2007-2008 VFC Influenza Vaccine Guidelines
VFC providers may administer flu vaccine to all VFC-eligible children aged 6 months through 18 years. If available supplies are limited, give priority to those groups listed below:
• Children ages 6 months through 4 years of age
• Children & adolescents ages 5 through 18 years with chronic disorders of the pulmonary or cardiovascular system, (including asthma)
• Children & adolescents ages 5 through 18 years who have required regular medical follow-up or hospitalization during the preceding year because of chronic metabolic diseases (including diabetes mellitus), renal dysfunction, hemoglobinopathies, immunosuppression (including immunosuppression caused by human immunodeficiency virus (HIV)
• Children & adolescents ages 5 through 18 years who have any condition (e.g., cognitive dysfunction, spinal cord injuries, seizure disorders, or other neuromuscular disorders) that can compromise respiratory function or the handling of respiratory secretions or that can increase the risk for aspiration
• Children & adolescents ages 5 through 18 years who are receiving long-term aspirin therapy and may therefore be at risk for developing Reye syndrome after influenza
• Children & adolescents ages 5 through 18 years who are residents of nursing homes and other chronic-care facilities that house persons of any age who have chronic medical conditions
• Adolescent females < 19 years of age who will be pregnant during the influenza season
• Children & adolescents age 5 through 18 years who are household contacts of persons in the following high-risk groups: children less than 5 years old; children or adolescents in any of the groups listed above; persons ages 50 years or older; adults with chronic disorders of the pulmonary or cardiovascular systems; adults who have required regular medical follow-up or hospitalization during the preceding year for chronic metabolic diseases, including diabetes mellitus, renal dysfunction, hemoglobinopathies, or immunosuppression (including immunosuppression caused by medications or by human immunodeficiency virus - HIV)
Influenza vaccine available through Michigan’s VFC program for eligible children & adolescents during the 2007/2008-flu season includes the following presentations:
• Preservative free Fluzone™ (sanofi pasteur) for 6-35 months and packaged as 0.25 mL pre-filled, needleless syringes
• Preservative free Fluzone™ (sanofi pasteur) for 36 months and older, packaged as 0.5 mL single dose vials
• Preservative containing Fluzone™ (sanofi pasteur) for 6 months and older, and packaged as 5 mL multi-dose vials
• FluMist™ (MedImmune) for healthy, non-pregnant persons 2-18 years of age, packaged in single dose 0.2 mL sprayers
Influenza Vaccine Dosing Chart 2007-08
Trivalent Inactivated Influenza Vaccine (TIV)Age / Dosage / No. of Doses per Season* / Route / Site / Needle Gauge / Needle Length**
6-35 mo / 0.25 mL / 1 or 2 doses* / IM / Anterolat. thigh / 22-25 g / 1 inch
3-8 yrs / 0.5 mL / 1 or 2 doses* / IM / Anterolat. thigh or deltoid / 22-25 g / 1 inch
9 yrs & older / 0.5 mL / 1 dose / IM / Anterolat. thigh or deltoid / 22-25 g / 1- 1.5 inches
Live, Attenuated Influenza Vaccine (LAIV) †
Age / Dosage / No. of Doses per Season* / Route / Site
New! 2-8 yrs / 0.2 mL Spray ½ the dose in each nostril as indicated on the syringe / 1 or 2 doses* / Intranasal / Each nostril
9 yrs & older / 0.2 mL Spray ½ the dose in each nostril as indicated on the syringe / 1 dose / Intranasal / Each nostril
*New Pediatric “2 Dose Rule”:
Children 6 mo-8 yrs receiving any flu vaccine for the 1st time should receive 2 doses of vaccine.
Children 6 mo- 8 yrs who received only 1 dose of flu vaccine in their 1st season of vaccination should receive 2 doses of vaccine in their 2nd season of vaccination. The 1st season of vaccination is the flu season the child received his first dose of flu vaccine. The 2nd season of vaccination is the next flu season he is vaccinated, regardless of calendar years in-between. Ex.: Child received his 1st dose of vaccine at age 6 mo in 2002 and is now getting vaccine for the 2nd time (2nd season) at age 5 yrs in 2007. This child should receive 2 doses of vaccine.
· NEW! Administer doses of flu vaccine (TIV or LAIV) 4 weeks apart. If possible, give the 2nd dose before December.
Children 6 mo-8 yrs in their 3rd or more season of vaccination should receive 1 dose of vaccine.
**Professional judgment is appropriate when selecting the needle length
†FluMist™ (LAIV) may NOT be given to: children less than 2 yrs of age, children & teens with a high risk condition, children 2-4 yrs of age with recurrent wheezing, household/close contacts of severely immunosuppressed (person needing protective environment) and persons with a history of Gullain-Barré syndrome within 6 weeks of any influenza vaccination. For more information regarding the use of LAIV, please refer to “A Quick Look at Using Refrigerated FluMistä (LAIV).”
Rev. September 21, 2007