Before Receiving This Vaccine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For influenza vaccine, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to influenza vaccine or to antibiotics, such as gentamicin, streptomycin, or other aminoglycosides. Influenza vaccine available in the U.S. or Canada may contain these antibiotics in very small amounts. Also tell your health care professional if you are allergic to any other substances, such as foods (especially eggs) or preservatives (especially sodium bisulfite or thimerosal). Influenza vaccine is grown in the fluids of chick embryos.

Pregnancy—Influenza vaccine (“shot”) has not been shown to cause birth defects or other problems in humans.

The nasal mist vaccine should not be given to a pregnant women.

Breast-feeding—Influenza vaccine (“shot”) has not been reported to cause problems in nursing babies.

The nasal mist vaccine may cause viral shedding in the mother. This shedding could infect the infant while breast-feeding.

Children—Use is not recommended for infants up to 6 months of age . In addition, only a split-virus influenza vaccine (“shot”) should be given to children 6 months to 12 years of age. Some side effects of the vaccine, such as fever, unusual tiredness or weakness, or aches or pains in muscles, are more likely to occur in infants and children, who are usually more sensitive than adults to the effects of influenza vaccine.

The nasal mist vaccine should not be used in children less than 5 years of age.

Older adults—This vaccine (“shot”) is not expected to cause different side effects or problems in older persons than it does in younger adults. However, elderly persons may not become as immune to head and upper chest influenza infections as younger adults, although the vaccine may still be effective in preventing lower chest influenza infections and other complications of influenza.

The nasal mist vaccine should not be used in adults 50 years of age and older.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your health care professional if you are using any other prescription or nonprescription (over-the-counter [OTC]) medicine.

When you are taking the nasal mist influenza vaccine it is especially important that your health care professional knows if you are taking any of the following:

• Aspirin therapy or
• Aspirin-containing therapy—Use of nasal mist influenza vaccine and aspirin or aspirin-containing products in children and adolescents (5 to 17 years of age) in not recommended. These medications may cause Reye syndrome.

• Immunosuppressive therapies such as:
  • Alkylating dugs (treat some kinds of cancer) or
  • Antimetabolite drugs (treat some kinds of cancer) or
  • Corticosteroids (a cortisone-like medicine) or
  • Immunosuppressive therapy (reduce the body's natural immunity) or
  • Radiation therapy (treat some kinds of cancer)—Use of nasal mist influenza vaccine is not recommended.

Other medical problems—The presence of other medical problems may affect the use of influenza vaccine. Make sure you tell your doctor if you have any other medical problems, especially:

• Asthma, bronchitis, pneumonia, or other illness involving lungs or bronchial tubes—Use of influenza vaccine (nasal mist or “shot”) may make the condition worse

• Immune deficiency diseases such as:
  • Agammaglobulinemia or
  • Cancer or
  • Human immunodeficiency virus infection (HIV) or
  • Immunodeficiency or
  • Leukemia or
  • Lymphoma or
  • Thymus gland problems—Use of live virus vaccines like nasal mist influenza vaccine is not recommended for patients with these medical problems.

• Guillain Barré syndrome, history of—Use of influenza vaccine (nasal mist or “shot”) may cause a recurrence of the symptoms of the condition

• Medical conditions that may make influenza infection more severe, such as:
  • Blood problems (hemoglobinopathies) or
  • Diabetes Mellitus (sugar diabetes) or
  • Heart disease (history of) or
  • Immunosuppression (inability of body to fight an infection) or
  • Kidney disease (history of) or
  • Lung disease (history of) or
  • Metabolic problems (history of)—Use of nasal mist influenza virus vaccine is not recommended. Your doctor will decide if use of inactivated influenza virus vaccine (“shot”) is right for you.

• Severe illness with fever—Influenza virus vaccine should not be given when a fever is present. Your doctor will decide when you are well enough to get your influenza virus vaccine.