The medical letter on drugs and therapeutics september 14 2015

The Medical Letter ® on Drugs and Therapeutics Objective Drug Reviews Since 1959 Volume 57 ISSUE ISSUE No 1433 1477 Volume 56 September 14, 2015 IN THIS ISSUE Influenza Vaccine for 2015-2016 .p 125 Choice of Contraceptives p 127 Important Copyright Message FORWARDING OR COPYING IS A VIOLATION OF U.S AND INTERNATIONAL COPYRIGHT LAWS The Medical Letter, Inc publications are protected by U.S and international copyright laws Forwarding, copying or any distribution of this material is prohibited Sharing a password with a non-subscriber or otherwise making the contents of this site available to third parties is strictly prohibited By accessing and reading the attached content I agree to comply with U.S and international copyright laws and these terms and conditions of The Medical Letter, Inc For further information click: Subscriptions, Site Licenses, Reprints or call customer service at: 800-211-2769 Published by The Medical Letter, Inc • A Nonprofit Organization The Medical Letter publications are protected by US and international copyright laws Forwarding, copying or any other distribution of this material is strictly prohibited For further information call: 800-211-2769 The Medical Letter ® on Drugs and Therapeutics Objective Drug Reviews Since 1959 Volume 57 ISSUE ISSUE No 1433 1477 September 14, 2015 Take CME Exams ALSO IN THIS ISSUE Choice of Contraceptives p 127 Volume 56 ▶ Influenza Vaccine for 2015-2016 Related article(s) since publication Annual vaccination against influenza A and B viruses is recommended for everyone ≥6 months old without a specific contraindication.1 EFFECTIVENESS — The effectiveness of the seasonal vaccine in preventing influenza in healthy adults depends on the match between the vaccine and circulating strains Vaccine effectiveness is highest (50-80% in young adults; lower in the elderly) when the match is close, but even when the match is poor, vaccination has been shown to reduce the risk of laboratory-confirmed influenza, hospitalization for influenza, and death.2,3 Quadrivalent vs Trivalent – All of the trivalent and quadrivalent seasonal influenza vaccines available in the US contain the same two influenza A virus antigens Trivalent vaccines contain only one influenza B virus antigen Quadrivalent vaccines contain virus antigens from the two genetic lineages of influenza B that have been circulating globally since the 1980s, increasing the likelihood that the vaccine will provide protection against currently circulating strains.4 Live vs Inactivated – Comparative studies in adults 18-49 years old have generally found the inactivated and live-attenuated vaccines to be similarly effective or the inactivated vaccine to be more effective.5-7 Early randomized trials in children found the liveattenuated vaccine to be more effective than the inactivated vaccine In 2014, the CDC Advisory Committee on Immunization Practices (ACIP) recommended use of the live-attenuated vaccine over the inactivated vaccine in healthy children 2-8 years old Observational data from recent seasons, however, have not found the live-attenuated vaccine to be consistently more effective in children.8,9 For the Table 2015-2016 Vaccine Composition and Recommendations COMPOSITION Trivalent Vaccine (Inactivated) A/California/7/2009 H1N1-like A/Switzerland/9715293/2013 H3N2-like B/Phuket/3073/2013-like (Yamagata lineage) Quadrivalent Vaccine (Live-Attenuated or Inactivated) A/California/7/2009 H1N1-like A/Switzerland/9715293/2013 H3N2-like B/Phuket/3073/2013-like (Yamagata lineage) B/Brisbane/60/2008-like (Victoria lineage) WHO SHOULD BE VACCINATED Everyone ≥6 months old without a specific contraindication, including pregnant women TIMING Now through the end of the influenza season (about May 2016)1 CHOICE OF VACCINE2 Healthy Children 2-17 years old3 Live-attenuated vaccine (FluMist Quadrivalent) or standard-dose inactivated vaccine4 Healthy Adults