccine). However, the inactivated particles are recognised by your body’s immune system.

When you receive a Fluvax injection your immune system will develop antibodies. Antibodies are the body’s natural defence system against a range diseases. Antibodies for influenza protect you from getting the flu. The antibodies stay in your system and provide protection from the flu for 6–12 months after your Fluvax injection.

Note that there are many different types of influenza. Fluvax contains particles of three different types of influenza virus. A government panel decides each year which influenza types are most suitable for including in the vaccine. However, it is important to be aware that Fluvax will only protect you from these type of influenza. You will not be protected from other influenza types.

Also be aware that while most people develop influenza antibodies following vaccination, taking the vaccine does not guarantee you will not get the flu.

Dose advice

Dose information

When to take Fluvax

The influenza vaccine should be taken on an annual basis, before the beginning of the influenza season. The vaccine is updated each year to make sure that it contains strains of the virus which have recently caused illness in Australia. Having a vaccination every year will provide protection against the most recent strains of influenza.

Use a vaccination card to record each time you have an influenza vaccine. This card can be used to select an appropriate time to return for your next vaccine.

How much Fluvax to take

The dose varies depending on the patient’s age and influenza vaccine history. For adults and children > 9 years who have already had at least one influenza vaccine in the past, a single injection of Fluvax is needed.

Children ≤ 9 years who have not previously been vaccinated require a second ‘booster’ dose, at least 4 weeks after administration of the first dose. Be sure to return for a booster shot at the time you doctor advises you to. The vaccine may not work as well if you do not take the booster dose.

Adults with reduced immunity may also require a booster dose. If the doctor suspects you will have a reduced immune response to the vaccine they may request you return for a blood antibody test. The test assesses the concentration of influenza antibodies in your blood and whether or not there is the need for a booster vaccination to increase immunity.

How to store Fluvax

Fluvax should be refrigerated at 2-8^oC and protected from light. It should not be frozen.

The vaccine comes packaged in a container attached to a disposable syringe. The container and syringe is wrapped in clear film. Do not use if the film is damaged or missing.

How Fluvax is administered

Fluvax is injected into a muscle, usually in the upper arm. It should not be injected into a vein.

The vaccine must be prescribed by a doctor and injected in a clinic or hospital which has appropriate equipment to treat you if you have an allergic reaction to the vaccine. Allergic reaction occurs rarely but is a serious and potentially life threatening reaction which requires urgent medical attention.

If you have any queries about the correct way to use Fluvax, please ask your doctor.

Contraindications

Fluvax should not be used under certain conditions. Tell your doctor if you have:

Ever had an allergic reaction (symptoms include difficulty breathing, swelling of the face or other body parts and skin rash):

• After being vaccinated with Fluvax or another vaccine;
• After eating eggs;
• After taking antibiotics called neomycin or polymyxin;
• Have a fever.

Precautions

Special care needs to be taken when using Fluvax under certain conditions. Tell your doctor if you have:

• Ever had an allergic reaction. Symptoms include:
  • Difficulty breathing;
  • Swelling of the face and throat;
  • Fainting;
  • Fitting;
  • Fever; and
  • Skin rash;
• Are allergic to any medicines, foods or other substances;
• Have an infection or illness or fever. The doctor may ask you to return for the vaccination when you are well again. However, if you have a minor illness like the flu it will probably be okay to have the vaccine;
• Have any of the following medical conditions:
• A kidney disorder which requires you to have dialysis;
• HIV/AIDS;
• Cancer;
• Malaria;
• Any other condition which affects your immune system; and
• Guillain-Barre syndrome, a condition which affects the nervous system;
• Use any of the following medications:
  • Corticosteroids;
  • Cyclosporine
  • Anti-cancer medications; and
  • Other medications which affect your immune system;
• Are pregnant or planning to become pregnant. Your doctor will advise you of the risks and benefits of using Fluvax during pregnancy and advise you about the best time to have the vaccine;
• Are breastfeeding. The doctor will advise you about the risks and benefits of taking Fluvax whilst breastfeeding;
• Are taking any medications, including medications you buy without a prescription from the pharmacy or supermarket. Some medicines interact with Fluvax and may cause it not work as well as it should. Fluvax may also change the way other medicines work. Your doctor will assess whether or not you should change the way you take any of your other medications to have Fluvax;
• Have been immunised with another vaccine in the past 4 weeks. You may need to wait if you have recently received a vaccine that interacts with Fluvax.

Pregnancy

Fluvax is a Pregnancy Category B2 medication. It is recommended for women who will be in the second and third trimester of pregnancy during the influenza season. The vaccine may be offered to women planning a pregnancy as part of prenatal care. If a woman did not have a Fluvax immunisation before becoming pregnant, the vaccine can be administered in the first trimester of pregnancy. There is no evidence that Fluvax is harmful to the pregnant woman or the foetus when it is taken during pregnancy.

Breastfeeding

Breastfeeding women should inform their doctor that they are breastfeeding before receiving Fluvax vaccine.

Children

Fluvax should not be used in children < 5 years of age. The vaccine prepared for the 2010 influenza season was given the children < 5 years; however, a larger than expected proportion of children developed side effects (fever and convulsions) following vaccination. Therefore in 2011 the vaccine is not recommended for children < 5 years of age.

There was also a higher than expected proportion of 5–9 year old children who developed fevers or experienced convulsions after a Fluvax injection in 2010. Doctors therefore use Fluvax cautiously in this age group of children and only administer the vaccine if the judge the benefits of doing so outweigh the risks.

Fluvax is safe for use in older children.

Schedule

Fluvax is a Schedule 4 medication.

Common side effects

All medicines have side effects [link to med dict]. Most commonly the side effects are minor; however, some can be more serious. Usually the benefits of taking a medication outweigh the associated side effects. Your doctor would have considered these side effects before giving you a Fluvax injection.

The side effects of Fluvax are usually minor and resolve without treatment. Adults and children experience side effects differently.

Talk to your doctor if you experience any of the following side effects and they bother you:

• An injection site reaction, including:
• Pain;
• Redness;
• Burning;
• Itching;
• Tenderness;
• Discomfort;
• Warmth;
• Stinging;
• Swelling;
• A hard lump or scar;
• Skin flushing or redness which is most likely to affect the face;
• Flu-like illness or generally feeling unwell. Symptoms include:
• Headache;
• Fatigue;
• Fever;
• Sore throat;
• Runny nose;
• Cough;
• Chills;
• Sweating;
• Nausea;
• Vomiting;
• Diarrhoea;
• Sore, aching, tired or weak muscles or joints;
• Reduced appetite;
• Irritability.

These reactions usually represent minor side effects which will resolve without treatment. However, if you are concerned, contact you doctor.

Some reactions indicate potentially serious side effects of the vaccine. If you experience any of the following reactions it is important to tell your doctor so that they can assess whether you need medical attention:

• Infection at the injection site;
• Unusual bleeding, bruising or a purple spot on the skin;
• Skin rash or itchy spots or lumps on the skin;
• Painful swollen joints;
• Severe stabbing or throbbing pain in the nerves;
• Tingling, numbness or weakness.

Uncommon side effects

Serious side effects occur rarely after administration of Fluvax. If they do occur it is very important to seek urgent medical attention (e.g. by going to the hospital emergency department). The following symptoms may indicate a serious reaction to Fluvax:

• An allergic reaction, symptoms of which include:
  • Skin rash, itchy or hives;
  • Shortness of breath, difficulty breathing or wheezing;
  • A fit, convulsion or seizure of any type;
  • Muscle pain or tenderness or extreme weakness affecting the muscles;
  • Loss of muscle strength;
• Being unable to urinate or passing only small amounts of urine;
• Painful or swollen bruises on the skin;
• Pain, swelling and heat in the joints, skin or other body parts;
• Headache and high temperature when the individual is:
• Hallucinating;
• Confused;
• Paralysed or partly paralysed;
• Behaving abnormally;
• Experiencing unusual speech or eye movements;
• Sensitive to light.

These symptoms may occur as a result of an allergic reaction or Guillain-Barre syndrome, a condition affecting the nervous system which causes paralysis. These are both serious conditions which require urgent medical attention.

References

1. Fluvax Product Information [online]. St Leonards, NSW: MIMS Online; 1 December 2010 [cited 18 April 2011]. Available from: [URL link]
2. Fluvax Consumer Medical Information [online]. St Leonards, NSW: MIMS Online; January 2010 [cited 18 April 2011]. Available from: [URL link]

For further information talk to your doctor.