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Published Online, 19 October 2004, www.theannals.com, DOI 10.1345/aph.1E191.
 The Annals of Pharmacotherapy: Vol. 38, No. 12, pp. 2086-2093. DOI 10.1345/aph.1E191
© 2004 Harvey Whitney Books Company.
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FORMULARY FORUM

Trivalent Intranasal Influenza Vaccine, Live

Michelle W McCarthy, PharmD

Director, Drug Information, University of Virginia Health System, Charlottesville, VA

Denise R Kockler, PharmD

Director, Drug Information Services, Virginia Commonwealth University Medical Center, Medical College of Virginia Hospitals, Richmond, VA

Reprints: Michelle W McCarthy PharmD, Drug Information, University of Virginia Health System, PO Box 800674, Charlottesville, VA 22908-0674, fax 434/982-1682, mm4tm{at}virginia.edu

OBJECTIVE: To review human data on the efficacy, safety, and clinical use of trivalent intranasal influenza vaccine, live (TIIVL).

DATA SOURCES: A MEDLINE search (1966–3rd week of January 2004) using the terms influenza vaccine, intranasal administration, and FluMist was conducted. References from pertinent articles were also reviewed.

STUDY SELECTION AND DATA EXTRACTION: Studies conducted in humans and published in English were selected. Double-blind, controlled trials evaluating the efficacy and safety of TIIVL were evaluated.

DATA SYNTHESIS: Administration of TIIVL results in mucosal and humoral immunity to influenza. Results of clinical trials in children and adults have demonstrated that TIIVL reduces the incidence of influenza. In children, TIIVL was also associated with a decrease in febrile illness and febrile otitis media. In adults, reductions in workday absences and medical visits due to febrile upper respiratory tract illness were also documented. TIIVL is well tolerated, with rhinorrhea or nasal congestion and sore throat occurring more frequently than with placebo.

CONCLUSIONS: TIIVL is an alternative to intramuscular inactivated influenza vaccine in healthy individuals between 5 and 49 years of age. However, the vaccine is contraindicated in the majority of patient populations for whom annual influenza vaccination is recommended.

Key Words: FluMist, influenza vaccine, intranasal administration

Published Online, October 19, 2004. www.theannals.com, DOI 10.1345/aph.1E191

THIS ARTICLE IS APPROVED FOR CONTINUING EDUCATION CREDIT
ACPE UNIVERSAL PROGRAM NUMBER: 407-000-04-037-H01


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