CDC H1N1 Flu | Monovalent Influenza Vaccine Dosage, Administration, and Storage

Monovalent Influenza Vaccine Dosage, Administration, and Storage
Inactivated Vaccine: Dosage, Administration, and Storage

The composition of the influenza A (H1N1) 2009 monvalent inactivated influenza vaccine varies according to manufacturer, and package inserts should be consulted. Inactivated vaccine formulations in multidose vials contain the vaccine preservative thimerosal; preservative-free, single-dose preparations also are available. Inactivated vaccine should be stored at 35°F to 46°F (2°C to 8°C) and should not be frozen. Inactivated vaccine that has been frozen should be discarded. Dosage recommendations and schedules vary according to age group (Table 1).

The intramuscular route is recommended for administering the influenza A (H1N1) 2009 monovalent inactivated vaccine. Adults and older children should be vaccinated in the deltoid muscle. A needle length of 1 inch or longer (25 mm or longer) should be considered for persons in these age groups because needles of less than 1 inch might be of insufficient length to penetrate muscle tissue in certain adults and older children. When injecting into the deltoid muscle in children with adequate deltoid muscle mass, a needle length of 7/8”to 1.25 inches is recommended.

Infants and young children should be vaccinated in the anterolateral aspect of the thigh. A needle length of 7/8” to 1 inch should be used for children younger than 12 months of age.

Live Attenuated Influenza Vaccine (LAIV): Dosage, Administration, and Storage
Each dose of 2009 monovalent LAIV contains the same vaccine antigen used in the inactivated vaccine. However, the antigen is constituted as a live, attenuated, cold-adapted, temperature-sensitive vaccine virus. Providers should refer to the package insert, which contains additional information about the formulation of this vaccine and other vaccine components. LAIV does not contain thimerosal. LAIV is made from an attenuated virus that is able to replicate efficiently only at temperatures present in the nasal mucosa. LAIV does not cause systemic symptoms of influenza in vaccine recipients, although a minority of recipients experience nasal congestion or fever, which is probably a result of the effects of intranasal vaccine administration or local viral replication or fever.

LAIV is intended for intranasal administration only and should not be administered by the intramuscular, intradermal, or intravenous route. LAIV is not licensed for vaccination of children younger than 2 years or adults older than 49 years of age. LAIV is supplied in a prefilled, single-use sprayer containing 0.2 mL of vaccine. Approximately 0.1 mL (i.e., half of the total sprayer contents) is sprayed into the first nostril while the recipient is in the upright position. An attached dose-divider clip is removed from the sprayer to administer the second half of the dose into the other nostril while the recipient is in the upright position. LAIV is shipped at 35°F to 46°F (2°C to 8°C). LAIV should be stored at 35°F to 46°F (2°C to 8°C) on receipt and can remain at that temperature until the expiration date is reached.

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CDC H1N1 Flu | Monovalent Influenza Vaccine Dosage, Administration, and Storage