Flu jab for over-50s and pregnant women advised

PREGNANT WOMEN and everyone over 50 should be vaccinated against influenza, according to the latest national immunisation guidelines for the Republic.

The changes to the guidelines were circulated to doctors last week by the National Immunisation Advisory Committee of the Royal College of Physicians in Ireland.

However, the guideline for pandemic influenza, swine flu, has not been updated this year despite ongoing concern about a link between the pandemic influenza vaccine Pandemrix and narcolepsy in young people. Some 30 cases of narcolepsy with a possible link to the vaccine have been identified by the Health Service Executive.

Asked about the status of the Pandemrix vaccine in the Republic, a spokesman for the HSE said: “The trivalent seasonal flu vaccine for this season [2011-12] contains the H1N1 virus strain so there is no need to have a separate monovalent vaccine (such as Pandemrix).

“Recent correspondence to GPs has indicated the monovalent vaccine should only be used in a pandemic and not for the under-19s.”

GPs have been advised to return any remaining stocks of Pandemrix to the HSE for disposal.

In advising all pregnant women at any stage of pregnancy to avail of this year’s seasonal influenza vaccine, which contains a H1N1 swine flu strain, the advisory committee guideline states: “Studies indicate that pregnancy may increase the risk of complications from influenza (especially H1N1 disease) because of the alterations in heart rate, lung capacity, and immunological function.

“It is estimated that immunisation could prevent one to two hospitalisations per 1,000 pregnant women. Because influenza virus vaccine is not a live vaccine it is considered very safe in pregnancy.”

Doctors have also been warned to exercise caution when administering the seasonal flu vaccine at the same time as the childhood pneumococcal vaccine.

It follows reports from the US of a small but increased risk of febrile convulsions among children aged between 12 and 23 months who received influenza and pneumococcal vaccine simultaneously.

“Consideration may be given to separating PCV13 [pneumococcal] and seasonal influenza vaccines by an interval of at least one week to decrease the risk of febrile seizures occurring,” the new guidelines state.

For the first time, the advisory committee has recommended the use of a vaccine against a common cause of childhood diarrhoea.

However, it has stopped short of including the vaccine in the routine childhood immunisation schedule which means it will not be available free.

Rotavirus vaccines – two of which are licensed for use in the Republic – help prevent rotavirus gastroenteritis when given to infants aged between six and 32 weeks.

Despite the HSE’s recommendation extending the age for flu vaccination to all aged 50 or over, it said the seasonal influenza vaccine would not be available free to all in this age group.