influenza H1N1 vaccine
influenza H1N1 vaccine(H1N1 vak-seen) , (trade name)
Pregnancy Category: C
ClassificationTherapeutic: vaccines immunizing agents
Intramuscular: Active immunization against the pandemic H1N1 virus with inactivated virus. Intranasal: Active immunization against the pandemic H1N1 virus with live virus.
Vaccine causes the production of antibodies against infection from the H1N1 virus.
Protection against H1N1 influenza disease with less time lost from work and school and decreased complications of influenza disease.
Absorption: Vaccine is absorbed following intramuscular and intranasal administration.
Metabolism and Excretion: Unknown.
Time/action profile (antibody production)
|IM, Intranasal||within days||within weeks||unknown|
Contraindicated in: Severe hypersensitivity to egg protein or previous life-threatening reaction from influenza vaccination; Hypersensitivity to eggs, egg protein, gentamicin, gelatin, arginine or previous life-threatening reaction from influenza vaccination; Concurrent aspirin therapy in children/adolescents 2–17 yr (↑ risk of Reye's Syndrome); Children <24 mo (↑ risk of wheezing/hospitalization); Children <5 yr with recurrent wheezing (↑ risk of wheezing post-vaccination).
Use Cautiously in: Immunosuppressed patients (may have ↓ antibody response); Recent (within 6 wk) Guillian-Barré Syndrome; consider risks and benefits; Geriatric: Elderly patients may have ↓ antibody response; Obstetric: Use in pregnancy only if clearly needed; Lactation: Use cautiously during breastfeeding; consider possible shedding of virus in milk and proximity during breast feeding for intranasal form; Pediatric: Safe and effective use in children <6 mo not established for IM dose form, safe use in children <2 yr not established for intranasal form; Underlying medical conditions that predispose to wild-type influenza infection complications.
Adverse Reactions/Side Effects
Central nervous system
- headache (most frequent)
- malaise (most frequent)
- pain (most frequent)
Central nervous system
Ear, Eye, Nose, Throat
- nasal congestion (most frequent)
- runny nose (most frequent)
- sore throat
- muscle aches
- fever (most frequent)
Drug-Drug interactionIntramuscular: Intranasal: Concurrent immunosuppressants or radiation therapy may ↓ antibody response. Intranasal: The use of antivirals active against influenza A or B will ↓ effectiveness; avoid immunization within 48 hours of discontinuing; treatment with antivirus should not be initiated for 2 weeks following immunization.
Intramuscular (Adults) 0.5 mL single dose.
Intramuscular (Children > 10 yr) 0.5 mL single dose.
Intramuscular (Children 3–9 yr) 0.5 mL, repeat one month later.
Intramuscular (Children 6–35 mo) 0.25 mL, repeat one month later.
Intranasal (Children 2–9 yr) 0.2 mL, repeat one month later.
Intranasal (Adults and Children 10–49 yr) 0.2 mL single dose.
Sterile suspension for IM injection (prefilled syringes preservative-free): 0.25 mL, 0.5 mL
Sterile suspension for IM injection (single dose vial preservative-free): 0.5 mL
Sterile suspension for IM injection (multidose vial-thimerosal preservative): 5 mL (contains 25 mcg mercury/0.5 mL dose)
Suspension for intranasal use (prefilled intranasal sprayer): 0.2 mL
- Monitor patient for signs of allergic reaction (rash, pruritus, laryngeal edema, wheezing) following administration. Keep epinephrine, an antihistamine, and resuscitation equipment close by in case of an anaphylactic reaction.
- Lab Test Considerations: May cause thrombocytopenia.
Potential Nursing DiagnosesRisk for infection (Indications)
Deficient knowledge, related to disease process and medication regimen (Patient/Family Teaching)
- Intramuscular: Shake well before administering single dose and before withdrawing dose from multi-dose vial. Administer IM.
- Do not mix with other vaccines in the same syringe or vial.
- Intranasal: To administer, remove rubber tip protector. Do not remove dose-divider clip at the other end of sprayer. With patient in an upright position, place tip just inside nostril. Depress plunger as rapidly as possible with a single motion until dose-divider clip prevents from going further. Pinch and remove dose-divider clip and repeat procedure in other nostril until remaining vaccine is administered. Dispose of sprayer at completion of procedure. Store in refrigerator; do not freeze.
- Explain to patient and parent the purpose of the vaccination. Inform patient that there are two vaccine formulations for this influenza season, the H1N1 vaccine and the seasonal trivalent influenza vaccine.
- Advise female patient to notify health care professional if pregnancy is planned or suspected or if breastfeeding.
- Intranasal: Advise patient to avoid contact with patients who are immunocompromised for at least 21 days.
- Prevention of influenza resulting in fewer lost days from work and school.