Influenza Vaccine Recombinant and Succinylcholine

• Generic Name: influenza virus vaccine, inactivated
• Dosage Forms: n.a.
• Other Brand Names: Afluria, Agriflu, Fluad 2019-2020, Fluarix, Flublok Quadrivalent 2019-2020, Flucelvax, FluLaval, Fluogen, Flushield, Fluvirin, Fluzone, Flucelvax, Fluzone Intradermal Quadrivalent, Fluzone Quadrivalent, Flublok, Flublok Quadrivalent

Prevention of seasonal influenza virus infection in adults ≥18 years of age.

Influenza is an acute viral infection; influenza viruses spread from person to person mainly through large-particle respiratory droplet transmission. In the US, annual epidemics of seasonal influenza occur, usually during the fall or winter. Influenza viruses can cause illness in any age group; children have highest rate of infection. Influenza can exacerbate underlying medical conditions or lead to pneumonia in certain individuals. Adults ≥65 years of age, children <2 years of age, and individuals with chronic medical conditions have highest risk of influenza-related complications and death.

Annual vaccination is the primary means of preventing seasonal influenza and its complications.

CDC Advisory Committee on Immunization Practices (ACIP), AAP, and others recommend routine influenza vaccination for all adults, adolescents, children, and infants ≥6 months of age using an age-appropriate seasonal influenza vaccine, unless contraindicated. Vaccination against seasonal influenza recommended for otherwise healthy individuals as well as those who have medical conditions that put them at increased risk for influenza-related complications or at higher risk for influenza-related outpatient, emergency department, or hospital visits.

Several different types of influenza vaccines may be available in the US for prevention of seasonal influenza: influenza virus vaccine inactivated (IIV), influenza vaccine recombinant (RIV), and influenza vaccine live intranasal (LAIV). Influenza virus vaccine inactivated is available as trivalent formulations containing influenza antigens representing 2 influenza A strains (H1N1 and H3N2) and an influenza B strain (Victoria lineage) and quadrivalent formulations containing antigens representing these 3 influenza strains and another influenza B strain (Yamagata lineage). Influenza vaccine recombinant and influenza vaccine live intranasal are only available as quadrivalent formulations.

Select specific seasonal influenza vaccine based on individual’s age and whether they have certain underlying medical conditions that put them at increased risk of influenza complications (e.g., pregnancy, immunocompromising disease or therapy), are in close contact with severely immunocompromised individuals, or have a personal history that contraindicates use of certain vaccines. For many individuals, more than one vaccine type may be appropriate.

For prevention of seasonal influenza in adults ≥18 years of age, ACIP states there are no preferential recommendations for any specific vaccine type or trade name, provided an age-appropriate vaccine is chosen based on FDA-labeled indications and contraindications.

ACIP does not state a preference for a trivalent or quadrivalent formulation. If an age-appropriate vaccine is available and there are no contraindications, do not delay influenza vaccination to obtain a specific product.

Travelers: All travelers (including those at high risk for influenza complications) who were not vaccinated during the preceding fall or winter should consider vaccination against seasonal influenza ≥2 weeks before departure if they will be traveling to the tropics, traveling to the Southern Hemisphere from April through September, or traveling with organized tourist groups at any time of the year. Revaccination not recommended for travelers who received influenza vaccine during the preceding fall and will be traveling during the summer. Risk for exposure to seasonal influenza during travel depends on time of year and destination. In the Northern Hemisphere, influenza season may begin as early as October and extend until May; in the Southern Hemisphere, influenza season may begin in April and last through September. In many tropical and subtropical areas, influenza viruses generally circulate throughout the year.

Seasonal influenza vaccines not effective against all possible strains of influenza, but may be effective against those strains (and possibly closely related strains) represented in the vaccines. (See Limitations of Vaccine Effectiveness under Cautions.)

Current information regarding influenza surveillance and updated recommendations for prevention and treatment of seasonal influenza is available from CDC.

• Generic Name: succinylcholine
• Dosage Forms: n.a.
• Other Brand Names: Anectine, Quelicin

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