[CIS PIDD] [cis-pidd] High-dose influenza vaccine for PID patients?

[Hsu, Florence]

The HD version we have (Fluzone) is 4-fold more concentrated, not 10.  The patients that are requesting it do not appear to have concerns re: flu-like symptoms after an inactivated vaccine; they are more concerned about mounting adequate immunity against the "real thing".  I have given it to 3 CVID patients so far, and two of these had actually received the high-dose vaccine last year (I am not sure why, since they are <65yo and hadn't been diagnosed with CVID yet), without adverse effect.

Does anybody else have any thoughts on this?

Thank you,  Ida

From: Sorensen, Ricardo [mailto:RSoren at lsuhsc.edu]
Sent: Sunday, November 04, 2012 8:09 AM
To: CIS-PIDD
Subject: RE:[cis-pidd] High-dose influenza vaccine for PID patients?

Hi Florence,

This is a question asked frequently  and we  have not found any publication about it. Although it is not a live vaccine, I would not do it. It is not unusual to have patients complaining that they  had flu-like symptoms after the regular vaccine; a 10 time higher dose seems risky to me. It would be interesting to know if other have a different opinion.

Ricardo Sorensen

From: Hsu, Florence [mailto:ida.hsu at yale.edu]
Sent: Thursday, November 01, 2012 11:55 AM
To: CIS-PIDD
Subject: [cis-pidd] High-dose influenza vaccine for PID patients?

Hi all,

I've had several inquiries from adult patients under the age of 65 with CVID or other IgG/IgA deficiencies regarding whether they should get the high-dose flu vaccine currently approved for >65 yo.  Is there any consensus whether this is indicated/good idea or not necessary?

Would love to hear what others are suggesting,
Ida

________________________________
F. Ida Hsu, M.D.
Section of Allergy and Immunology
Department of Medicine
Yale University School of Medicine
Phone:   (203) 785-4143
Fax:        (203) 785-3229


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