The aim of influenza immunisation is to reduce the morbidity and mortality from influenza by immunising those most likely to develop severe or complicated illness consequent to influenza infection.

The aim of influenza immunisation is to reduce the morbidity and mortality from influenza by immunising those most likely to develop severe or complicated illness consequent to influenza infection.

Groups recommended for vaccination

National policy for 2001/2002 is that influenza immunisation should be offered to:

1. People of all ages in the following risk groups:

Chronic respiratory disease, including asthma

 

 This includes 
  • chronic obstructive pulmonary disease (COPD), including chronic bronchitis and emphysema
  • bronchiectasis
  • cystic fibrosis
  • interstitial lung fibrosis
  • pneumoconiosis
  • asthma requiring continuous or repeated use of inhaled or systemic steroids or with previous exacerbations requiring hospital admission
Chronic heart disease This includes 
  • chronic ischaemic heart disease,
  • congenital heart disease 
  • hypertensive heart disease requiring regular medication and follow-up (but excluding uncomplicated controlled hypertension)
  • chronic heart failure
Chronic renal disease Including 
  • nephrotic syndrome
  • chronic renal failure
  • renal transplantation.
Diabetes mellitus Diabetes mellitus requiring 
  • insulin
  • oral hypoglycaemic drugs.
Immunosuppression Due to disease or treatment, including systemic steroids equivalent to 20mg prednisolone daily for more than 2 weeks. However, please note that some immunocompromised patients may have a suboptimal immunological response to vaccine.

2. All aged 65 years and over.

3. Those living in long-stay residential and nursing homes or other long-stay facilities.

Target

Frequency

Dose and administration of vaccine

Adults and children aged 13 years and over:
a single injection of 0.5ml im or deep sc
 
Children aged 4-12 years:
0.5m1 im or deep sc, repeated 4-6 weeks later if receiving influenza vaccine for the first time Children aged 6
 
6 months to 3 years:
0.25m1 im or deep sc, repeated 4-6 weeks later if receiving influenza vaccine for the first time.

Only children with severe respiratory problems or immune deficiency should be immunised.

The deltoid muscle is the recommended site for adults and older children. For infants and young children the preferred site is the anterolateral aspect of the thigh.

Antibody levels may take up to 10-14 days to rise. Influenza activity is not usually significant before the middle of November, and therefore the ideal time for immunisation is October/early November.

Adverse reactions

Influenza vaccine is usually well tolerated apart from occasional soreness at the immunisation site. In rare instances it can, however, cause:

  1. fever, malaise, myalgia and/or arthralgia beginning 6 to 12 hours after immunisation and lasting up to 48 hours.
  2. Immediate reactions such as urticaria, angio-oedema, bronchospasm and anaphylaxis, most likely due to hypersensitivity to residual egg protein.

Guillain-Barré syndrome has been reported very rarely after immunisation with influenza vaccine, although a causal relationship has not been established.

Influenza vaccine contains inactivated virus and cannot cause influenza.

Contraindications

Recording information

Recording is best achieved using the SOPHIE designed for pneumococcal and flu vaccine data entry.