Live, attenuated intranasal H1N1 vaccine

1. Live, attenuated intranasal H1N1 vaccine

2. Indications • Healthy people 2-24 years old • Those 25-49 and • Live with or care for infants younger than 6 months • Health care or emergency medical personnel • As becomes more available, any healthy 2-49 year old

3. Contraindications • Allergy to: • Previous influenza vaccine • Eggs, egg products, gentamicin, gelatin, arginine • Fever or acute illness • Age less than 2 or greater than 49 • Pregnant females • Immunocompromised or contact with • History Guillain-Barre syndrome • Long term medical condition

4. Contraindications • All not absolute • Discuss with nurse or physician • May “qualify” for injection

5. Vaccine Considerations • For 2009, only one manufacturer • MedImmune • Supplied in pre-filled unit-dose nasal syringes • Storage: 35-46° F (2-8° C) • Can be administered at same time as any other vaccine EXCEPT another intra-nasal vaccine

6. Dosing • 0.2mL (0.1mL per nostril) • Dosing same regardless of age • Age 2-9: 2 doses 3-4 weeks apart • Age 10-49: 1 dose sufficient

7. Procedure • Obtain and verify vaccine • Colorless to pale yellow • Clear to slightly cloudy • Some small proteinaceous particles may be present • Ensure VAR complete

8. Procedure • Patient in upright position • Remove rubber tip protector • Insert tip just inside nare • Rapidly depress plunger until dose-divider clip stops • Remove from nose, remove dose-divider clip, and administer remainder in opposite nare

9. Considerations • If patient sneezes, no need to repeat • Immunocompromised should not give vaccine • Possible reactions • Runny nose or congestion • Fever, chills, malaise, myalgia • Headache, sore throat, nausea, vomiting