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H1N1 Nasal Spray Vaccine (cont.)

When should the 2009 H1N1 nasal-spray flu vaccine be given?

Flu vaccination should begin as soon as vaccine is available and continue throughout the influenza season, into December, January, and beyond. By early October 2009, extensive 2009 H1N1 flu activity was being reported in the United States. It's possible that there may be waves of 2009 H1N1 activity during the 2009-2010 flu season that hit communities more than once over the course of the influenza season, which typically peaks in January or February but can last as late as May.

How many doses of nasal spray vaccine are needed?

In adults, only one dose of 2009 H1N1 vaccine, including the 2009 H1N1 nasal spray vaccine, is needed for protection.

All children 2 through 9 years of age getting a 2009 H1N1 vaccine will need two doses of 2009 H1N1 vaccine (either the 2009 H1N1 flu shot or the 2009 H1N1 nasal spray vaccine), The first dose should being given as soon as vaccine becomes available. The second dose should be given 28 or more days after the first dose. The first dose "primes" the immune system; the second dose provides immune protection. Children who only get one dose of vaccine when they need two doses may have reduced or no protection. Be sure to follow up to get your child a second dose if they need one. It usually takes about two weeks after the second dose for protection to begin.

Can people who got the flu shot last year get the nasal-spray flu vaccine LAIV this year?

Yes, people who got inactivated influenza vaccine (the flu shot) last year can get the nasal-spray flu vaccine this year.

Can the nasal-spray flu vaccine be given at the same time as other vaccines?

The nasal spray flu vaccine can be given at the same time or around the same time as an inactivated (killed) vaccine or any other live vaccine except for the seasonal nasal spray vaccine. (The seasonal nasal spray vaccine and the 2009 H1N1 nasal spray vaccine should not be given at the same time.) The 2009 H1N1 flu shot (inactivated 2009 H1N1 vaccine) can be given at the same visit as any other vaccine, including pneumococcal polysaccharide vaccine.

Can the 2009 H1N1 nasal spray vaccine and the seasonal nasal spray vaccine be given at the same time to the same person?

No. The seasonal nasal spray vaccine and the 2009 H1N1 nasal spray vaccine should not be given at the same time. This is because the nasal spray vaccines might not be as effective if given together. It is fine to receive the 2009 H1N1 nasal spray at the same time as the seasonal influenza (flu) shot, or the seasonal flu nasal spray at the same time as the 2009 H1N1 flu shot vaccine.

Can the nasal-spray flu vaccine be used together with influenza antiviral medications?

If a person is taking an influenza antiviral drug (including Tamiflu® or Relenza®, then the nasal spray flu vaccine should not be given until 48 hours after the last dose of the influenza antiviral medication was given. If a person takes antiviral drugs within two weeks of getting the nasal spray flu vaccine, that person should get revaccinated. (The antiviral drugs will have killed the vaccine viruses that are supposed to cause the immune response against those viruses.)

Antiviral drugs can be taken with the inactivated (i.e. killed) flu vaccine.

If a child under the age of 9 years is getting seasonal influenza vaccine for the first time and requires 2 doses, does the same type of vaccine have to be used for both doses?

Ideally the same type of vaccine should be used for both doses as we know a series of two doses of the same type of vaccine has worked in clinical trials. No information is available about how effective a series of two different vaccines might be. If different types of vaccine are used for the first and second doses, however, there is no need to revaccinate a child. The doses should be separated by at least one month (28 days).

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