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Summer 2016 Pharmacist Administered Immunization Updates
FDA Approves First Cholera Vaccine in the U.S.
In June, the FDA approved the first vaccine for cholera, helping protect travelers from the disease often caused by contaminated food or water particularly in less developed areas of the world. The liquid vaccine, called Vaxchora, is intended for adults ages 18 to 64 who are traveling to countries affected by cholera.
Vaxchora is a live, weakened vaccine that is taken as a single, oral liquid dose of approximately three fluid ounces at least 10 days before travel to a cholera-affected area.
ACIP Votes Down Use of LAIV for 2016-17 Influenza Season
Following three seasons of poor effectiveness, the CDC’s Advisory Committee on Immunization Practices (ACIP) voted that live attenuated influenza vaccine (LAIV), also known as the “nasal spray” flu vaccine, should not be used during the 2016-2017 flu season. ACIP still recommends annual flu vaccination, with either the inactivated influenza vaccine (IIV) or recombinant influenza vaccine (RIV), for everyone 6 months and older. ACIP is a panel of immunization experts that advises the CDC.
In late May, preliminary data on the effectiveness of LAIV among children 2 years through 17 years during the 2015-2016 season became available from the U.S. Influenza Vaccine Effectiveness Network. That data showed the estimate for LAIV VE among study participants in that age group against any flu virus was 3 percent (with a 95 percent Confidence Interval (CI) of -49 percent to 37 percent). This 3 percent estimate means no protective benefit could be measured. In comparison, IIV (flu shots) had a VE estimate of 63 percent (with a 95 percent CI of 52 percent to 72 percent) against any flu virus among children 2 years through 17 years. Other (non-CDC) studies support the conclusion that LAIV was less effective than IIV this season. The data from 2015-2016 follows two previous seasons (2013-2014 and 2014-2015) showing poor and/or lower than expected vaccine effectiveness (VE) for LAIV.
CDC: 2015-16 Influenza Season Was Less Severe Overall Compared With The Preceding Three Seasons
During the 2015-16 influenza season (Oct. 4, 2015-May 21, 2016) in the United States, influenza activity was lower and peaked later compared with the previous three seasons (2012-13, 2013-14, and 2014- 15). Activity remained low from October 2015 until late December 2015 and peaked in mid-March 2016. During the most recent 18 influenza seasons (including this season), only two other seasons have peaked in March (2011-12 and 2005-06). Overall influenza activity was moderate this season, with a lower percentage of outpatient visits for influenza-like illness (ILI), lower hospitalization rates and a lower percentage of deaths attributed to pneumonia and influenza (P&I) compared with the past three seasons. Influenza A(H1N1)pdm09 viruses predominated overall, but influenza A(H3N2) viruses were more commonly identified from October to early December, and influenza B viruses were more commonly identified from mid-April through mid-May.
CDC Guidelines Stress Pharmacists’ Role In Large-Scale Immunization Clinics
CDC released new guidelines that offer a comprehensive blueprint for successful large-scale influenza immunization clinics. The document describes best practices that span both clinical and practical matters for planning and conducting clinics.
Many of the guidelines address logistics: crowd management, smooth traffic flow, comfortable waiting areas, areas that offer privacy for those receiving the vaccine, and spaces dedicated to vaccine preparation. Adequate supplies, such as alcohol swabs, hand sanitizer, and biohazard containers, are important.
Several pharmacist and student pharmacist led initiatives were highlighted in the study.