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influenza vaccine (nasal)(in-floo-en-za vak-seen) ,
Pregnancy Category: C
ClassificationTherapeutic: vaccines immunizing agents
Active live immunization for prevention of disease caused by Influenza A and B.
Active immunization with live virus produces antibodies against Influenza.
Decreased influenzal illness, with fewer days lost from school or work.
Absorption: Virus replicates in nasopharynx causing production of antibodies.
Metabolism and Excretion: Unknown.
Contraindicated in: Obstetric: Pregnancy; Hypersensitivity to FluMist, eggs, or egg products; History of asthma or reactive airways disease; Other live vaccine within 1 mo or inactivated vaccine within 2 weeks; Concurrent immunosuppressive therapy or disease causing immunosuppression or immunocompromise; Antiviral agents (not for 48 hr prior or 2 wk after); Pediatric: Children or adolescents (5–17 yr) receiving aspirin, aspirin-containing or salicylate therapy (risk of Reye syndrome); Chronic illness including cardiac/pulmonary disease, metabolic disease, renal impairment or hemoglobinopathy; History of Guillain-Barré.
Use Cautiously in: Obstetric / Pediatric: Lactation, children <2 yr, patients >50 yr (safety not established).
Adverse Reactions/Side Effects
Central nervous system
Ear, Eye, Nose, Throat
- nasal congestion
Drug-Drug interactionConcurrent use of aspirin or salicylates in children/adolescents may ↑ risk of Reye syndrome.Concurrent antiviral therapy (may affect desired immune response to FluMist).
Intranasal (Adults and Children 9–49 yr) One dose (0.5 mL)/season.
Intranasal (Children 2–8 yr) Previously immunized with FluMist—one dose (0.2 mL)/season; not previously immunized with FluMist—two doses (0.2 mL each)/30 days apart for initial season.
Pre-filled single-use intranasal sprayer: 0.5 mL/sprayer, 0.2 mL/sprayer
- Assess patient for history of asthma or reactive airway disease. Patients with positive history should not receive FluMist.
- Lab Test Considerations: 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.
Potential Nursing DiagnosesDeficient knowledge, related to medication regimen (Patient/Family Teaching)
- Do not administer rimantidine or other antiviral agents within 48 hrs before or 2 wks after administration intranasal influenza virus vaccine (FluMist).
- Store solution in refrigerator until just before use; do not freeze. Solution should be colorless to pale yellow and clear to slightly cloudy.
- Do not administer FluMist concurrently with other vaccines, or in patients who have received a live virus vaccine within 1 mo or an inactivated vaccine within 2 wks of vaccination.
- Intranasal: With the patient in an upright position, approximately 0.25 mL (half the dose of a single FluMist sprayer) is administered into each nostril. Insert the tip of the sprayer just inside the nostril and depress the plunger to spray. Remove the dose divider clip and administer the second half of the dose into the other nostril. Dispose of sprayer in routine for biohazard disposal.
- Explain to patient and parent the purpose of the vaccination.
- 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.