Staff Vaccinations

Influenza Vaccines SPCs and PILs

• IIVc SPC
• IIVc PIL

 

• IIVr SPC
• IIVr PIL

 

• aIIV SPC
• aIIV PIL

 

• IIVe SPC
• IIVe PIL

Protecting yourself from the flu.

Frontline healthcare workers are more likely to be exposed to the influenza (flu) virus, particularly during winter months when some of their patients will be infected. It has been estimated that up to one in four healthcare workers may become infected with influenza during a mild influenza season - a much higher incidence than expected in the general population.

Typically, the elderly, the very young, and people with underlying medical conditions are at a greater risk of suffering severe illness. However, even previously healthy people and the young can develop severe complications from influenza including bronchitis, secondary bacterial pneumonia and, more rarely, meningitis, encephalitis and/or death.

Protecting your family against flu.

Some healthcare workers, aware that they are more likely to become infected with influenza (flu), get the flu vaccination to protect their family members, particularly babies, children or other relatives who may fall into at-risk groups such as elderly parents.

Protecting your patients against flu.

Influenza is a highly transmissible infection. The patient population found in hospital is much more vulnerable to its severe effects. Healthcare workers may transmit the illness to patients even if they are mildly or sub-clinically infected. There are reports of influenza outbreaks within hospitals and other care settings where transmission from healthcare workers to patients is likely to have facilitated the spread of the disease. From our newborn babies cared for by our health visitors to our community nurses supporting our elderly patients, we have a duty to protect them.

In short, the flu vaccine is safe. The most common side effect can be very mild bruising.

Although people sometimes say that the vaccine gave them influenza, this is not possible. The influenza vaccines offered to healthcare workers in the UK are inactivated and do not contain live viruses. Only one vaccine (Fluenz) contains a live virus that has been attenuated and adapted to grow at temperatures below body temperature, but this is only used for the extension of the flu immunisation programme to healthy children.

It is most likely that the flu-like symptoms experienced by people who have just had the vaccine are not caused by influenza but by one of many other circulating viruses that can produce influenza-like symptoms. Since it can take up to two weeks following vaccination to develop immunity to influenza, it is possible for infection to occur if exposed to influenza during this period.

Influenza can cause a spectrum of illness ranging from mild to severe, even among people who were previously well. The impact on the population varies from year to year, depending on how many people are susceptible, any changes to the influenza virus and the severity of the illness caused by the influenza subtype in circulation. The capacity for the virus to mutate/change and the duration of protection from the vaccine (about one season), are the reasons that the vaccine is tailored each year to protect against the most commonly circulating strains and shows why annual vaccination is necessary.

The timing, extent and severity of influenza seasons is unpredictable, and intermittent epidemics can cause significant illness and mortality.

The UKHSA estimated that an average 8,000 people die from flu in England each year. Some years that figure could go beyond 14,000.

There are benefits to both mother and child. The inactivated influenza vaccine is now recommended for women during pregnancy, because flu during pregnancy may be associated with perinatal mortality, prematurity, smaller neonatal size, lower birth weight and increased risk of complications for mother.

The risk of having an anaphylactic reaction to the seasonal influenza vaccine is very low, but anyone who has had a severe reaction (anaphylaxis) to a previous dose of seasonal influenza vaccine, or to any part of the vaccine, should not receive it.

Individuals who have an egg allergy can be immunised in primary care with an egg-free influenza vaccine if available, or an inactivated vaccine with an ovalbumin content of less than 0.12 μg/ml. Patients who have either confirmed anaphylaxis to egg or egg allergy with severe uncontrolled asthma can be immunised with an egg-free influenza vaccine.

As with all medicines used in the UK, influenza vaccines require licensing by the Medicines and Healthcare Products Regulatory Agency (MHRA). Like other medical products, passive surveillance, using reports from yellow cards, is used to identify adverse events. The observed rate of adverse reports is compared to the expected rate, based on data from a general practice research database, after making allowance for under-reporting.

Vegan:  A vegan diet excludes all animal products, including meat, dairy, eggs, and honey. The lifestyle also typically avoids animal exploitation in general, including products tested on animals.

Vegetarian:  A vegetarian diet excludes meat, fish, and poultry. Most vegetarians, known as lacto-ovo-vegetarians, eat dairy and eggs.

Halal:  In Islam, "halal" refers to what is permissible or lawful. Halal food adheres to Islamic law, which prohibits certain animals (including pigs), blood, and alcohol. Specific slaughtering practices, known as dhabiha, are required for meat.

Kosher:  In Judaism, "kosher" describes food that complies with the laws of kashrut. These laws specify which animals can be eaten and how meat is prepared and slaughtered (shechita). It also mandates that meat and dairy products cannot be mixed.

Flu vaccine comparison table

Table Caption

Vaccine Type	Production Method	Vegan	Vegetarian	Halal	Kosher
Cell-Based Injectable Vaccine (IIVc) (offered to staff aged 18-64)	Virus is grown in cultured animal cells, often from canine kidney cells.	Individual Choice Some vegans accept the use of cultured cells, while others object to the animal cell origin.	Individual Choice (Contains no eggs or meat products)	Yes (Generally considered permissible) Does not contain porcine gelatine	Yes (Generally considered permissible)
Recombinant Injectable Vaccine (IIVr) (mainly offered to staff age 65 and over but may be offered to any staff over 18 if IIVc not available)	Uses recombinant DNA technology to produce the flu protein in insect cell culture.	Individual Choice Some vegans accept the use of cultured cells, while others may object to the use of insect cells	Individual Choice (Contains no eggs or meat products)	Yes (Generally considered permissible) Does not contain porcine gelatine	Yes (Generally considered permissible)
Egg-Based Injectable Vaccine (IIVe) (will only be offered to staff aged 18-64 if IIVc is unavailable)	Virus is grown in fertilized hen's eggs. Trace amounts of egg protein may remain.	No (Uses fertilized chicken eggs)	Individual choice Some vegetarians may object, as the virus is grown in fertilized eggs.	Individual choice Muslim scholars may differ in opinion.   Does not contain porcine gelatine	Yes The eggs and hens are kosher animals, and non-oral products are exempt from dietary laws.

Note on religious interpretation:  For halal and kosher requirements, opinions can vary among different communities and authorities. For life-saving medical treatments, religious laws often permit the use of otherwise forbidden substances if no alternative exists. Consult with a trusted religious leader for the most accurate guidance.

Dietary Preferences: Individual opinions may vary depending on the extent to which animals and animal products have been used in the production process or testing on  animals has occurred. Consideration may also be given to animal use in products used to treat any disease resulting from not having vaccination.

Cell culture: Cell lines are derived from a single cell taken from the original source tissue.

Further information for healthcare professionals and patient information leaflets, including ingredients in the final product:

Cell-based Trivalent Influenza Vaccine (Surface Antigen, Inactivated) Seqirus suspension for injection in pre-filled syringe - Summary of Product Characteristics (SmPC) - (emc) | 15818

Supemtek TIVr solution for injection in pre-filled syringe - Summary of Product Characteristics (SmPC) - (emc) | 100729

Vaxigrip suspension for injection in pre-filled syringe - Summary of Product Characteristics (SmPC) - (emc) | 100673

Useful further reading (including links to how vaccines are made and religious views):

https://vaccineknowledge.ox.ac.uk

Guide to the use of human and animal products in vaccines - GOV.UK

Are Vaccines Vegan? | VeganFriendly.org.uk

Vaccines and porcine gelatine - GOV.UK (included for information, but vaccines used for staff flu vaccine don't contain gelatine)

The live attenuated vaccine Fluenz that is used for the childhood flu programme contains a highly processed form of gelatine that is derived from pigs, which is used in a range of many essential medicines.

The new vaccines should be available each year from the beginning of October and any healthcare worker with direct patient contact is urged to get vaccinated as soon as possible. Any healthcare worker in at-risk groups can receive the vaccine at their GP surgery but are asked to report this vaccination at work to ensure inclusion in uptake figures collected and published by UKHSA.

There is no possible way the flu vaccine can give you the flu as the virus when injected is already dead. Some people may mistake the symptoms from bugs caught at the same time or the body's response to the vaccine for flu.

Only bacterial infections can be treated with antibiotics; the flu is a virus and therefore antibiotics would have no effect on the flu.

It is true that flu is dangerous for people over 65, however flu can also be dangerous for others, when they are healthy, unhealthy, young or elderly.

Lots of people assume that if they have had the flu recently, they can't get it again, so they won't need the vaccine, however there may be more than one type of flu virus in circulation. There is nothing stopping you catching the flu virus more than once.

Each year the strain of flu can vary meaning the vaccination varies. Plus, your antibodies produced by vaccination decrease overtime so you may have less if no protection against the flu.

·       Having the flu jab will protect yourself and others. By having the flu jab you will not only be protecting yourself but those around you preventing the spread of the virus.

·       Anyone can catch the flu. But the vaccine offers the best protection from the strains of flu in the vaccine.

·       You can be contagious one day before symptoms occur. Flu is a highly infectious illness you can carry and pass the flu virus around before you know you have got it. This is another reason why getting the flu vaccine is important.

·       The strain of the virus can change each year. This is why it is important to get your vaccination annually.

·       Flu often occurs as an epidemic. This is where an outbreak of sickness affects a lot more people than normal vaccinations can reduce the number of those affected.

·       You are 11 times more likely to die if you get the flu if you are one of the following:

-       65 or over

-       Pregnant

-       Someone with a serious medical history

-       Someone who lives in a residential or nursing home

-       The main carer of an older and or disabled person.

·       People with mild or no symptoms of flu can infect others.

·       The vaccination of health and social care workers protects a chain of people. It protects them and reduces the risk of spreading the flu to their patient's service users colleagues and family members.

·       Flu immunisation is one of the most effective interventions we can provide to reduce harm from flu and pressures on health and social care services during the winter.

·       By preventing flu infection through vaccination, secondary bacterial infections such as pneumonia are prevented. This reduces the need for antibiotics and helps prevent antibiotic resistance.

·       By reducing transmission of flu, it should also avert many cases of severe flu and flu-related deaths in older adults and people in clinical risk groups.

·       Getting vaccinated against flu can help protect you, your patients and family everyone is susceptible to flu, even if you are in good health and eat well you can be infected with the virus and have no symptoms but can still pass flu virus to others including patients or residents.

·       Good infection control measures reduce spread of flu and other acute respiratory infections in healthcare settings but are not sufficient alone to prevent them.

·       Throughout the last 10 years there has generally been a good to moderate match between the strains of flu virus in the vaccine and those that subsequently circulated.