Friday, November 10, 2017

Installing Virus Protection Software

Hello rxBriefCase,

No, I am not referring to the software you install to protect your computer from a virus, but rather the influenza vaccination you provide patients to protect them from the flu. This blog post will provide an overview of important guideline recommendations and answers to common questions.

Recommendations to Remember
  • Two Doses for Children to Start: Any child getting vaccinated for the first time between the ages of 6-months through-8 years-old, will requires two doses, at least four weeks apart.1,2,3 It is recommended that children get their first dose as soon as the vaccine is available for the season.1
  • FluMist Recommendation Change: FluMist, the intranasal vaccine (LAIV4), is no longer the preferred vaccine for children.1,2,3 This means that either the injection or the intranasal vaccination can be used for children, without preference.2,3 Though more child friendly, the intranasal formulation is not considered to have superior effectiveness.2 Alberta and Saskatchewan have stopped covering this intranasal option under their immunization program.9 Read more: Flu shot or nasal spray?
  • Preferred Vaccine in Children: Children under the age of 18 are recommended to receive the quadrivalent vaccine.2,3 The trivalent vaccine provides protection against three different flu viruses (2A, 1B), compared to the quadrivalent which protects from four strains (2A, 2B). The quadrivalent vaccine is recommended for kids under the age of 18 because the morbidity and mortality resulting from B strains is higher in that age group versus the adult population.2,3
  • Pregnancy and Flu Shots: Pregnant women may receive any licensed and recommended (consider age) influenza vaccine.3,4 Data shows the influenza vaccination does not lead to any pregnancy complications or birth defects.4 Note: LAIV should not be used in pregnancy.3
  • Egg Allergy and Flu Shots: An allergy to eggs is no longer a contraindication for flu shots. 2,3 Studies have shown that the use of chicken embryos in the production of the vaccine do not create any issues for patients with egg allergies.5 Patients with an allergy to eggs, like all other patients, should be observed for 15 minutes after receiving the flu shot.1,5 Read more: Algorithm for patients with egg allergies
  • New Vaccine Available for Seniors: There is a new high dose trivalent vaccine (Fluzone High Dose) available for seniors (65+). This vaccine is currently not covered by any province, but it was just announced that it will be covered in Ontario next year.2,3,6 The high dose vaccine is four times as potent. It is suggested for the elderly due to the high disease burden of influenza and their declining immune response.3 The high dose vaccine is predicted to help create a stronger immune response and be more effective for seniors.2,3 Canadian Association of Retired Persons (CARP) supports the high dose vaccine: There’s a new flu vaccine available this year, just for Canadians 65+ (Video)

Common Questions from Patients
When is the best time for me to get the flu shot?
It is recommended to get the vaccine before the onset of influenza cases in the community or by the end of October.1,3 However, getting the vaccine later in the flu season can still be beneficial.1,3

Will the flu shot give me the flu?
No, it will not. You may experience a low-grade fever, aches, or some injection site soreness, redness and swelling.7 

Why did I get the flu even though I got the flu shot?
The flu shot does not guarantee 100% protection, but it is the best way to try and protect yourself and others.8 There are a few possible reasons why you may have gotten the flu despite getting vaccinated. You may have been exposed to the flu virus before you got the flu shot or during the two weeks it takes your body to create antibodies which help provide the protection.8 Also, the virus you may have been exposed to might not have been included in the vaccine for that season.8 The vaccine provides protection for the most common circulating strains, but not all strains.8 Furthermore, the protection one gets depends on their overall health and age. 8

Helpful Links to Help Update Your Influenza Knowledge:

  1. Grohskopf LA, Sokolow LZ, Broder KR, et al. Prevention and control of seasonal influenza with vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2017–18 Influenza Season. MMWR Recomm Rep 2017;66 (No. RR-2):1–20. DOI:
  2. Bhaidani, S. [Hey Pharmacist]. (2017, October 4). Giving the Flu Shot? Here's 5 Things to Know
  3. [Video File]. Retrieved from
  4. National Advisory Committee on Immunization. Advisory Committee Review: Canadian Immunization Guide Chapter on Influenza and Statement on Seasonal Influenza Vaccine for 2017-2018:
  5. Centre for Disease Control and Prevention. (2017, September 19). Flu Vaccine Safety and Pregnancy. Retrieved from
  6. Centre for Disease Control and Prevention. (2016, September 2). Flu Vaccine and People with Egg Allergies. Retrieved from
  7. Ministry of Senior Affairs. (2017, November 7). Aging with Confidence: Ontario’s Action Plan for Seniors. Retrieved from
  8. Centre for Disease Control and Prevention. (2016, August 25). Seasonal Flu Shot Question and Answers. Retrieved from
  9. Centre for Disease Control and Prevention. (2017, October 26). Frequently Asked Flu Questions 2017-2018 Influenza Season. Retrieved from
  10. Mulholland, A. (2017, October 16). Flu shot or nasal spray? Conflicting studies lead to confusion. Retrieved from