Fluzone High-Dose 2026-2027 (influenza virus vaccine trival split 2026-2027(65 yr up)/PF)

Dose and dosing schedule (i.e., number of doses) of influenza virus vaccine inactivated for prevention of seasonal influenza depend on the individual's age, vaccination history, and specific product administered.

Inactivated influenza vaccines are administered by IM injection; do not administer intradermally or subcutaneously.

The vaccine product should be inspected visually for particulate matter and discoloration prior to administration. Discard the vaccine if it contains particulates, appears discolored, or cannot be resuspended with thorough agitation.

Influenza vaccine inactivated should not be mixed with any other vaccine or solution.

Influenza vaccine inactivated should be stored at 2-8degreesC; do not freeze (if freezing occurs, discard vaccine). Multiple-dose vials should be returned to 2-8oC between uses. The vaccine should be protected from light. Single-dose vials are preservative-free. Multiple-dose vials contain thimerosal as a preservative.

Syncope (vasovagal or vasodepressor reaction; fainting) may occur following vaccination; such reactions occur most frequently in adolescents and young adults. Take appropriate measures to decrease the risk of injury if a vaccine recipient becomes weak or dizzy or loses consciousness (e.g., vaccine recipients should sit or lie down during and for 15 minutes after vaccination). If syncope occurs, observe the individual until symptoms resolve.

Influenza vaccine inactivated may be administered concurrently with other vaccines during the same health-care visit. When multiple vaccines are administered during a single health-care visit, each parenteral vaccine should be given using separate syringes and at different injection sites. Injection sites should be separated by at least 1 inch (if anatomically feasible) to allow appropriate attribution of any local adverse effects that may occur.

No dosing information is available for this tab.

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There is no enhanced messaging for this drug.

Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient.

Vaccines/Pariglasgene Brecaparvovec

SEVERITY LEVEL: 1-Contraindicated Drug Combination: This drug combination is contraindicated and generally should not be dispensed or administered to the same patient.

MECHANISM OF ACTION: Pariglasgene brecaparvovec therapy may decrease the effectiveness of vaccines. The mechanism is not known.(1)

CLINICAL EFFECTS: The expected serum antibody response may not be obtained.(1)

PREDISPOSING FACTORS: None determined.

PATIENT MANAGEMENT: The US manufacturer of pariglasgene brecaparvovec states that vaccines should be avoided for 1 month prior to pariglasgene brecaparvovec administration.(1)

DISCUSSION: Pariglasgene brecaparvovec therapy may decrease the effectiveness of vaccines.(1)

There are no severe interactions for this drug.

Moderate Interaction: Assess the risk to the patient and take action as needed.

Vaccines/Hepatitis B Vaccine (Fendrix)

SEVERITY LEVEL: 3-Moderate Interaction: Assess the risk to the patient and take action as needed.

MECHANISM OF ACTION: No data is available on the concurrent administration of the hepatitis B vaccine Fendrix and other vaccines.(1)

CLINICAL EFFECTS: It is unknown if concurrent administration of the hepatitis B vaccine Fendrix and other vaccines will affect the efficacy of either vaccine.(1)

PREDISPOSING FACTORS: None determined.

PATIENT MANAGEMENT: The Swedish manufacturer of Fendrix states that since there is no data available for the concurrent administration of Fendrix with other vaccines, the administration of Fendrix and other vaccines should be separated by 2 to 3 weeks.(1)

DISCUSSION: No data is available on the concurrent administration of the hepatitis B vaccine Fendrix with other vaccines.(1)

*History of severe hypersensitivity (e.g., anaphylaxis) to previous dose of any influenza vaccine.

*Egg-based influenza vaccine inactivated: History of severe hypersensitivity (e.g., anaphylaxis) to any component of the vaccine, including egg protein.

*Cell culture-based influenza vaccine inactivated: History of severe allergic reactions (e.g., anaphylaxis) to any component of the vaccine.

There are no contraindication contraindications for this drug.

• Guillain-barre syndrome

There are no moderate contraindications for this drug.

The most common adverse effects of influenza vaccine inactivated are listed below for individual vaccine preparations.

Rare or Very Rare

• Anaphylaxis
• Angioedema
• Bell's palsy
• Brachial plexus disorder
• Cellulitis
• Dyspnea
• Encephalopathy
• Guillain-barre syndrome
• Hypersensitivity drug reaction
• Myelitis
• Optic neuritis
• Serum sickness
• Stevens-johnson syndrome
• Thrombocytopenic disorder
• Vasculitis

More Frequent

• Bruising
• Chills
• Erythema
• Fatigue
• Headache disorder
• Induration of skin
• Injection site pain
• Injection site sequelae
• Malaise
• Myalgia
• Pruritus of skin

Less Frequent

• Appetite changes
• Arthralgia
• Cough
• Diarrhea
• Ecchymosis
• Fever
• Injection site erythema
• Injection site inflammation
• Nausea
• Pharyngitis
• Vomiting

Rare or Very Rare

• Back pain
• Dizziness
• Extensive limb swelling after injection
• Flushing
• Lymphadenopathy
• Neuralgia
• Pain in oropharynx
• Paresthesia
• Seizure disorder
• Skin rash
• Syncope
• Urticaria

No enhanced messaging available.

Fluarix(R), Flulaval(R), Fluzone(R), Flucelvax(R): Safety and efficacy not established in infants <6 months of age.

Fluad(R) adjuvant-containing: Safety and efficacy not established in pediatric patients.

Fluzone(R) High-Dose: Safety and efficacy not established in pediatric patients.

Data collected in a prospective pregnancy exposure registry from women vaccinated with influenza virus vaccine inactivated quadrivalent (Fluarix(R), Flucelvax(R)) found no evidence of a vaccine-associated increase in the risk of major birth defects and miscarriages when administered during any trimester of pregnancy. Data for quadrivalent vaccines are relevant to trivalent products because both vaccines are manufactured using the same process and have overlapping compositions. Data are insufficient to assess the risk of use during pregnancy for other inactivated influenza vaccines (Fluzone(R), Fluad(R), Flulaval(R)).

Animal reproduction studies have not revealed evidence of harm to a fetus. Pregnant and postpartum women are at higher risk for severe influenza and influenza-related complications, particularly during the second and third trimesters, which may lead to adverse pregnancy outcomes including preterm labor and delivery.

To monitor pregnancy outcomes and newborn health status following influenza vaccination of pregnant women, some manufacturers have established pregnancy registries.

It is not known whether influenza vaccine inactivated is distributed into human milk. Data are insufficient to assess effects on the breast-fed infant or on milk production. Consider the benefits of breast-feeding and importance of the vaccine to the woman; also consider potential adverse effects on the breast-fed child from the vaccine or underlying maternal condition (i.e., susceptibility to influenza infection).

ACIP states that breast-feeding is not a contraindication to influenza vaccine inactivated; the vaccines do not pose any unusual risks for the mother or her nursing infant.

For dosing in geriatric patients, see dosage recommendations for adults based on age.

Fluarix(R), Flucelvax(R), Flulaval(R), Fluzone(R): No overall differences in safety relative to younger adults; may be less immunogenic in geriatric individuals.

Fluad(R) adjuvant-containing: Use only in adults >=65 years of age.

Fluzone(R) High-Dose: Use in adults >=65 years of age. Each 0.5 mL of Fluzone(R) High-Dose contains 4 times the amount of antigen contained in standard-dose Fluzone(R). In adults >=65 years of age, higher incidence of injection site reactions and systemic adverse effects reported with Fluzone(R) High-Dose compared with standard-dose Fluzone(R). Some evidence that the high-dose formulation elicits higher antibody titers and higher seroconversion rates than the standard-dose formulation in adults >=65 years of age and may be more effective in preventing laboratory-confirmed influenza in this age group.

ACIP states that all adults >=65 years of age should be vaccinated against influenza using influenza virus vaccine inactivated or influenza vaccine recombinant. ACIP states a preference for Fluzone(R) High-Dose, Flublok(R) recombinant influenza vaccine, or the standard-dose adjuvant-containing vaccine (Fluad(R)), but if none of these 3 vaccines is available at the time of vaccine administration, then adults >=65 years may receive a standard-dose preparation.