Acceptability of fluzone intradermal vaccine to patients and vaccine administrators.
ABSTRACT Fluzone Intradermal (ID) vaccine was licensed in the United States in May 2011 and uses a microinjection device with a 1.5-mm, 30-gauge needle that delivers a smaller volume and antigen load than the Fluzone Intramuscular (IM) vaccine. The same ID microinjection system has been used in Argentina and Australia since 2010 with documented acceptance by both patients and vaccine administrators.
To evaluate the acceptability of Fluzone ID influenza vaccine in clinical practice in the United States among patients and vaccine administrators and to compare the ID and IM influenza vaccines in terms of patient preference, preinjection anxiety, postinjection pain, and vaccine selection in future years.
The authors developed 3 surveys-an initial and a follow-up survey for recipients of the ID vaccine and another survey for administrators-to assess opinions of ID administration. Vaccine recipients were surveyed at the time of injection concerning vaccine acceptability, vaccine preference, preinjection anxiety, and postinjection pain. Recipients who had received the IM influenza vaccine within the past 3 years were asked to compare the ID vaccine with their prior IM vaccine experience. Vaccine administrators were also surveyed after administering the ID vaccine at their assigned clinic. Recipients were then surveyed 7 days later.
Vaccine clinic participants were offered 3 vaccines: the ID and the IM Fluzone vaccines and Flumist (Medimmune) intranasal vaccine. Of the 367 participants vaccinated, 249 (67.8%) chose the ID vaccine and 117 (31.9%) chose the IM vaccine. Immediately after ID vaccination, 234 of 235 recipients (99.6%) reported being satisfied with the method of administration. One hundred seventy-five of 178 ID vaccine recipients (99.4%) who had also received the IM vaccine in the past 3 years reported being satisfied. Previous IM recipients reported a preference for the ID vaccine over the IM vaccine. They also reported less preinjection anxiety and postinjection pain compared with the IM vaccine administration, both immediately and 7 days after vaccination. All vaccine administrators reported satisfaction with the ID vaccine.
The current study demonstrates the overall acceptability of the Fluzone ID vaccine in clinical practice in the United States by both patients and vaccine administrators. Additionally, the study is the first to our knowledge to document a patient preference for ID influenza vaccine over IM influenza vaccine.
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ABSTRACT: Healthcare personnel (HCP) are at risk for exposure to and transmission of potentially life-threatening vaccine preventable diseases to patients and colleagues. The Centers for Disease Control and Advisory Committee on Immunization Practices (ACIP) recommend routine influenza immunization and maintenance of immunity to hepatitis B and pertussis, among others. In this article, we aim to review recently approved influenza vaccines, as well as address some of the issues regarding hepatitis B and pertussis vaccinations in HCP. Several new formulations of influenza vaccines are now available, including quadrivalent vaccines and non-egg-based vaccines; their use in HCP requires further study. An alarming rise in pertussis rates has led to a revision of ACIP guidelines recommending vaccination for women during each pregnancy. Persistent lack of immunity to hepatitis B after vaccine series remains a problem for many HCP. Inactivated trivalent influenza vaccines remain the safest and most widely studied influenza vaccinations for healthcare workers. A pertussis booster in the form of Tdap is now recommended for most HCP. More studies are needed regarding the issue of nonresponders in HCP who receive the three-dose hepatitis B vaccine series, as there are some promising strategies available that may boost immune responses.Current Opinion in Infectious Diseases 08/2013; 26(4):366-377. DOI:10.1097/QCO.0b013e3283630ee5 · 5.03 Impact Factor
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ABSTRACT: Simple and efficacious delivery methods for influenza vaccines are needed to improve health outcomes and manage possible pandemics both in the United States and globally. One approach to meeting these needs is the microneedle patch (MNP), a small array of micron-scale needles that is applied to the skin like a bandage. To inform additional technical developments and the eventual introduction of MNPs for influenza vaccination, we interviewed key opinion leaders in the United States for insights into the opportunities and challenges associated with this technology, particularly its potential for self-administration. All interviewees expressed high support for administration of influenza vaccine in MNPs by health care providers and for self-administration in groups supervised by a provider. Self-administration via prescription and over-the-counter purchase of MNPs received lower levels of support. Interviewees also highlighted priorities that should be considered in the ongoing development of an influenza vaccine MNP, such as confirming it to be as efficacious as existing methods of influenza vaccine delivery and ensuring safety for self-administration. For patient and health care provider acceptability, important attributes are ease of use, short wear times, and an easily accessible application site. Stakeholders agreed that using MNPs can help increase coverage, facilitate easy and safe delivery, reduce the cost of vaccination, and decrease the global morbidity and mortality associated with influenza. Another opportunity for this delivery method is the potential for self-administration. The prospect of reduced provider training requirements, increased thermostability, and high patient and provider acceptability makes it an attractive option for use in remote and low-resource settings worldwide. However, in addition to the technological challenges associated with producing the patch, developers must be mindful of cost considerations and key product attributes or requirements, such as usability, wear time, and proper disposal, that can affect how the product will be received in the marketplace. Copyright © 2015. Published by Elsevier Ltd.Vaccine 04/2015; 368. DOI:10.1016/j.vaccine.2015.03.062 · 3.49 Impact Factor