influenza vaccine: prescribing and clinical use
Focused clinical detail for use alongside current product information, local policy and patient-specific assessment.
influenza vaccine: clinical details
Prescribing considerations
- Confirm age, vaccination history, current medicines, immune status, asthma or wheezing history, pregnancy status and close contact with severely immunocompromised people.
- Defer during severe acute febrile illness, acute infection or substantial nasal blockage; minor infection or low-grade fever alone is not normally a reason to defer.
- Avoid in severe asthma or current wheezing because these groups have not been adequately studied.
- Record the product name and batch number for traceability.
- Ensure facilities and trained staff are available to manage anaphylaxis.
Contraindications and cautions
- Hypersensitivity to the active substances, excipients or gentamicin residues.
- Previous severe allergic reaction to eggs or egg proteins.
- Clinical immunodeficiency caused by specified diseases or immunosuppressive treatment, including high-dose corticosteroids.
- Salicylate therapy in children or adolescents.
- Not licensed below 2 years; not recommended during pregnancy and should not be used during breastfeeding.
Monitoring
- No routine laboratory monitoring is required.
- Check immediate tolerance and remain alert for hypersensitivity.
- Advise reporting suspected adverse reactions through the Yellow Card scheme.
- Review exposure risk when close contact with a severely immunocompromised person cannot be avoided after vaccination.
Clinical pharmacology
A trivalent, live attenuated vaccine containing cold-adapted and temperature-sensitive strains. Limited replication in the nasopharynx induces immune responses to the included influenza A and B strains.
Formulation and product differences
- Fluenz is administered intranasally; injectable influenza vaccines are inactivated alternatives when the live nasal vaccine is unsuitable.
- It contains gelatin and may contain trace egg proteins and gentamicin.
- Seasonal strains are updated periodically; the selected formulation contains three influenza strains.
- It is supplied as a single-use nasal applicator and must not be injected.
influenza vaccine interactions
Check current medicines and recent antiviral treatment before administering Fluenz.
Salicylates, including systemic aspirin
Fluenz is contraindicated during salicylate treatment. Salicylates should also be avoided afterwards unless medically necessary because of the theoretical risk of Reye’s syndrome.
Influenza antiviral medicines
These may reduce vaccine-virus replication and weaken the immune response, so administration timing requires clinical review.
Other vaccines
Fluenz may be given alongside specified live childhood vaccines. Follow product-specific and current programme guidance for other combinations.
Sources
These sources were used to prepare and review this medicine page.
Prepared and reviewed by the iatroX editorial team.