Seasonal Influenza Vaccine Supply for the U.S. 2012-13 Influenza Season
How much influenza vaccine is projected to be available for the 2012-13 influenza season?
At the current time, six influenza vaccine manufacturers are projecting that as many as 145 million doses of influenza vaccine will be available from currently licensed manufacturers in the U.S. for use during the 2012-13 influenza season.
How much thimerosal-free influenza vaccine is expected to be available for the 2012-13 season?
For the 2012-13 season, manufacturers will produce approximately 62 million doses of thimerosal-free or preservative-free (trace thimerosal) influenza vaccine.
Can I still buy influenza vaccine for the 2012-13 season?
Influenza vaccine pre-booking typically occurs between January and March, though most preparations of vaccine should still be available for purchase. Providers should contact distributors and local vendors about remaining supply. Information about distributors who still have influenza vaccine available for sale can be found at http://www.preventinfluenza.org/ivats/.
What can we anticipate in terms of the timing of vaccine availability for the 2012-13 season?
Distribution of most products is anticipated to begin in July or August and manufacturer projections indicate that the majority of vaccine will be distributed by the end of October. However, some vaccine distribution will likely continue into November.
Are all influenza vaccines the same?
Different influenza vaccine preparations have different indications as licensed by the FDA. See the table below for an overview of these indications.
TABLE. Influenza vaccine information, by age group --- United States, 2012--13 influenza season*
TABLE. Influenza vaccine information, by age group — United States, 2012–13 influenza season* | ||||||||
|---|---|---|---|---|---|---|---|---|
Vaccine | Trade name | Manufacturer | Presentation | Mercury content (µg Hg per 0.5 mL dose) | Ovalbumin content (µg per 0.5mL dose)† | Age group | No. of doses | Route |
TIV | Fluzone | Sanofi Pasteur | 0.25 mL prefilled syringe | 0.0 | —§ | 6–35 mos | 1 or 2¶ | IM** |
0.5 mL prefilled syringe | 0.0 | —§ | ≥36 mos | 1 or 2¶ | IM** | |||
0.5 mL vial | 0.0 | —§ | ≥36 mos | 1 or 2¶ | IM** | |||
5.0 mL multidose vial | 25.0 | —§ | ≥6 mos | 1 or 2¶ | IM** | |||
TIV | Agriflu**** | Novartis Vaccines | 0.5 mL prefilled syringe | 0 | <0.4 | ≥18 yrs | 1 | IM** |
TIV | Fluvirin | Novartis Vaccines | 0.5 mL prefilled syringe | ≤1 | ≤1 | ≥4 yrs | 1 or 2¶ | IM** |
5.0 mL multidose vial | 25.0 | ≤1 | ||||||
TIV | Fluarix | GlaxoSmithKline | 0.5 mL prefilled syringe | 0 | ≤0.05 | ≥3 yrs | 1 or 2¶ | IM** |
TIV | FluLaval | ID Biomedical Corporation of Quebec (distributed by GlaxoSmithKline) | 5.0 mL multidose vial | <25.0 | ≤0.3 | ≥18 yrs | 1 | IM** |
TIV | Afluria | CSL Biotherapies (distributed by Merck) | 0.5 mL prefilled syringe | 0.0 | ≤1 | ≥9 yrs†† | 1 | IM** |
5.0 mL multidose vial | 24.5 | ≤1 | ||||||
TIV high- dose§§ | Fluzone High-Dose | Sanofi Pasteur | 0.5 mL prefilled syringe | 0.0 | —§ | ≥65 yrs | 1 | IM** |
TIV intradermal¶¶ | Fluzone Intradermal | Sanofi Pasteur | 0.1 mL prefilled microinjection system | 0.0 (per 0.1 mL) | —§ | 18–64 yrs | 1 | ID |
LAIV | FluMist*** | MedImmune | 0.2 mL prefilled intranasal sprayer | 0.0 (per 0.2 mL) | <0.24 (per 0.2mL)††† | 2–49 yrs§§§ | 1 or 2¶ | IN |
Abbreviations: TIV = trivalent inactivated vaccine; LAIV = live-attenuated influenza vaccine; IM = intramuscular; ID = intradermal; IN = intranasal. * Vaccination providers should consult Food and Drug Administration–approved prescribing information for 2012–13 influenza vaccines for the most updated information, including indications, contraindications, and precautions. † Data on maximum ovalbumin content is supplied in package inserts of certain vaccines. Persons with a history of mild allergy to egg (specifically, those who experience only hives) should receive TIV with additional precautions (Figure 2). § Information is not included in package insert but is available upon request from the manufacturer, Sanofi Pasteur, by contacting 1-800-822-2463 or mis.emails@sanofipasteur.com. ¶ Figure 1 describes two approaches for determining the number of doses needed for children aged 6 months through 8 years. ** For adults and older children, the recommended site of vaccination is the deltoid muscle. The preferred site for infants and young children is the anterolateral aspect of the thigh. †† Age indication per package insert is ≥5 years; however, the Advisory Committee on Immunization Practices recommends that Afluria not be used in children aged 6 months through 8 years because of increased risk for febrile reactions noted in this age group with CSL's 2010 Southern Hemisphere TIV. If no other age-appropriate, licensed inactivated seasonal influenza vaccine is available for a child aged 5 through 8 years who has a medical condition that increases the child's risk for influenza complications, Afluria can be used; however, vaccination providers should discuss with the parents or caregivers the benefits and risks of influenza vaccination with Afluria before administering this vaccine. Afluria may be used in persons aged ≥9 years. §§ A 0.5-mL dose contains 60 µg of each vaccine antigen (180 µg total). ¶¶ A 0.1-mL dose contains 9 µg of each vaccine antigen (27 µg total). *** A new quadrivalent formulation of FluMist was approved by the Food and Drug Administration in February 2012. It is anticipated that this formulation will replace the currently available seasonal trivalent LAIV formulation for the 2013–14 season. FluMist is shipped refrigerated and stored in the refrigerator at 35°F–46°F (2°C–8°C) after arrival in the vaccination clinic. The dose is 0.2 mL divided equally between each nostril. Health-care providers should consult the medical record, when available, to identify children aged 2 through 4 years with asthma or recurrent wheezing that might indicate asthma. In addition, to identify children who might be at greater risk for asthma and possibly at increased risk for wheezing after receiving LAIV, parents or caregivers of children aged 2 through 4 years should be asked, "In the past 12 months, has a health-care provider ever told you that your child had wheezing or asthma?" Children whose parents or caregivers answer "yes" to this question and children who have asthma or who had a wheezing episode noted in the medical record within the past 12 months should not receive FluMist. ††† Insufficient data available for use of LAIV in egg-allergic persons. §§§ Flumist is indicated for healthy, nonpregnant persons aged 2 through 49 years. Persons who care for severely immunosuppressed persons who require a protective environment should not receive FluMist given the theoretical risk for transmission of the live-attenuated vaccine virus. **** Not available in the U.S. for the 2012-13 season | ||||||||
