Therefore, the choice of influenza vaccine has become more complex. NACI recommends that influenza vaccine should be offered as a priority to the groups for whom influenza vaccination is particularly recommended (see. Individuals who have an allergy to substances that are not components of the influenza vaccine are not at increased risk of allergy to influenza vaccine. N Engl J Med. Shedding is generally below the levels needed to transmit infection, although in rare instances, shed vaccine viruses can be transmitted from vaccine recipients to unvaccinated people. Refer to Vaccine Safety in Part 2 of the CIG for additional information. 2004;7(4):272-7, Ochiai H, Fujieda M, Ohfuji S, Fukushima W, Kondo K, Maeda A, Nakano T, Kamiya H, Hirota Y, Influenza Vaccine Epidemiology Study Group. Can Commun Dis Rep. 2011;37(ACS-7):1-77, Block SL, Falloon J, Hirschfield JA, Krilov LR, Dubovsky F, Yi T, Belshe RB. Therefore, NACI recommends seasonal influenza vaccination for people in direct contact with poultry infected with avian influenza during culling operations, as these individuals may be at increased risk of avian influenza infection because of exposure during the culling operationFootnote 57,Footnote 58,Footnote 59,Footnote 60. Individuals who experienced ORS with lower respiratory tract symptoms should have an expert review. MMWR Morb Mortal Wkly Rep. 2010;59(33):1057-62, Cromer D, van Hoek AJ, Jit M, Edmunds WJ, Fleming D, Miller E. The burden of influenza in England by age and clinical risk group: a statistical analysis to inform vaccine policy. 2000;181(3):831-7, Schanzer DL, Tam TW, Langley JM, Winchester BT. MF59 further facilitates the internalization of antigen by these dendritic cellsFootnote 115,Footnote 117. Pediatrics. Refer to Section II.5 below for recommendations on choice of influenza vaccine by age group. Accessed: 9 October 2018. Am J Obstet Gynecol. IIV3-HD is expected to provide superior protection compared to IIV3-SD; however, with cost-effectiveness assessments having been outside the scope of the evidence review and without data on the relative efficacy and effectiveness between IIV3-HD, IIV3-Adj, and IIV4-SD, there is insufficient evidence to make a comparative recommendation on the use of these vaccines at the programmatic level. The target groups for influenza and pneumococcal polysaccharide vaccines overlap considerably. J Infect Dis. NACI recommends that influenza vaccine should be offered annually to anyone 6 months of age and older, including travellers, who does not have contraindications to the vaccine, with focus on the groups for whom influenza vaccination is particularly recommended (see, Health care and other care providers in facilities and community settings who, through their activities, are capable of transmitting influenza to those at high risk; and. The immune response to the B strain found only in the quadrivalent formulation was better in children who received the quadrivalent vaccineFootnote 141,Footnote 142,Footnote 143. A teacher-approved American English reading skills series for upper secondary and university students. Hum Vaccin Immunother. Recommendation for individual-level decision making, (i.e., individuals wishing to protect themselves from influenza or vaccine providers wishing to advise individual patients about preventing influenza). Pediatrics. There are four types of inactivated influenza vaccines (IIV3-SD, IIV3-Adj, IIV3-HD, and IIV4-SD) authorized for use in Canada for adults 65 years of age and older. Higher or comparable systemic reactions compared to IIV3-SD; systemic reactions were mild to moderate and transient. Thimerosal: updated statement. Liaison Representatives: Dr. J. Brophy (Canadian Association for Immunization Research and Evaluation), Dr. E. Castillo (Society of Obstetricians and Gynaecologists of Canada), Dr. A. Cohn (Centers for Disease Control and Prevention, United States), Ms. T. Cole (Canadian Immunization Committee), Dr. J. Emili (College of Family Physicians of Canada), Dr. K. Klein (Council of Chief Medical Officers of Health), Dr. C. Mah (Canadian Public Health Association), Dr. D. Moore (Canadian Paediatric Society), and Dr. A. Pham-Huy (Association of Medical Microbiology and Infectious Disease Canada). NACI recommends the inclusion of all pregnant women, at any stage of pregnancy, among the particularly recommended recipients of IIV, due to the risk of influenza-associated morbidity in pregnant womenFootnote 16,Footnote 17,Footnote 18,Footnote 19,Footnote 20, evidence of adverse neonatal outcomes associated with maternal respiratory hospitalization or influenza during pregnancyFootnote 21,Footnote 22,Footnote 23,Footnote 24, evidence that vaccination of pregnant women protects their newborns from influenza and influenza-related hospitalizationFootnote 25,Footnote 26,Footnote 27,Footnote 28, and evidence that infants born during influenza season to vaccinated women are less likely to be premature, small for gestational age, and of low birth weightFootnote 29,Footnote 30,Footnote 31,Footnote 32. Therefore, the evidence summarized in this section may not include the latest studies. 2016;213(8):1216-23, Louie JK, Acosta M, Jamieson DJ, Honein MA. NACI recommends that any age-appropriate IIV, but not LAIV, should be offered to HCWs. BMJ. This section describes the influenza vaccine products that are available for use in Canada for the 2019–2020 season. The hyphenated suffix “-SD” is used when referring to IIV products that do not have an adjuvant, contain 15 µg hemagglutinin (HA) per strain and are administered as a 0.5 mL dose by intramuscular injection; “-Adj” refers to an IIV with an adjuvant (e.g., IIV3-Adj for Fluad® or Fluad Pediatric®); and “-HD” refers to an IIV that contains higher antigen content than 15 µg HA per strain (e.g., IIV3-HD for Fluzone® High-Dose). PLoS One. Protective measures and human antibody response during an avian influenza H7N3 outbreak in poultry in British Columbia, Canada. In this same review of the literature, NACI reviewed the immunogenicity data for IIV4-SD produced by manufacturers who supplied influenza vaccine in Canada at the time of the literature review: AstraZeneca, GlaxoSmithKline, and Sanofi Pasteur. In observational studies, influenza vaccination has been shown to reduce the number of physician visits, hospitalizations, and deaths in adults 18–64 years of age with high-risk medical conditionsFootnote 101, hospitalizations for cardiac disease and stroke in adults 65 years of age and olderFootnote 102, and hospitalization and deaths in adults 18 years of age and older with diabetes mellitusFootnote 103 during influenza epidemics. Further advice regarding the timing of influenza vaccination programs may be obtained through consultation with local public health agencies. Insufficient head-to-head studies comparing immunogenicity data of IIV3-Adj, IIV3-HD, and IIV4-SD. 2007;176(1):47-53, Heckler R, Baillot A, Engelmann H, Neumeier E, Windorfer A. Cross-protection against homologous drift variants of influenza A and B after vaccination with split vaccine. 1995;333(14):889-93, Department of Health (UK). Vaccine providers should take the opportunity to vaccinate eligible people against pneumococcal disease when influenza vaccine is given. Vaccine. Most studies have shown that administration of a second dose of influenza vaccine in the same season to older adults or other individuals who may have an altered immune response does not result in a clinically significant antibody boostFootnote 75,Footnote 76,Footnote 77,Footnote 78. In theory, the administration of two live vaccines sequentially within less than 4 weeks could reduce the efficacy of the second vaccine. 2008;19(6):419-23, Scharpé J, Evenepoel P, Maes B, Bammens B, Claes K, Osterhaus AD, Vanrenterghem Y, Peetermans WE. During the 22 seasons in which influenza A(H3N2) was the prominent strain, the average influenza-associated mortality rates were 2.7 times higher than for the nine seasons that it was not (all age groups combined), and on average, there were about 37% more annual influenza-associated deaths, regardless of the underlying medical cause. 2007;357(26):2729-30, Orenstein EW, De Serres G, Haber MJ, Shay DK, Bridges CB, Gargiullo P, Orenstein WA. Because children 6–23 months of age are less likely to have had prior priming exposure to an influenza virus, special effort is warranted to ensure that a two-dose schedule is followed for previously unvaccinated children in this age group. The national goal of the annual influenza immunization programs in Canada is to prevent serious illness caused by influenza and its complications, including death. Occup Med (Lond). Epidemiol Infect. Worldwide, annual epidemics result in approximately one billion cases of influenza, three to five million cases of severe illness, and 290,000 to 650,000 deaths. In view of the considerable morbidity and mortality associated with influenza, a diagnosis of influenza vaccine allergy should not be made without confirmation, which may involve consultation with an allergy or immunology expert. This moderate improvement in antibody response without an increase in reactogenicity is the basis for the full dose recommendation for unadjuvanted inactivated vaccine for all ages. Manufacturer(s) have sought approval of the vaccine(s) and provided evidence as to its safety and efficacy only when it is used in accordance with the product monographs. The 1966 Outer Space Treaty 4. No studies have been done to assess the possibility of interference between LAIV and other live vaccines, or on LAIV given before or after other live vaccines. The influenza viruses contained in LAIV are attenuated so that they do not cause influenza and are cold-adapted and temperature sensitive, so that they replicate in the nasal mucosa rather than the lower respiratory tract. Recommendation for public health program-level decision-making, (i.e., provinces/territories making decisions for publicly funded immunization programs). Based on the body of evidence indicating a higher rate of influenza-associated hospitalization and death among Indigenous peoples, NACI recommends the inclusion of this population among the particularly recommended recipients of influenza vaccine. Influenza vaccination of health care workers in long-term-care hospitals reduces the mortality of elderly patients. There is insufficient evidence (cost-effectiveness assessments have not been performed) to make comparative public health program-level recommendations on the use of the available vaccines. Am J Epidemiol. 1991;29(7):1530-2, Levandowski RA, Regnery HL, Staton E, Burgess BG, Williams MS, Groothuis JR. Antibody responses to influenza B viruses in immunologically unprimed children. This finding led to the manufacturer replacing the A(H1N1)pdm09 component of LAIV with a new strain. 2013, Grotto I, Mandel Y, Green MS, Varsano N, Gdalevich M, Ashkenazi I, Shemer J. Refer to Human Health Issues Related to Avian Influenza in Canada for PHAC recommendations on the management of domestic avian influenza outbreaks. 2010, European Medicines Agency. On the basis of this moderate improvement in antibody response without an increase in reactogenicity, NACI recommends the use of a 0.5 mL dose for all recipients of IIV-SDs, including young children, which is thought to mitigate the reduced immune response observed in the studies with the 0.25 mL dose of IIV-SDs. Guillain-Barre syndrome and preceding infection with campylobacter, influenza and Epstein-Barr virus in the general practice research database. 2009;49(5):750-6, Loeb M, Russell ML, Moss L, Fonseca K, Fox J, Earn DJ, Aoki F, Horsman G, Van Caeseele P, Chokani K, Vooght M. Effect of influenza vaccination of children on infection rates in Hutterite communities: a randomized trial. In particular, a single dose of IIV3-Adj is more immunogenic than a single dose of IIV3-SD, and has been shown in one study to produce greater GMTs than 2 doses of IIV3-SD against influenza AFootnote 123. Effect of interval between inoculation of live smallpox and yellow-fever vaccines on antigenicity in man. 2015;61(2):171-6, Falsey AR, Treanor JJ, Tornieporth N, Capellan J, Gorse GJ. Available from: http://nces.ed.gov/pubs2008/nativetrends/ind_1_6.asp, Indigenous and Northern Affairs Canada. Although its utility may be compromised if exposure to influenza has already occurred, vaccine providers should use every opportunity to give influenza vaccine to individuals at risk who have not been immunized during the current season, even after influenza activity has been documented in the community. 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. 2006;35(2):337-44, Jackson LA, Nelson JC, Benson P, Neuzil KM, Reid RJ, Psaty BM, Heckbert SR, Larson EB, Weiss NS. The quadrivalent formulation (LAIV4) was approved for use in Canada for the 2014–2015 season and has been in use since that time. 2012;31(7):745-51, Block SL, Yi T, Sheldon E, Dubovsky F, Falloon J. MMWR Morb Mortal Wkly Rep. 2018;67(22):643-5, National Advisory Committee on Immunization. 2017. Although influenza vaccine can inhibit the clearance of warfarin and theophylline, clinical studies have not shown any adverse effects attributable to these drugs in people receiving influenza vaccine. Although the initial antibody response in older adults may be lower to some influenza vaccine components when compared to those in other age groups, a literature review identified no evidence for a subsequent antibody decline that was any more rapid in older adults than in younger age groupsFootnote 70. 2004;10(12):2196-9, Skowronski DM, Li Y, Tweed SA, Tam TW, Petric M, David ST, Marra F, Bastien N, Lee SW, Krajden M, Brunham RC. It should be noted that the incidence of influenza is often underreported since the illness may be confused with other viral illnesses and many people with influenza-like illness (ILI) do not seek medical care or have viral diagnostic testing done. 2008;105(30):10501-6, Calabro S, Tortoli M, Baudner B, Pacitto A, Cortese M, O’Hagan DT, De Gregorio E, Seubert A, Wack A. A variety of influenza vaccines are available for use in Canada, some of which are authorized for use only in specific age groups. List 1: Groups for whom influenza vaccination is particularly recommended, People at high risk of influenza-related complications or hospitalization, People capable of transmitting influenza to those at high risk. PHAC acknowledges that the advice and recommendations set out in this statement are based upon the best current available scientific knowledge and is disseminating this document for information purposes. 2009;27(50):7031-5, Pebody RG, Andrews N, Fleming DM, McMenamin J, Cottrell S, Smyth B, Durnall H, Robertson C, Carman W, Ellis J, Sebastian-Pillai P. Age-specific vaccine effectiveness of seasonal 2010/2011 and pandemic influenza A(H1N1) 2009 vaccines in preventing influenza in the United Kingdom. 2010;28(15):2722-9, Kwong JC, Maaten S, Upshur RE, Patrick DM, Marra F. The effect of universal influenza immunization on antibiotic prescriptions: an ecological study. Abbreviations: FFU: fluorescent focus units; HA: hemagglutinin; IIV3-Adj: adjuvanted trivalent inactivated influenza vaccine; IIV3-HD: high-dose trivalent inactivated influenza vaccine; IIV3-SD: standard-dose trivalent inactivated influenza vaccine; IIV4-SD: standard-dose quadrivalent inactivated influenza vaccine; IM: intramuscular; LAIV4: quadrivalent live attenuated influenza vaccine; NA: neuraminidase. Vaccine. The impact of influenza epidemics on hospitalizations. Due to a lack of safety data at this time, LAIV should not be administered to pregnant women due to the theoretical risk to the fetus from administering a live virus vaccine. Recommendations are developed based on a review of a variety of issues, which can include: the burden of influenza illness and the target populations for vaccination; efficacy, effectiveness, immunogenicity, and safety of influenza vaccines; vaccine schedules; and other aspects of influenza immunization. Egg allergy is not a contraindication for influenza vaccination as there is a low risk of adverse events associated with the trace amounts of ovalbumin allowed in influenza vaccines manufactured using eggs. 2007;7(11):2567-72, Buxton JA, Skowronski DM, Ng H, Marion SA, Li Y, King A, Hockin J. Additional technical information related to seasonal influenza vaccine can be found in the remainder of this statement. PloS One. A randomized, double-blind noninferiority study of quadrivalent live attenuated influenza vaccine in adults. 2002;185(8):1005-10, Puzelli S, Di Trani L, Fabiani C, Campitelli L, De Marco MA, Capua I, Aguilera JF, Zambon M, Donatelli I. Serological analysis of serum samples from humans exposed to avian H7 influenza viruses in Italy between 1999 and 2003. Information not available at time of writing; refer to product monograph. People with immune compromising conditions, due to underlying disease, therapy, or both, as the vaccine contains live attenuated virus; People with severe asthma (defined as currently on oral or high-dose inhaled glucocorticosteroids or active wheezing) or medically attended wheezing in the 7 days prior to the proposed date of vaccination; LAIV is not contraindicated for people with a history of stable asthma or recurrent wheeze. 2011;342:d3214, Goldenberg R, Culhane J, Iams J, Romero R. Epidemiology and causes of preterm birth. The information in this section constitutes the influenza chapter of the CIG and is adapted for inclusion in the NACI Statement on Seasonal Influenza Vaccine. All single dose formulations of IIV and LAIV are thimerosal-free. Studies on LAIV3 have shown that vaccine virus can be recovered by nasal swab in children and adults following immunization (i.e., “shedding”). Two types of influenza vaccine are available for use in adults 60–64 years of age: IIV3-SD and IIV4-SD. Washington, DC: National Academy of Sciences. Hum Vaccin Immunother. Available from: https://clinicaltrials.gov/ct2/show/results/NCT00952705, Ritzwoller DP, Bridges CB, Shetterly S, Yamasaki K, Kolczak M, France EK. MMWR Morb Mortal Wkly Rep. 2010;59(21):657-61, Kwong JC, Vasa PP, Campitelli MA, Hawken S, Wilson K, Rosella LC, Stukel TA, Crowcroft NS, McGeer AJ, Zinman L, Deeks SL. To ensure the ongoing safety of influenza vaccines in Canada, reporting of AEFIs by vaccine providers and other clinicians is critical, and in some jurisdictions, reporting is mandatory under the law. However, pre-licensure clinical trials (refer to Literature Review on Quadrivalent Influenza Vaccines) and post-marketing surveillance showed that IIV4-SD had a similar safety profile to IIV3-SDFootnote 138. Study of Fluzone® influenza virus vaccine 2011-2012 formulation (intramuscular route) among adults. LAIV3 is no longer available in Canada. This four-level American English reading course uses carefully selected reading texts to help students read effectively. MMWR Morb Mortal Wkly Rep. 2009;58(48):1341-4, National Center for Education Statistics. Exports from Dushanbe consisted of $8,343,200 during the first half of 2019. Protective levels of humoral antibodies, which correlate with protection against influenza infection, are generally achieved by 2 weeks after vaccination; however, there may be some protection afforded before that time. Vaccination is recommended for contacts, both adults and children, of individuals at high risk of influenza-related complications or hospitalization (see List 1), whether or not the individual at high risk has been vaccinated. Delivery of LAIV as a nasal spray may be preferable for children who are averse to receiving the vaccine by needle injection. Influenza B viruses have evolved into two antigenically distinct lineages since the mid-1980s, represented by B/Yamagata/16/88-like and B/Victoria/2/87-like viruses. Am J Public Health. There are vaccine contraindications specific to LAIV. Clin Infect Dis. A trivalent product (IIV3-HD; Fluzone® High-Dose) for adults 65 years of age and older is available. 2011;10(4):447-62, Vesikari T, Knuf M, Wutzler P, Karvonen A, Kieninger-Baum D, Schmitt HJ, Baehner F, Borkowski A, Tsai TF, Clemens R. Oil-in-water emulsion adjuvant with influenza vaccine in young children. Refer to the Statement on Seasonal Influenza Vaccine for 2018–2019 for more information on the immunogenicity of IIV3-Adj in adults 65 years of age and older. The pictorial method used in this book is based on a thorough understanding of language structure and how language is successfully learned. No studies were found on potential immune interference between LAIV and other live attenuated vaccines (oral or parenteral) administered within 4 weeks. I. Gemmill, and approved by NACI. In these studies, LAIV3 has generally been shown to be equally, if not more, immunogenic compared to IIV3-SD for all 3 strains in children, whereas IIV3-SD was typically more immunogenic in adults than LAIV3. Influenza vaccination is efficacious and safe in renal transplant recipients. For these reasons, NACI recommends that influenza vaccine should not be offered to infants less than 6 months of age, noting that influenza vaccine should be offered to their household contacts and care providers (see List 1). NACI will continue to monitor the literature related to this issue. Based on a systematic review of the literature, NACI has concluded that there is insufficient evidence at this time on the comparative effectiveness and immunogenicity of unadjuvanted subunit and split virus inactivated influenza vaccines in adults 65 years of age and older to support specific recommendations on the differential use of these vaccines (Grade I Evidence). Decisions regarding the precise timing of vaccination in a given setting or geographic area should be made according to local epidemiologic factors (influenza activity, timing, and intensity), opportune moments for vaccination, as well as programmatic considerations. Statement on Seasonal Influenza Vaccine for 2014–2015. However, the potential risk of GBS recurrence associated with influenza vaccination must be balanced against the risk of GBS associated with influenza infection itself and the benefits of influenza vaccination. Data from post-marketing surveillance of influenza vaccines in Canada (Canadian Adverse Events Following Immunization Surveillance System [CAEFISS]) have shown seasonal influenza vaccines to have a safe and stable profile for adverse events following immunization (AEFIs) with no unexpected events. As expected, these studies showed that the immune response to the B strain that was not in the trivalent formulation was better in subjects who received the quadrivalent vaccine, which contained the additional B strain. 2005;192(8):1318-22, Tweed SA, Skowronski DM, David ST, Larder A, Petric M, Lees W, Li Y, Katz J, Krajden M, Tellier R, Halpert C. Human illness from avian influenza H7N3, British Columbia. This paper. Recommendations for use and other information set out herein may differ from that set out in the product monograph(s) of the Canadian manufacturer(s) of the vaccine(s). Clin Infect Dis. In the study by Couch et al., seroprotection was higher only against A(H1N1), possibly attributed to the fact that 78% of participants were vaccinated against the same influenza strains within 6 months prior to the studyFootnote 129. For example, randomized controlled trials (RCTs) conducted in geriatric long-term care settings have demonstrated that vaccination of HCWs is associated with substantial decreases in morbidityFootnote 47,Footnote 48,Footnote 49 and all-cause mortalityFootnote 46,Footnote 47,Footnote 48,Footnote 49 in the residents. J Infect Dis. N Engl J Med. 2013;31(6):861-6, DiazGranados CA, Dunning AJ, Kimmel M, Kirby D, Treanor J, Collins A, Pollak R, Christoff J, Earl J, Landolfi V, Martin E. Efficacy of high-dose versus standard-dose influenza vaccine in older adults. 2010;303(15):1517-25, Mak TK, Mangtani P, Leese J, Watson JM, Pfeifer D. Influenza vaccination in pregnancy: current evidence and selected national policies. A pre-licensure efficacy trial in children 6–71 months of age found a higher relative efficacy for IIV-Adj than the unadjuvanted IIV3-SDFootnote 118. Efficacy of inactivated and cold-adapted vaccines against influenza A infection, 1985 to 1990: the pediatric experience. Greater rates of seroconversion to LAIV3 occurred in baseline seronegative individuals compared to baseline seropositive individuals in both pediatric and adult populations, because pre-existing immunity may interfere with response to a live vaccine. Recovery is a critical component of the resuscitation Chain of Survival. If IIV is used, NACI recommends that a quadrivalent vaccine should be used. Although the burden of influenza can vary from year to year, it is estimated that there are an average of 12,200 hospitalizations related to influenza and approximately 3,500 deaths attributable to influenza annuallyFootnote 4,Footnote 5. As noted in PHAC’s Guidance: Infection Prevention and Control Measures for Healthcare Workers in Acute Care and Long-term Care Settings for seasonal influenza, all health care organizations should have a written plan for managing an influenza outbreak in their facilities. In the absence of contraindications, refusal of HCWs to be vaccinated against influenza implies failure in their duty of care to patients. Prerequisite for Space to Ground Capabilities 5. Either IIV4-SD or LAIV4 should be used in children without contraindications, including those with non-immune compromising chronic health conditions, given the burden of influenza B disease in this age group and the potential for lineage mismatch between the predominant circulating strain of influenza B and the strain in a trivalent vaccine. Preliminary results: surveillance for Guillain-Barré syndrome after receipt of influenza A (H1N1) 2009 monovalent vaccine - United States, 2009-2010. All household, work, and social contacts identified between Jan 23, 2020 (date of identification of the first COVID-19 case in Singapore) and April 3, 2020, were approached for informed consent via telephone, to participate in a risk factor questionnaire (appendix 2 pp 3–6) and a one-time blood draw for SARS-CoV-2 serology testing. Risk of influenza A (H5N1) infection among poultry workers, Hong Kong, 1997-1998. The standard-dose inactivated influenza vaccines (IIV-SDs) currently authorized for use in Canada are a mix of split virus and subunit vaccines. Washington, DC: US Department of Education. Serious adverse events are rare following influenza vaccination, and in most cases, data are insufficient to determine a causal association. Split virus vaccines contain whole inactivated viruses split with detergent, ether, or both, while subunit vaccines are made of purified HA and NA. Serious adverse events were rare and similar in frequency to IIV3-SD. Chang Chin Liang's Cometary Lensing Updated 1st February 2021 2.3. Insufficient head-to-head studies directly comparing efficacy and effectiveness of IIV3-Adj, IIV3-HD, and IIV4-SD. Three subtypes of HA (H1, H2, and H3) and two subtypes of NA (N1 and N2) are recognized among influenza A viruses as having caused widespread human disease over the decades. Pediatr Infect Dis J. Severe 2009 H1N1 influenza in pregnant and postpartum women in California. People administering the vaccine should also be aware of the contents of the relevant product monograph(s). Lancet Infect Dis. Large cohort studies of administrative health databases have found no association between childhood vaccination with thimerosal-containing vaccines and neurodevelopmental outcomes, including autistic-spectrum disordersFootnote 13. Booster doses are not required within the same influenza season. The following highlights key information for vaccine providers. Rates of seroconversion were found to be about 19% higher (ranging from 8–39%) for those receiving the higher dose vaccine across all three vaccine strains. 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. Single dose pre-filled syringe with Luer tip, Single dose pre-filled syringe without a needle, Single dose pre-filled syringe without attached needle, Single-dose pre-filled syringe without attached needle. 2008;371(9606):75-84, McNeil SA, Dodds LA, Fell DB, Allen VM, Halperin BA, Steinhoff MC, MacDonald NE. Higher rate of some systemic reactions than IIV3-SD; most systemic reactions were mild and transient. Manufacturer investigation identified potential reduced replicative fitness of the A(H1N1)pdm09-like LAIV viruses in the nasal mucosa from the two affected A(H1N1)-dominant seasons compared to pre-2009 pandemic influenza A(H1N1) LAIV viruses as contributing to the poor LAIV effectiveness against circulating A(H1N1)Footnote 139. Dec 15, 2020 Playoff Scenario: What it takes for the Steelers to clinch the division and more what is needed to clinch the spot with known tiebreakers in most cases. Impact of repeated vaccination on vaccine effectiveness against influenza A(H3N2) and B during 8 seasons. Provincial and territorial health authorities then determine which of the available products will be used in their respective publicly funded influenza immunization programs and for which population groups. If IIV4-SD or LAIV4 is not available, IIV3-SD should be used. CMAJ. Clin Infect Dis. IIV should be used for adults for whom LAIV is contraindicated, such as in: adults with any of the chronic health conditions identified in. Influenza vaccine effectiveness in primary school children in Japan: a prospective cohort study using rapid diagnostic test results.
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