[TheForge] Fw: [SCA-Chirurgeon] Fw: Risks of FluMist Vaccine-OT-
more info
Peter Fels And Phoebe Palmer
[email protected]
Fri Dec 19 02:07:00 2003
But Good St Phlip;
That was for flu-mist..not for the innoculation which most folks would
be getting and which doesn't have all those conterindications......Pete F
Phlip wrote:
>From: "Friar Galen of Ockham" <[email protected]>
>To: <[email protected]>
>Sent: Thursday, December 18, 2003 7:00 PM
>Subject: Re: [SCA-Chirurgeon] Fw: Risks of FluMist Vaccine-OT
>
>
>
>
>>Here's a good review of the problems with FluMist that came through the
>>USAF medical channels:
>>
>>
>>
>>Barb's DTC (Direct To Clinician) Academic Detailing for FluMist
>>
>>By: LtCol Barbara Roach, USAF, MC
>>
>>The print ads will begin to appear today (Tuesday, 23 Sept 2003), and the
>>DTC (Direct To Consumer) television adds will start in the prime time
>>
>>
>hours
>
>
>>next Monday, 29 Sept 2003. Some of the following may be helpful to your
>>providers if there is an onslaught of poorly informed patients. The
>>
>>
>answers
>
>
>>come from the FluMist package insert. The summary below is from the August
>>2003 DoD P&T Committee Minutes regarding FluMist.
>>
>>Influenza intranasal vaccine (FluMist; Medimmune/Wyeth)
>> * FDA approved on 17 Jun 03:
>> * First nasally administered live influenza virus vaccine.
>> * Approved for active immunization for the prevention of disease
>>
>>
>caused
>
>
>>by influenza A and B viruses in healthy children ages 5-17 and healthy
>>adults ages 18-49.
>> * FluMist is not to be administered to asthmatics, immunocompromised
>>patients, or patients taking drugs which compromise the immune system
>>(chemo agents, high dose steroids, etc).
>> * Not added to the TMOP Formulary since the product is not intended
>>
>>
>for
>
>
>>self-administration and must remain frozen prior to use.
>> * Not added to the BCF - no vaccines are currently on the BCF.
>> * The product is not intended for self-administration and must remain
>>frozen prior to use.
>> * The FSS price for FluMist is substantially higher than the
>>
>>
>injectable
>
>
>>trivalent influenza vaccine available through FSS pricing:
>> * FluMist (MedImmune) (0.5ml) dose: $34.43
>> * Monarch influenza trivalent subviron syringe (0.5ml) dose: $2.72
>> * Monarch influenza trivalent subviron vial (0.5ml dose): $1.73
>>
>>The bullets above should answer most patients' and parents' questions such
>>
>>
>as:
>
>
>>Q. Will this drug replace the flu shot?
>>A. NO - not even remotely. This medication is not approved for the
>>people most at risk of dying from flu.
>>
>>Q. My child is asthmatic (or diabetic or has cancer, the list can
>>
>>
>go
>
>
>>on and on) and always has to get a flu shot. This seems like a great
>>alternative.
>>A. It's only a great alternative if you don't mind them being at
>>increased risk of an adverse event due to the medication. FluMist is
>>specifically NOT for asthmatics or anyone who is immunocompromised.
>>� "In a large safety study in children 1-17 years of age, children
>><5 years of age who received FluMist were found to have an increased rate
>>of asthma within 42 days of vaccination when compared to placebo
>>recipients." (From package insert)
>>� "The safety of FluMist in individuals with underlying medical
>>conditions that may predispose them to severe disease following wild-type
>>influenza infection has not been established. FluMist is not indicated for
>>these individuals. According to the Advisory Committee on Immunization
>>Practices (ACIP), such individuals include, but are not limited to, adults
>>and children with chronic disorders of the cardiovascular and pulmonary
>>systems, including asthma; pregnant women who will be in their second or
>>third trimesters during influenza season; adults and children who required
>>regular medical follow-up or hospitalization during the preceding year
>>because of chronic metabolic diseases (including diabetes), renal
>>dysfunction, or hemoglobinopathies; and adults and children with
>>
>>
>congenital
>
>
>>or acquired immunosuppression caused by underlying disease or
>>immunosuppressive therapy. Intramuscularly administered inactivated
>>influenza vaccines are available to immunize high-risk individuals [1]."
>>
>>1. Centers for Disease Control and Prevention. Prevention and control of
>>Influenza: recommendations of the Advisory Committee on Immunization
>>Practices (ACIP). MMWR 2003; 52 (No.RR-8):1-34.
>>
>>Q. Well even though my a) child, b) spouse and/or c) someone I live
>>with, is immunocompromised, I'm not immunocompromised. I don't want to get
>>a shot. I fall within the age range and I'm healthy. Is there a problem
>>
>>
>now?
>
>
>>A. Then FluMist is a viable alternative for you - unfortunately,
>>you'll have to avoid any close contact (household contact) with anyone who
>>is immunocompromised for 21 days after you receive the nasal vaccination.
>>You'll need to move out for a few weeks.
>>
>>Q. But I have (or my child has) an egg allergy so can't get the flu
>>shot for that reason. I want to get this alternative.
>>A. Egg allergy is a contraindication for FluMist also.
>>
>>Q. But it will save me a trip to doctor's office. I can pick up the
>>prescription and give it at home and not have to wait around.
>>A. It is not intended for self-administration, and it must remain
>>frozen in a special freezer up to the time of its administration. Your
>>freezer at home won't cut it.
>>
>>Q. I'm pregnant and I don't want to get a shot. I'd rather take
>>
>>
>this
>
>
>>nasal drug.
>>A. FluMist is contraindicated in pregnancy. The injection isn't.
>>
>>Q. My elderly parent has paper-thin skin and I'd like to avoid the
>>bleeding and bruising a shot may cause.
>>A. There were few patients over the age of 50 in the Flu Mist
>>trials. Therefore the FDA did not approve Flu Mist for patients over 49
>>years of age.
>>
>>Q. But there's no needle involved. My child hates needles.
>>A. And the child will let someone else squirt something up his/her
>>nose?
>>Needlephobic children between the ages of 5-17 years old could potentially
>>be candidates for vaccine. The Flu Mist package insert recommends two
>>
>>
>doses
>
>
>>- 60 days apart the first year they receive FluMist.
>>See the dosing administration pictures below.
>>
>>clip_image002.jpg
>>
>>� According to the American Lung Association, influenza is
>>estimated to cost in excess of $14 billion each year in the United States
>>alone. Approximately 10% to 20% of the U.S. population becomes infected
>>with the influenza virus annually.
>>
>>� The flu shot is one of the most important preventive
>>medicine interventions with solid data to back its use. There is not much
>>reason to mess around with success when FluMist offers no advantage to the
>>flu shot except in needlephobic individuals.
>>
>>� The CDC website has a lot of excellent information
>>
>>
>regarding
>
>
>>influenza. Go to
>>
>>
>>
><http://www.cdc.gov/ncidod/diseases/flu/fluvirus.htm>http://www.cdc.gov/ncid
>od/diseases/flu/fluvirus.htm
>
>
>>
>>
>>Disclaimer: This Direct to Clinician Academic Detailing paper is meant to
>>supply some information about this new product. It is not meant to be an
>>authoritative source of information, clinicians are invited to consult the
>>official package labeling for definitive clinical information. This paper
>>reflects the views of the author, and does not necessarily reflect the
>>views of any agencies within the Department of Defense.
>>
>>
>>
>>
>
>
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