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Author: Aimee Lin

About the LIAV flu vaccine

For the 2018-19 flu season, the Advisory Committee on Immunization Practices has added the intranasal live-attenuated influenza vaccine (LAIV) back to the list of recommended flu vaccines for children and adults.  The ACIP recommended against LAIV for the past few seasons because of poor effectiveness.  Why is it being reintroduced now?

How is LAIV different from inactivated influenza vaccines (IIV)? 

Inactivated influenza vaccines are made by growing influenza viruses in eggs, purifying the virus then inactivating, or killing the purified virus.  It is given as a shot and leads to an immune response that will give us protection, but the inactivated virus cannot reproduce to cause infection.  We have been using this method to make flu vaccines since the 1940s. The flu virus changes a little each year so we have to make a  new vaccine to make sure we get a good match.

LAIV is made by growing influenza virus in egg cells then weakening it.  It is given as a nasal spray so that the weakened virus can reproduce just enough to spark an immune response and give us protection, but the live virus is too weak to cause disease.  Because LAIV sparks an immune response in the nose where we are also exposed to influenza, it could be an especially effective way to provide protection

Why was LAIV removed from the list of recommended vaccines in 2016?

When LAIV was first introduced, it did appear to work a little better, especially in children.  So in 2014, the ACIP gave LAIV a preferential recommendation, in other words, the ACIP preferred LAIV over the inactivated vaccine.  But shortly afterwards, when the ACIP noticed that LAIV stopped working well.  For 3 years in a row, LAIV did not perform any better than IIV- in fact it had lower effectiveness.  While the CDC worked to determine why LAIV wasn’t working well, the ACIP removed their recommendation for LAIV.

What happened?

It turned out that one of the flu strains in LAIV (every flu vaccine protects against 3 or 4 strains) did not reproduce well enough to spark a good immune response- so protection was not very good either.  The affected strain was H1N1 and we happened to have flu seasons with a lot of H1N1.

Why is LAIV now available again?

Once the problem with LAIV was recognized, the vaccine manufacturer replaced the H1N1 strain that wasn’t reproducing well with another one that works better.  They also checked to make sure that there is a good immune response to the new LAIV for all of the included strains.  The ACIP reviewed all of this information and felt that the issue was resolved and LAIV was added back to the list of recommended influenza vaccines for anyone between 2 and 49 years of age.

Even though the ACIP has recommended LAIV for 2018-19, I read that the American Academy of Pediatrics still prefers the inactivated vaccine. Why is there a discrepancy?

When the ACIP reviewed information about the new LAIV, they felt that the strong immune response was a good indicator that the vaccine should work at least as well as the inactivated vaccine so should be available for administration.  The ACIP also reviewed studies on LAIV effectiveness from other countries who had continued using LAIV and found these studies to be reassuring.  The AAP was also reassured that the new LAIV leads to a strong immune response, but they wanted to see more information on protection against actual disease before strongly recommending LAIV.  For that reason they decided to recommend a preference for the inactivated vaccine until we learn more about actual LAIV effectiveness.

So what should I do?

The new LAIV addresses the problem that made LAIV show poor effectiveness and leads to a good immune response which is a sign of good protection.  Flu vaccine effectiveness always varies each year due to the match between our vaccines and circulating influenza types- but vaccination is still our best method of protection.  Since the fear of injections is one reason some people decline flu vaccines, availability and use of LAIV may help increase the likelihood that some patients say yes to flu vaccines.

 

 

 

ProQuad now available through VFC

ProQuad vaccine now available through the VFC program

ProQuad is now available through the Philadelphia Vaccines for Children (VFC) program. ProQuad is a combination MMR (measles, mumps, and rubella) and Varicella vaccine. This combined vaccine lets you administer more vaccines with fewer injections.

About ProQuad

The CDC’s Advisory Committee on Immunization Practices recommends ProQuad for a patient’s second dose of MMR and varicella vaccine. As a first dose, ProQuad is associated with a slightly higher risk of febrile seizure, so use separate MMR and varicella vaccines for the first dose unless a parent prefers ProQuad.

Ordering ProQuad

Order ProQuad through PhilaVax at https://vax.phila.gov the way you normally order other vaccines. Before you order ProQuad for your VFC-eligible patients, you should also stock enough privately-purchased ProQuad to treat patients who are not eligible for VFC.

ProQuad now available through VFC

ProQuad vaccine now available through the VFC program

ProQuad is now available through the Philadelphia Vaccines for Children (VFC) program. ProQuad is a combination MMR (measles, mumps, and rubella) and Varicella vaccine. This combined vaccine lets you administer more vaccines with fewer injections.

About ProQuad

The CDC’s Advisory Committee on Immunization Practices recommends ProQuad for a patient’s second dose of MMR and varicella vaccine. As a first dose, ProQuad is associated with a slightly higher risk of febrile seizure, so use separate MMR and varicella vaccines for the first dose unless a parent prefers ProQuad.

Ordering ProQuad

Order ProQuad through PhilaVax at https://vax.phila.gov the way you normally order other vaccines. Before you order ProQuad for your VFC-eligible patients, you should also stock enough privately-purchased ProQuad to treat patients who are not eligible for VFC.

Protect adults from shingles with the new Shingrix vaccine

Protect adults from shingles with the new Shingrix vaccine

Shingrix (recombinant zoster vaccine) is a vaccine to protect healthy adults age 50 and older from shingles. You can now order Shingrix through the Vaccines for Adults At Risk program (VFAAR) for adults 50+ and uninsured.

About Shingrix

Administer Shingrix to adults age 50 and older, with two doses separated by 2 to 6 months.

Ordering Shingrix

Order Shingrix through PhilaVax at https://vax.phila.gov the way you normally order other vaccines. We recommend ordering a small amount, initially, to gauge demand. We will work with you to help figure out how much to order: our VFAAR coordinator will review orders and make adjustments to avoid wastage. Before you order Shingrix for your VFAAR-eligible patients, you should also stock enough privately-purchased Shingrix to treat patients who are not eligible for VFAAR.

Storing and Handling

Shingrix must be stored in the refrigerator. Administer it immediately after reconstitution or store it in the refrigerator and use it within 6 hours. Do not freeze Shingrix. If Shingrix freezes, it is spoiled.

Register for a required Clinic Tools training

Good news! PhilaVax is adding a new tool called Clinic Tools.

Clinic Tools makes it easier to communicate temperature and clinic information with the VFC/VFAAR programs. Through Clinic Tools, you’ll be able to:

  • Keep track of storage units and data loggers
  • Upload temperatures directly to PhilaVax (no more faxing in paper logs, though you still need to keep them filed for 3 years)
  • Maintain up-to-date clinic contact information
  • Access and complete your annual VFC/VFAAR enrollment form

Register for a required Clinic Tools training

We need to train you to use this tool. You can attend the training from your own computer. Click here to register. Unable to register? Give us a call at  215-685-6872 (Mohan) or 215-685-6490 (Joani), or email us at  DPHProviderHelp@phila.gov and we can help you out.

Training dates

Morning times: 10 AM – 10.30 AM

  • December 11

Important changes to kids.phila.gov

Important changes to kids.phila.gov

Over the next few weeks, you’ll notice some changes to kids.phila.gov. We hope these changes will make it easier to find resources that will be helpful for you in your job.

The website looks a little different

We re-organized the information on the website so that it will be easier for you to find resources that you need to vaccinate Philadelphia’s residents. Take a look. If there’s something you’d like to see on the site, feel free to email us at Vaccines@phila.gov.

And the URL will change—so update your bookmark!

On Tuesday, June 26th, the  web site’s URL will change. You’ll find the site at https://vax.phila.gov. So update your bookmarks: starting June 26th, you won’t be able to find us at the old URL.  Use the new URL to access PhilaVax, the Immunization Information System, the same way you do now. So make sure to update your bookmark.

 

Register for a required Clinic Tools training

Register for a required Clinic Tools training

Good news! PhilaVax is adding a new tool called Clinic Tools.

Clinic Tools makes it easier to communicate temperature and clinic information with the VFC/VFAAR programs. Through Clinic Tools, you’ll be able to:

  • Keep track of storage units and data loggers
  • Upload temperatures directly to PhilaVax (no more faxing in paper logs, though you still need to keep them filed for 3 years)
  • Maintain up-to-date clinic contact information
  • Access and complete your annual VFC/VFAAR enrollment form

Register for a required Clinic Tools training

We need to train you to use this tool. You can attend the training from your own computer. Click here to register. Unable to register? Give us a call at  215-685-6872 (Mohan) or 215-685-6490 (Joani), or email us at  DPHProviderHelp@phila.gov and we can help you out.

Training dates

Morning times: 10 AM – 10.30 AM

  • December 11

 

Protect adults from shingles with the new Shingrix vaccine

Protect adults from shingles with the new Shingrix vaccine

Shingrix (recombinant zoster vaccine) is a vaccine to protect healthy adults age 50 and older from shingles. You can now order Shingrix through the Vaccines for Adults At Risk program (VFAAR) for adults 50+ and uninsured.

About Shingrix

Administer Shingrix to adults age 50 and older, with two doses separated by 2 to 6 months.

Ordering Shingrix

Order Shingrix through PhilaVax at https://vax.phila.gov the way you normally order other vaccines. We recommend ordering a small amount, initially, to gauge demand. We will work with you to help figure out how much to order: our VFAAR coordinator will review orders and make adjustments to avoid wastage. Before you order Shingrix for your VFAAR-eligible patients, you should also stock enough privately-purchased Shingrix to treat patients who are not eligible for VFAAR.

Storing and Handling

Shingrix must be stored in the refrigerator. Administer it immediately after reconstitution or store it in the refrigerator and use it within 6 hours. Do not freeze Shingrix. If Shingrix freezes, it is spoiled.

Reminder: we need your emergency management plan

The VFC/VFAAR Emergency Vaccine Management Plan has been updated for 2018. This document helps both you and us prepare for an emergency – like if the power goes out or if your refrigerator or freezer stops working.

If you haven’t already done this, we need you to update your information on the Emergency Management Plan and send it to us. To update your plan:

  • Download the Emergency Management Plan here
  • Print a copy of the plan
  • Complete the first page and fax it to us at 215-238-6948
  • Gather the supplies needed for emergency transport (listed on pages 6-7) and store them near your storage units
  • Post the Emergency Vaccine Management Plan near your storage units

Keep vaccines safe while defrosting – check out our guidance

Freezers can sometimes build up too much ice. When you need to defrost your VFC/VFAAR unit, we can help you move or store your vaccine while you defrost your primary unit. Contact us for defrosting guidance.

Reminder: we need your emergency management plan

Reminder: we need your emergency management plan

The VFC/VFAAR Emergency Vaccine Management Plan has been updated for 2018. This document helps both you and us prepare for an emergency – like if the power goes out or if your refrigerator or freezer stops working.

If you haven’t already done this, we need you to update your information on the Emergency Management Plan and send it to us. To update your plan:

  • Download the Emergency Management Plan here
  • Print a copy of the plan
  • Complete the first page and fax it to us at 215-238-6948
  • Gather the supplies needed for emergency transport (listed on pages 6-7) and store them near your storage units
  • Post the Emergency Vaccine Management Plan near your storage units

Keep vaccines safe while defrosting – check out our guidance

Freezers can sometimes build up too much ice. When you need to defrost your VFC/VFAAR unit, we can help you move or store your vaccine while you defrost your primary unit. Contact us for defrosting guidance.