Flu vaccines. Pros and cons, which vaccine to choose?

Influenza - Data from the World Health Organization (WHO)

Key Facts

• Influenza is an acute viral infection that is easily spread from person to person.
• Influenza circulates throughout the world and can affect anyone of any age group.
• Influenza causes annual seasonal epidemics that peak in winter in temperate climates.
• Influenza is a serious public health problem that causes severe illness and death in high-risk populations.
• The epidemic may have a negative impact on the economy through reduced labor productivity and place undue strain on health services.
• Vaccination is the most effective way to prevent infection.
• Antiviral drugs are available for treatment, but influenza viruses can develop drug resistance.

Review

Seasonal influenza is an acute viral infection caused by the influenza virus.

There are three types of seasonal influenza - A, B and C. Influenza A viruses are divided into subtypes according to different types and combinations of surface proteins of the virus. Among the many subtypes of influenza A viruses, influenza A(H1N1) and A(H3N2) subtypes are currently circulating in humans. Influenza viruses circulate in all parts of the world. Cases of influenza type C are much less common compared to influenza types A and B. For this reason, seasonal flu vaccines contain only influenza A and B viruses.

Signs and symptoms

Seasonal influenza is characterized by a sudden onset of high fever, cough (usually dry), headache, muscle and joint pain, severe malaise (feeling unwell), sore throat and runny nose. Influenza can cause severe illness or death in people at higher risk. The period between infection and illness, known as the incubation period, lasts about two days.

Who is at risk?

Annual influenza epidemics can have a serious impact on all age groups, but children under age two, adults age 65 and older, and people of any age with certain medical conditions, such as chronic heart disease, lung disease, or kidney disease are at highest risk of complications. , blood and metabolic diseases (eg diabetes), or with a weakened immune system.

Transmission of infection

Seasonal influenza is easily transmitted and can spread quickly in schools, nursing homes, businesses and cities. When an infected person coughs, infected droplets become airborne. Another person can inhale them and become exposed to the virus. The virus can also be transmitted through hands infected with the virus. To prevent transmission, people should cover their mouth and nose when coughing with a handkerchief and wash their hands regularly.

Influenza has a global prevalence, with annual incidence rates estimated at 5%-10% among adults and 20%-30% among children. The disease can lead to hospitalization and death, mainly among high-risk groups (very young children, the elderly or chronically ill people).

Prevention

The most effective way to prevent the disease or its severe consequences is vaccination. Safe and effective vaccines have been available and used for more than 60 years. In healthy people, the influenza vaccine may provide moderate protection. However, among older adults, the influenza vaccine may be less effective at preventing illness, but may reduce the severity of illness and reduce complications and death.

Vaccination is especially important for people at higher risk of developing serious flu complications and for people who live with or care for people at high risk.

WHO recommends annual vaccination for the following population groups:

• pregnant women at any stage of pregnancy;
• children from 6 months to 5 years;
• seniors 65 years and older;
• people with chronic diseases;
• healthcare workers.

Influenza vaccination is most effective when circulating viruses closely match those in the vaccine. Influenza viruses are constantly changing, and the WHO Global Influenza Surveillance Network (GISN), a partnership of National Influenza Centers around the world, monitors influenza viruses circulating in people.

For many years, WHO has updated its vaccine composition recommendations twice a year, targeting the 3 most common circulating virus types (two subtypes A and one subtype B of influenza viruses).

World Health Organization (WHO) Fact Sheet No. 211 March 2014

Vaccine INFLUVAK® (Influvac)

Manufacturer: Solvay Biologicals BV, Netherlands

Influenza vaccine, subunit, inactivated

Dosage form:

suspension for intramuscular and subcutaneous administration

Compound:

Influvac® is a trivalent inactivated influenza vaccine consisting of surface antigens (hemagglutinin (HA), neuraminidase (NA)) of influenza viruses type A and B grown in chicken embryos. The antigenic composition of the influenza vaccine is updated annually according to the recommendations of the World Health Organization.

Active substances:

One dose of the vaccine (0.5 ml) contains GA and NA of the following viral strains:

* After the name of the strain, the name of the type recommended by WHO for the current epidemic influenza season is given.

Excipients:

potassium chloride, potassium dihydrogen phosphate, sodium phosphate dihydrate, sodium chloride, calcium chloride dihydrate, magnesium chloride hexahydrate, water for injection.

Immunological properties

The vaccine develops specific immunity to influenza viruses type A and B, which is fully formed, as a rule, 14 days after vaccination and lasts up to 1 year.

Purpose

Prevention of influenza in adults and children from 6 months. Vaccination is recommended for all persons and, first of all, for the following categories of the population who are at increased risk if influenza is combined with existing diseases: persons over 65 years of age, regardless of their health status; patients with respiratory diseases; patients with cardiovascular diseases of any etiology; patients with chronic renal failure; patients with diabetes mellitus; patients with immunodeficiency diseases (HIV infection, malignant blood diseases, etc.) and patients taking immunosuppressants, cytostatics, undergoing radiation therapy or receiving high doses of corticosteroids; children and adolescents (from 6 months to 18 years) who have been taking medications containing acetylsalicylic acid for a long time and, therefore, are at increased risk of developing Reye's syndrome due to influenza infection; pregnant women in the 2nd and 3rd trimesters of pregnancy. Pregnant women in high-risk categories should be vaccinated regardless of gestational age.

Contraindications

Hypersensitivity to chicken protein or any other component of the vaccine, severe fever or allergic reactions after previous vaccination with subunit influenza vaccines. Vaccination is postponed until the end of acute manifestations of the disease and exacerbation of chronic diseases. For mild ARVI, acute intestinal and other diseases, vaccination is carried out immediately after the patient has established a normal temperature.

Directions for use and dosage
Dose for adults and adolescents (from 14 years of age):
0.5 ml.
The vaccine is administered once. Dose for children from 6 months.
up to 3 years: 0.25 ml.
Dose for children from 3 to 14 years:
0.5 ml. The vaccine is administered once. For children who have not previously had influenza and have not previously been vaccinated, it is recommended that the vaccine be administered twice with an interval of 4 weeks. Patients with immunodeficiency are recommended to administer the vaccine twice with an interval of 4 weeks.

Mode of application.

Immunization is carried out annually in the autumn. The vaccine is administered intramuscularly or deeply subcutaneously.

Interaction with other drugs and other forms of interaction

Influvac® can be used simultaneously with other vaccines. In this case, vaccines should be administered to different parts of the body with different syringes.

Use during pregnancy and lactation

Current experience shows that Influvac® does not have a teratogenic or toxic effect on the fetus. The Influvac® vaccine can be used during lactation.

Side effects

The vaccine has a high safety profile; allergic reactions, headaches, and decreased platelet levels in the blood are rarely observed. Local reactions may be observed: redness, swelling, pain, hardening at the injection site. There may be a short-term increase in temperature and malaise. Symptoms usually go away on their own without treatment.

Influence on the ability to drive a car and control machines and mechanisms

Influvac® does not affect the ability to drive a car or use machines and mechanisms.

Incompatibility

There are no known cases of incompatibility of Influvac® with other drugs.

How is vaccination carried out?

Vaccination is carried out in a vaccination room, in compliance with all sanitary requirements. All drugs are certified. A certificate for the drug is provided upon request.

Without reminders, before vaccination, the medical worker must show the drug and the expiration date of the vaccine.

Only sterile and disposable instruments are used. The vaccination must be carried out using disposable medical gloves.

On the day of vaccination, the child is examined by a pediatrician and the temperature is measured. In the absence of contraindications, vaccination is carried out. Information about the vaccination performed is entered into the card, vaccination certificate, and detailed recommendations for caring for the child in the post-vaccination period are given.

Before vaccination, the doctor will answer all your questions. Be sure to bring information about previous vaccinations to your appointment!

Please note that vaccination of a child, Mantoux test, Diaskintest can only be carried out in the presence of parents or legal representatives of the child (guardians), or if the accompanying person has a NOTARIZED power of attorney to carry out the manipulation (indicating the drug planned for administration) . Otherwise, vaccination will be denied. We comply with the laws of the Russian Federation.

Only here!

In Russia in the fall they will not vaccinate with foreign flu vaccines

Are there foreign vaccines in Russia?

Currently, the State Register of Medicines (GRLS) contains information on registration certificates for 18 tri- and quadrivalent influenza vaccines. Almost 90% of the volume of all domestic vaccines is provided by only four NPO Microgen (both are part of the National Immunobiological Institute and the St. Petersburg Research Institute of Vaccines and Serums (SPbNIIVS), follows from data from the analytical company DSM Group.

Of the 18 registered, only two are foreign: “Influvac” produced by the Dutch French Sanofi Pasteur. But, according to the Roszdravnadzor register as of September 12, not a single series of influenza vaccines from these manufacturers has been released into civilian circulation in 2021.

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Why are there no foreign vaccines?

Interruptions in the supply of foreign vaccines at the beginning of the vaccination campaign in Russia are observed systematically. In 2021, Vaxigrip appeared only at the end of September, there were no supplies of Influvac, and in 2021 it was also impossible to get vaccinated against the flu with a foreign drug. In September 2021, RBC reported that vaccines would remain unavailable until mid-October.

Supplies of the trivalent vaccine “Vaxigrip” produced by Sanofi Pasteur to Russia have been stopped since 2021, Yuri Mochalin, director of corporate relations for Sanofi in the Eurasian region, told RBC. The company made this decision in connection with plans to completely switch the production of influenza vaccines in syringes to a quadrivalent vaccine. Now in Russia the procedure for state registration of this vaccine is underway, he adds, information about the delivery time will be provided after the completion of the procedure. “Therefore, there are no plans to supply this vaccine to the Russian Federation in 2021,” Mochalin concluded.

The population of Russia is provided free of charge exclusively with domestic vaccines in accordance with the legislation of the country, the pharmaceutical industry said in its response, they explained. Thus, the finished dosage form in the form of the Influvac vaccine is not supplied to Russia.

Foreign companies do not see prospects for supplying influenza vaccines to Russia, since at the state level only Russian vaccines are purchased for the national vaccination calendar, explains DSM Group CEO Sergei Shulyak. Foreign companies cannot participate in tenders due to the current “third wheel” rule, according to which foreign manufacturers are not allowed to bid if at least two manufacturers from EAEU countries enter the auction.

RBC sent requests to the Ministry of Health and Roszdravnadzor with a request to comment on whether foreign-made influenza vaccines will appear in circulation by the end of the year.

Does anyone have stocks of foreign vaccines?

The clinics surveyed by RBC now offer only domestic vaccines - Sovigripp, Ultrix Quadri, Flu-M; foreign supplies are not expected this year; representatives of pharmacy chains give similar answers.

Foreign vaccines “Influvac”, “Vaxigrip” and others are not available at Medsi clinics and, most likely, they will not appear during the vaccination period, medical director of the network Tatyana Shapovalenko told RBC. The network of Mother and Child clinics currently offers one Russian vaccine, Sovigripp, and clarifies that at the end of September another anti-influenza vaccine is expected to arrive, but also of domestic production. JSC Meditsina currently does not provide flu vaccinations, and the clinic also does not have information about the supply of imported vaccines to Russia, said Zhanna Dorosh, director of the network’s medical service.

Protsenko warned about the risk of an imminent outbreak of COVID-19 in Russia Society

The network of clinics “Be Healthy” (part of the group) reported that there are also no foreign vaccines for flu vaccinations. The director of the Rassvet clinic, Alexey Paramonov, with reference to suppliers, explained that neither Vaxigrippa nor Influvac will be available at the clinic this year. Now in the clinic you can be vaccinated with the Flu-M vaccine; according to Paramonov, its composition corresponds to Vaxigrip and has the required dose of antigen. He calls tri- and quadrivalent Ultrix another high-quality domestically produced vaccine. “However, it is practically inaccessible to private clinics, since almost all batches are purchased by the state. In a city clinic, the likelihood of getting it is greater than in a clinic,” he says. The European Medical Center clinic did not respond to RBC’s request.

In the retail segment, sales of foreign Vaxigrippa and Influvac are unstable or declining. For example, in 2019, pharmacies sold the French “Vaxigrip” in the amount of 1,948 packages, in 2021 - almost 4 thousand; in seven months of 2021, only 96 packages were sold. As for Influvac, after 2021, when retail sales amounted to 30 thousand packages, in 2021 they dropped significantly - only 1,579 packages were sold. For seven months of 2021, sales stopped at 48 packages.

The Rigla pharmacy chain explained that there are currently no trivalent influenza vaccines on sale either online or at distributors; they admit that they can be vaccinated as part of VHI. The 36.6 network also reported that Vaxigrippa and Influvac are not on sale. The Neopharm and Magnit Pharmacy networks were unable to provide comments to RBC at the time of publication of the material.

Why there is no point in waiting for imported vaccines

Doctors interviewed by RBC agree that the currently available Russian flu vaccines are made of high quality, and adherence to foreign ones is nothing more than a prejudice. They also note that it is advisable to take a break of at least 21 days between vaccinations against coronavirus and flu.

According to therapist Andrei Kondrakhin, this is necessary so as not to burden the immune system with an additional amount of antigens; in addition, by waiting the required period of time, the likelihood of getting the maximum effect from two vaccinations - coronavirus and influenza - increases. “This way you can control the immune response and eliminate side effects. This is justified reinsurance,” he told RBC.

In the center of Gamaleya they assessed the mutual influence of vaccines against coronavirus and influenza Society

It is acceptable to get two vaccinations in a short period of time, if there are epidemiological indications for it, says Doctor of Biological Sciences, Professor of Virology Alexander Shestopalov, but the need for this must be calculated separately from region to region. According to him, it is quite enough to be vaccinated with a trivalent vaccine, which contains three strains of influenza. “You shouldn’t wait for foreign vaccines; Russian anti-flu vaccines are made using updated strains and are made with high quality. And while waiting for an imported one, you can simply get sick,” he concluded.

Earlier, Health Minister Mikhail Murashko reported that the decision on combining vaccinations against coronavirus and influenza had not yet been made. The ministry intended to announce the corresponding procedure last week. Last year, at the presentation of the Sputnik V vaccine for journalists, the director of the Center named after. N.F. Gamaleya Alexander Ginzburg explained that between the administration of vaccines against influenza and coronavirus it is worth “keeping a gap of two to three weeks.”

Influvac

Please check with the clinic administrators for availability of vaccines.

Winter comes every year, and with it every year comes the flu epidemic. Many thousands of people died from it in the last century.

The flu of today is becoming dangerous not only with death, but also with the possibility of severe complications.

However, using the technologies and innovations of modern medicine, specialists facilitate the course of the disease itself and successfully prevent its occurrence by using vaccination.

“Influvac” - what kind of vaccination is it?

Influvac is an influenza vaccine. It contains killed viral strains; to be more precise, it contains surface antigens of the strains.

First, viruses are cultivated in chicken embryos, they are selected, and they are inactivated using formaldehyde. After which, using special technologies, particles containing antigens are separated from them. All remaining contents are thoroughly cleaned.

The Influvac vaccine is produced in the Netherlands and supplied by Abbott Biologicals BV. Since 1988, the vaccine has been registered and approved for use in the Russian Federation. The vaccine contains antigens of influenza A and B viruses. These particles cannot cause disease, but they can cause lasting immunity.

Every year, taking into account which type of influenza is expected, the composition of the vaccine is updated. Therefore, the instructions specify the season of use. The validity of the vaccine is limited according to the specified time, after this period the effect of the vaccine ceases. Vaccination is recommended every year.

Influvac for influenza is a representative of three-component type vaccines, they contain viruses: A (H3N2); A (H1N1); IN.

Who is recommended to get a flu shot?

Taking into account the fact that Influvac does not have living virus bodies, its use does not cause a reaction, therefore, the vaccine can be prescribed to children from six months of age, as well as to all adults.

The Influvac flu vaccine is necessary for the entire population, but vaccination is especially recommended for the following categories:

• That part of the population who often suffers from ARVI;
• For people over 65 years of age;
• For patients who suffer from heart and vascular diseases;
• For people suffering from diabetes;
• In cases where there is a decrease in immunity (HIV disease, when taking hormonal drugs, immunosuppressants);
• For children who are frequently prescribed aspirin: Children may develop Reye's syndrome;
• For pregnant women in the second half of pregnancy.

How does Influvac work?

Antigens trigger an immune system response in the body. After two weeks, specific antibodies accumulate in the body. In the case of vaccination, the influenza virus enters the body, which has the same antibodies, the shell is destroyed and the viral particle dies.

Conducted in 2000–2001. developments on the drug have shown effectiveness in 90% of cases of vaccine use. This result indicates high immunogenicity, therefore, a high level of body protection.

There is a number of data confirming that after vaccination the incidence of both influenza and acute respiratory infections decreases. Two weeks pass from the moment of vaccination to the formation of immunity, then the effect of immunity lasts a whole year. The best option is to vaccinate in early autumn.

Contraindications

Instructions for use of Influvac stipulate the following contraindications for vaccination:

• In case of individual intolerance;
• In case of allergic reactions to other ingredients of the vaccine;
• In the presence of acute diseases: in the case of acute respiratory viral infections, in case of chronic diseases in the acute stage;
• Children under 6 months of age.

The contraindications that the Influvac vaccine has are typical for vaccines belonging to this category.

In the event that ARVI has mild manifestations, or the disease has minor exacerbations, then vaccination can be performed immediately after body temperature normalizes. It is recommended not to combine several vaccinations on the same day. Otherwise, it is better to perform injections in different limbs.

Use of Influvac for children and pregnancy

Vaccination with Influvac is carried out for children from six months. It should be noted that children respond to vaccination more than adults.

In addition to fever, which is a fairly typical sign during vaccination, they may have a cough and nasal congestion. These manifestations especially apply to infants. This feeling can last for several weeks, as some of the mothers noted.

The flu vaccine Influvac is approved for use in the prescribed manner in case of pregnancy after the second trimester.

It is a purified product, so its use has absolutely no effect on the fetus. If a woman belongs to any risk group, then vaccination is possible, regardless of the timing of pregnancy. Vaccination is also permitted during breastfeeding.

Benefits of flu vaccination at the Miracle Doctor clinic:

• Vaccination is performed only after a thorough examination of the patient by a therapist;
• When vaccinating, high-quality drugs that have mandatory certification are used;
• Carrying out vaccination in a clinic under the supervision of specialists ensures the high effectiveness of the drug and the ability to avoid complications;
• Compliance with all rules and regulations allows you to be vaccinated against influenza with the Influvac vaccine at the Miracle Doctor clinic without any complications or side effects.

The specialists working at the Miracle Doctor clinic always achieve the best possible results for each patient. By contacting us for help, you can always find understanding and avoid many problems.

Take care of your health in advance, get preventive vaccinations!