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SAMJ: South African Medical Journal

Print version ISSN 0256-9574

SAMJ, S. Afr. med. j. vol.99 no.2 Cape Town Feb. 2009

 

SAMJ FORUM
DRUG ALERT

 

Recommendations pertaining to the use of viral vaccines: influenza 2009

 

 

Recommended vaccine formulation

The following strains have been recommended by the World Health Organization for the 2009 Southern Hemisphere influenza season:

• A/Brisbane/59/2007 (H1N1)-like virus (A/South Dakota/6/2007 (an A/Brisbane/59/2007-like virus) is a current vaccine virus used in live attenuated vaccines)

• A/Brisbane/10/2007 (H3N2)-like virus (A/Brisbane/10/2007 and A/Uruguay/716/2007 (an A/Brisbane/10/2007-like virus) are current vaccine viruses)

• B/Florida/4/2006-like virus (B/Florida/4/2006 and B/Brisbane/3/2007 (a B/Florida/4/2006-like virus) are current vaccine viruses)

Vaccines should contain 15 µg of each haemagglutinin antigen in each 0.5 ml dose.

 

Indications

1. Persons (adults or children) who are at high risk for influenza and its complications because of underlying medical conditions and who are receiving regular medical care for conditions such as chronic pulmonary and cardiac disease, chronic renal diseases, diabetes mellitus and similar metabolic disorders, and individuals who are immunosuppressed (including HIV-infected persons with CD4 counts above 200 cells/ml).

2. Residents of old-age homes, chronic care and rehabilitation institutions.

3. Children on long-term aspirin therapy.

4. Medical and nursing staff responsible for the care of highrisk cases.

5. Adults and children who are family contacts of high-risk cases.

6. All persons over the age of 65 years.

7. Women who would be in the second or third trimester of pregnancy during the influenza season. Pregnant women with medical conditions placing them at risk for influenza complications should be immunised at any stage of pregnancy.

8. Any persons wishing to protect themselves from the risk of contracting influenza, especially in industrial settings, where large-scale absenteeism could cause significant economic losses.

 

Dosage

• Adults: Whole or split-product or subunit vaccine - 1 dose IM.

• Children (<12 years): Split-product or subunit vaccine - 1 dose IM.

• Children <9 years who have never been vaccinated should receive 2 doses 1 month apart.

• Children less than 3 years of age should receive half the adult dose on two occasions separated 1 month apart.

 

Contraindications

1. Persons with a history of severe hypersensitivity to eggs.

2. Persons with acute febrile illnesses should preferably be immunised after symptoms have disappeared.

3. The vaccine should be avoided in the first trimester of pregnancy unless there are specific medical indications - see above indication No. 7.

 

Timing

Vaccines should be given sufficiently early to provide protection for the winter. A protective antibody response takes about 2 weeks to develop.

Department of Health

 

 

Corresponding author: B D Schoub (barrys@nicd.ac.za)