A: Vaccines are a primary prevention and control method for limiting the spread of transmissible diseases. They're particularly important in healthcare settings because they can protect your patients as well as yourself. Although influenza can occur in all age groups, the majority of the morbidity and mortality associated with the seasonal flu virus occurs in high-risk groups, namely older and very young patients, those who are immunocompromised, and those with underlying medical conditions. Because these patients constitute frequent users of healthcare, healthcare providers are at risk for exposure to influenza and may spread the infection to other vulnerable patients.
Unless contraindicated, the CDC recommends that all healthcare providers be vaccinated against influenza. In addition, for the 2009-2010 flu season, H1N1 vaccines are available to protect against the H1N1 influenza virus. Remember that the regular seasonal flu vaccine won't protect you against the current H1N1 flu. Vaccination of healthcare providers is recommended as soon as the vaccine becomes available, ideally before the seasonal influenza activity begins in your community. The CDC continues to encourage people to get vaccinated throughout the flu season, which can begin as early as October and last as late as May.
The nasal spray LAIV, or live attenuated influenza vaccine, can be used for healthy, nonpregnant adults up to age 49 who have no specific contraindications. The flu shot TIV, or trivalent influenza vaccine, is recommended for healthy people age 6 months and older, during pregnancy, and for people in high-risk groups, such as those with asthma, diabetes, or heart disease. The TIV is recommended for healthcare providers caring for high-risk patients because of the theoretical risk of transmission. Viral shedding can occur after receiving the LAIV; you shouldn't care for high-risk patients for 7 days.
As with the seasonal flu vaccines, there are two kinds of H1N1 vaccine available: the flu shot and the nasal spray.
In otherwise healthy adults, the most common adverse reactions to the LAIV include nasal congestion/rhinorrhea, headache, and sore throat. The most common adverse reaction to the TIV is soreness at the injection site. Although immediate hypersensitivity reactions are rare, provisions must be in place to treat anaphylaxis if it occurs. See package inserts for complete listings of adverse reactions.
Both the TIV and LAIV are contraindicated in people with severe allergy to egg or any of the vaccine components. See package inserts for a complete listing of precautions and contraindications before immunization.
What if you're pregnant or breastfeeding? The American College of Obstetricians and Gynecologists recommends routine vaccination with the TIV for all pregnant women. Unless contraindicated by other factors, lactating women may receive either the LAIV or TIV.
When the vaccine and the circulating virus are well matched, a 70% to 90% reduction in lab-proven influenza infections has been reported; when the vaccine isn't well matched with the virus, effectiveness is about 50%.
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