Vaccinations for Seasonal and Pandemic Flu

In an attempt to reduce the understandable confusion (hell, I'm confused) about who should receive what influenza vaccine, information from the CDC and news sources is condensed here for reference. But the reader is urged to consult the relevant CDC web pages (for example, here) and a treating physician for authoritative recommendations. Notably guidelines for the pandemic H1N1 vaccine are developing actively and rapidly.

Seasonal Influenza Vaccine (available now)

Who should receive the seasonal influenza vaccine?

• Individuals from 6 months to 19 years of age and individuals 50 years of age or older
• Pregnant women
• Persons with certain chronic medical conditions
• Individuals living in nursing-home or long-term care facilities
• Persons living or working with others who are at risk for influenza-related complications (eg, healthcare workers, daycare employees).

Who is a candidate for the intranasal spray vaccine, which contains 3 live, attenuated seasonal influenza viruses?

Healthy, nonpregnant persons 2-49 years of age.

Who is a candidate for the intramuscular vaccine, which contains 3 inactivated seasonal influenza viruses?

Children 6-35 months of age (dose, 0.25 mL) and individuals 3 years of age or older (dose, 0.5 mL).

Who should receive 2 doses of the seasonal influenza vaccine (each separated by 4 weeks)?

Children younger than 9 years of age who 1) are receiving the seasonal influenza vaccine for the first time or 2) received the vaccine for the first time during the previous influenza season and received only 1 dose.

Pandemic H1N1 (Swine Flu) Vaccine (expected in October)

Who should receive the swine flu vaccine?

• Pregnant women
• Persons who live with or care for infants younger than 6 months of age
• Healthcare and emergency medical personnel
• Persons aged from 6 months to 24 years
• Individuals aged 25-64 years who are at risk for influenza-related complications (eg, persons with asthma, diabetes, hypertension, HIV). 

Who is a candidate for the intranasal spray vaccine, which contains the live, attenuated pandemic H1N1 virus?

The same individuals who are candidates for the intranasal seasonal influenza vaccine: healthy, nonpregnant persons 2-49 years of age.

Who is a candidate for the intramuscular vaccine, which contains the inactivated pandemic H1N1 virus?

All individuals who are priority candidates for the pandemic H1N1 vaccine.*

Who should receive 2 doses of the swine flu vaccine (each separated by 3-4 weeks)?

Late-breaking data suggest that 1 vaccine dose will be sufficient to induce a protective immune response in persons 10 years of age or older. Children from 6 months to 9 years of age, however, will likely require 2 doses of vaccine.

* I suspect that doses, like those for the seasonal influenza vaccine, are cut by half for children 6-35 months of age; however, I have not yet confirmed this information.

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The US Department of Health and Human Services (HHS) recently ordered 56 million more doses of the pandemic H1N1 vaccine from MedImmune and sanofi pasteur for an additional $438,143,025. The total US government spend on the pandemic H1N1 vaccine is now $2,255,120,945, which amounts to $8.98 per vaccine dose.

Novartis	$979,144,920
GSK	$253,400,000
sanofi pasteur	$395,908,025
CSL Biotherapies	$180,000,000
MedImmune	$446,668,000