Flu season is just around the corner can you tell us who should be getting vaccinated with the influenza vaccination?
Beverly E. Walt M.D.:
Well currently for a number of years now the recommendations have been if you are older than six months of age you should get a flu shot if you want to reduce your risk of influenza.
And can you tell us a little bit about the different formulations and sort of how that applies to different age groups?
There are a number of different formulations out there now. The main differences would be there’s an intranasal live attenuated vaccine that’s given to healthy persons up to the age of 50 and then there are inactivated injectable forms of which there are a number of different varieties that have their kind of subtle advantages or disadvantages.
And what about patients that have severe egg allergies?
So as of last year, the American College of immunization practices has stated, based on the current data, that none of the influenza vaccines available now are contraindicated even for those individuals who have had anaphylaxis to egg products. However, you know those of us in clinical practice to recognize there are still going to be those patients who will refuse the vaccines because of their remaining concern. There is now one recombinant vaccine that has no egg protein flu block that could be an alternative for these patients.
So herpes zoster or shingles cause significant morbidity in the US and a new formulation or new vaccine was recently approved by the FDA. Can you tell us a little bit about the new guidelines for a shingles vaccination?
So SHINGRIX is a killed vaccine so that’s different than the old Zostavax which was a live weakened virus vaccine and thus had some concerns when you were trying to immunize immuno-compromised patients. So now that this one is killed, we don’t have those concerns and it’s also more immunogenic so the age of when we should initiate shingles vaccine now has moved down to age 50. It used to be 60 with the older vaccine because immunity waned generally seven to nine years after receipt and we were concerned if we gave it too early you would not have immunity when you were older and even more at risk of reactivation chickenpox disease.
And what about the efficacy behind SHINGRIX vs Zostavax for example?