Flu Vaccine Availability, Kinds and Choices

Influenza Vaccines Egg and Tissue Based, Injected and Nasal Types

May 9, 2009

Eggs Used for Influenza Culture, CDC PHIL photo 10759

For those with egg allergies there is an alternative flu vaccine and for those who prefer a nasal spray attenuated virus, rather than be injected, there is a choice.

The value of influenza vaccines cannot be underestimated. Vaccines save lives. Persons who are compromised or have chronic or acute asthma, bronchitis, bronchiectasis or related conditions, may be protected by flu vaccines from primary lung infections and damage. Preventing influenza also limits secondary bacterial infections with bacteria such as Staphylococcus, Streptococcus, and Haemophilus. Children two years and older may benefit from flu vaccines. There are the standard egg-cultivated, injected influenza vaccines, and there are some new flu vaccine alternatives.

Yearly and Decade Influenza Illness and Death

The data that follows are of interest:

Over the past 30 years about 900,000 influenza-related deaths have occurred in the United States alone.
Of all vaccine-preventable infections, influenza is a leading cause of death and illness among persons 65 and older.
There are about 200,000 influenza-related hospitalizations and about 36,000 influenza-related deaths in a typical yearly epidemic season in the United States.

(All data above are from: Blue Ribbon Panel Report on Influenza, p.5, NIAD of NIH.gov).

Therefore, influenza studies of all types are invaluable, and new, improved or innovative vaccines are welcome.

Recent Influenza Vaccine Innovations

Injected vaccine is the standard delivery for most antigens such as rabies, polio (Salk), mumps, measles, chickenpox and smallpox. Smallpox, now eradicated, is only available as an emergency vaccine. Unique vaccine deliveries include oral vaccines for polio (Sabin) and the oral typhoid vaccine.

Influenza has seen two major changes in the last decade:

Nasal spray flu vaccine with live attenuated virus (FluMist).
Injected flu vaccine prepared in tissue culture with no egg embryo involvement (Optaflu).

The tissue culture vaccine is prepared from cells with no egg materials and promises to be a major advance. People with moderate to severe egg allergies now can be immunized and protected, rather than be unvaccinated and vulnerable to infection. Further, this vaccine can be mass produced faster than egg embryos. A recent summary of a conference on Influenza Vaccines of the World (May 1, 2009, by Todd Neale, Medpage.today.com) compared tissue-based with egg-based flu vaccines. The results were:

protection equal to the egg-based flu vaccine.
allergic reactions similar, but not related to any egg components.

FluMist (R), an nasal spray flu vaccine, is a small dose unit that is kept refrigerated and then sprayed into the nose. Here are important facts and warnings about FluMist abstracted from the manufacturer:

FluMist contains a live, weakened influenza virus.
Is approved for prevention of certain types of influenza disease.
Age range: 2–49 (not effective for people over 55)
FluMist may not protect everyone.
Is for intranasal administration only.
FluMist must not be given to: people with history of hypersensitivity to eggs, egg proteins, gentamicin, gelatin or arginine; people with life-threatening reactions to previous influenza vaccinations; and children and adolescents receiving aspirin or aspirin containing therapy.
Children less than 24 months are not eligible for FluMist.
Restrictions may apply to certain individuals and situations: people with asthma or active wheezing, or children less than 5 years of age with recurrent wheezing; people with a history of Guillain-Barré syndrome; people with a weakened immune system; people with long-term medical conditions including heart disease, kidney disease, and metabolic diseases, such as diabetes; and pregnant women.
If you or your child falls into one of the above groups, be sure to tell your healthcare provider. They will decide if FluMist is right for you or your child.

To understand more about flu read: pandemics and epidemics, and swine, avian and human flu.

Source

Brooks, G.F., J.S. Butel and S. A. Moore. 2004. Medical Microbiology. 23rd ed., Lange Medical Books, McGraw-Hill, New York. 818 pp

The copyright of the article Flu Vaccine Availability, Kinds and Choices in Immunology is owned by Donald Reinhardt. Permission to republish Flu Vaccine Availability, Kinds and Choices in print or online must be granted by the author in writing.