This information is intended for use by health professionals
Influvac sub-unit, suspension for injection (influenza vaccine, surface antigen, inactivated).
Influenza virus surface antigens (haemagglutinin and neuraminidase) of the following strains*:
- A/Michigan/45/2015 (H1N1)pdm09-like strain (A/Singapore/GP1908/2015, IVR-180)
15 micrograms HA **
- A/Singapore/INFIMH-16-0019/2016 (H3N2)-like strain (A/Singapore/INFIMH-16-0019/2016, NIB-104)
15 micrograms HA **
- B/Colorado/06/2017-like strain (B/Victoria/2/87 lineage) (B/Maryland/15/2016, NYMC BX-69A)
15 micrograms HA **
per 0.5 ml dose
* propagated in fertilised hens' eggs from healthy chicken flocks.
This vaccine complies with the World Health Organisation (WHO) recommendation (northern hemisphere), and EU recommendation for the 2018/2019 season.
For a full list of excipients see section 6.1.
Influvac may contain traces of eggs (such as ovalbumin, chicken proteins), formaldehyde, cetyltrimethylammonium bromide, polysorbate 80, or gentamicin, which are used during the manufacturing process (see section 4.3).
Suspension for injection in prefilled syringes; a colourless clear liquid, filled in single-dose syringes (glass, type I).
Prophylaxis of influenza, especially those who run an increased risk of associated complications.
Influvac is indicated in adults and children from 6 months of age.
The use of Influvac should be based on official recommendations.
Adults: 0.5 ml.
Children from 36 months onwards: 0.5 ml.
Children from 6 months to 35 months: Clinical data are limited. Dosages of 0.25 ml or 0.5 ml may be given, for detailed instructions on administering a 0.25ml or 0.5ml dose, see section 6.6. The dose given should be in accordance with existing national recommendations.
For children who have not previously been vaccinated, a second dose should be given after an interval of at least 4 weeks.
Children less than 6 months: the safety and efficacy of Influvac in children less than 6 months have not been established. No data are available.
Method of Administration
Immunisation should be carried out by intramuscular or deep subcutaneous injection.
Precautions to be taken before handling or administrating the medicinal product:
For instructions for preparation of the medicinal product before administration, see section 6.6.
Hypersensitivity to the active substances, to any of the excipients listed in section 6.1 or to any component that may be present as traces such as eggs (ovalbumin, chicken proteins) formaldehyde, cetyltrimethylammonium bromide, polysorbate 80, or gentamicin.
Immunisation shall be postponed in patients with febrile illness or acute infection.
As with all injectable vaccines, appropriate medical treatment and supervision should always be readily available in case of an anaphylactic event following the administration of the vaccine.
Influvac should under no circumstances be administered intravascularly.
Anxiety-related reactions, including vasovagal reactions (syncope), hyperventilation or stress-related reactions can occur following, or even before any vaccination as a psychogenic response to the needle injection. This can be accompanied by several neurological signs such as transient visual disturbances, paraesthesia and tonic-clonic limb movements during recovery. It is important that procedures are in place to avoid injury from faints.
Antibody response in patients with endogenous or iatrogenic immunosuppression may be insufficient.
Interference with serological testing: see section 4.5.
Influvac may be given at the same time as other vaccines. Immunisation should be carried out on separate limbs. It should be noted that the adverse reactions may be intensified.
The immunological response may be diminished if the patient is undergoing immunosuppressant treatment.
Following influenza vaccination, false positive results in serology tests using the ELISA method to detect antibodies against HIV1, Hepatitis C and especially HTLV1 have been observed. The Western Blot technique disproves the false-positive ELISA test results. The transient false-positive reactions could be due to the IgM response by the vaccine.
Inactivated influenza vaccines can be used in all stages of pregnancy. Larger datasets on safety are available for the second and third trimester, compared with the first trimester; however, data from worldwide use of influenza vaccine do not indicate any adverse foetal and maternal outcomes attributable to the vaccine.
Influvac may be used during breast-feeding.
No fertility data are available
Influvac has no or negligible influence on the ability to drive and use machines.
ADVERSE REACTIONS OBSERVED FROM CLINICAL TRIALS
The safety of trivalent inactivated influenza vaccines is assessed in open label, uncontrolled clinical trials performed as annual update requirement, including at least 50 adults aged 18 - 60 years of age and at least 50 elderly aged 61 years or older. Safety evaluation is performed during the first 3 days following vaccination.
The following undesirable effects have been observed during clinical trials with the following frequencies:
very common (≥ 1/10); common (≥ 1/100, < 1/10); uncommon (≥ 1/1,000, < 1/100).
Tabulated list of adverse reactions:
≥ 1/100, < 1/10
≥ 1/1,000, < 1/100
Nervous system disorders
Skin and subcutaneous tissue disorders
Musculoskeletal and connective tissue disorders
General disorders and administration site conditions
fever, malaise, shivering, fatigue
Local reactions: redness, swelling, pain, ecchymosis, induration*
* These reactions usually disappear within 1-2 days without treatment
ADVERSE REACTIONS REPORTED FROM POST-MARKETING SURVEILLANCE
Adverse reactions reported from post marketing surveillance are, next to the reactions which have also been observed during the clinical trials, the following:
Blood and lymphatic system disorders:
Transient thrombocytopenia, transient lymphadenopathy
Immune system disorders:
Allergic reactions, in rare cases leading to shock, angioedema
Nervous system disorders:
Neuralgia, paraesthesia, febrile convulsions, neurological disorders, such as encephalomyelitis, neuritis and Guillain Barré syndrome
Vasculitis associated in very rare cases with transient renal involvement
Skin and subcutaneous tissue disorders:
Generalised skin reactions including pruritus, urticaria or non-specific rash
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard
Overdosage is unlikely to have any untoward effect.
Pharmacotherapeutic group: Influenza vaccine, ATC Code: J07BB02.
Seroprotection is generally obtained within 2 to 3 weeks. The duration of postvaccinal immunity to homologous strains or to strains closely related to the vaccine strains varies but is usually 6-12 months.
Potassium chloride, potassium dihydrogen phosphate, disodium phosphate dihydrate, sodium chloride, calcium chloride dihydrate, magnesium chloride hexahydrate and water for injections.
In the absence of compatibility studies, this medicinal product must not be mixed with other medicinal products.
Store in a refrigerator (+2°C to +8°C).
Do not freeze.
Store in the original package in order to protect from light.
0.5 ml suspension for injection in prefilled syringe with/without needle (glass, type I), pack of 1 or 10.
Not all pack sizes may be marketed.
The vaccine should be allowed to reach room temperature before use.
Shake before use. Inspect visually prior to administration.
For the administration of a 0.25 ml dose from a single dose 0.5ml syringe, push the front side of the plunger exactly to the edge of the mark so that half of the volume is eliminated; a volume of 0.25ml of the vaccine remains in the syringe, suitable for administration. See also section 4.2.
Any unused product or waste material should be disposed of in accordance with local requirements.
Mylan Products Ltd.
20 Station Close
Date of first authorisation: February 1998
Date of latest renewal: December 2007