Flu Vaccines Good with HIV

posted: 12/01/2011

People with HIV are strongly recommended to have an annual flu jab, following a recent study. Swine flu (or H1N1 flu) hasn’t gone away, and the flu vaccine being given to people this winter protects against this.

Some new studies have shown that vaccination against flu works well and is safe for people with HIV.
 

The studies show

• vaccination produces protective antibodies against flu
• better levels of protection come if you have a booster dose
• rates of flu were much lower among people vaccinated
• CD4 cell count is not affected
• viral load stays stable.

Flu jab : Strongly recommended with HIV 
The research results show recommending vaccination of people with HIV is “justified” and they strongly recommend that people should contact their GP and ask for the vaccination.
 

In the UK flu jabs are available from GPs. HIV clinics can provide advice on dealing with swine flu and being vaccinated.

The NHS Choices website allows you to search the database of all GPs.

Source

Flu Vaccine on Mersey

posted: 23/11/2009

Liverpool hospital is writing to people with HIV to encourage people to have both winter and swine flu (HINI) vaccinations at their GP. People can take and show the letter to their GP.

The letter to patients says

With the winter flu season approaching, we would like to take this opportunity to remind you about your seasonal and H1N1 swine flu vaccination available from your GP surgery. Vaccination is the best way of protecting yourself against infection and those close to you by preventing the spread of the virus.

As you have HIV we would strongly advise that you take advantage of the free vaccines to prevent catching seasonal and H1N1 swine flu and developing potentially dangerous complications. Patients with HIV Infection will need to receive a second swine flu vaccination after 3 weeks.

More information about the H1N1 swine flu vaccination is provided overleaf.

It is in your interests to be vaccinated against both swine flu and seasonal flu. Help safeguard yourself by booking an appointment at your earliest convenience at your GP surgery. We will not be providing routine flu vaccinations in clinic.

If you do not have a GP we advise that you register with a GP as you will require a GP to manage any non HIV related illnesses.

If you already have appointments for flu vaccinations or you have already received the seasonal and H1N1 swine flu vaccines, please ignore this letter.

Yours sincerely

Dr SH Khoo
(on behalf of the Liverpool Centre for Sexual Health and the Department of Infectious Diseases, Royal Liverpool & Broadgreen University Hospitals NHS Trust)

?........................................................................................................................

Dear GP

Your patient ................................................. is immunocompromised and requires vaccination for seasonal (single dose) and pandemic H1N1 influenza (2 doses at least 3 weeks apart).

Many thanks

Swine flu and the swine flu vaccination

What is swine flu? It is a respiratory disease caused by a new strain of influenza virus. The symptoms of swine flu are very similar to those caused by seasonal flu. Swine flu is generally a mild infection that comes on quickly and lasts for about a week. It causes fever, tiredness, cough and sore throat. Other symptoms include headache, aching muscles, chills, sneezing, runny nose, loss of appetite, vomiting or diarrhoea.

However, for those with underlying health conditions or who are pregnant or who are having medical treatment such as chemotherapy, swine flu can be very serious.

Why am I being offered the swine flu vaccination? The groups of people who are most vulnerable to serious illness as a result of swine flu are being offered the vaccine first. Based on the current evidence (from the UK and elsewhere), the highest rates for severe disease are in: people with underlying health conditions; and pregnant women.

As with seasonal flu, people who have underlying health conditions (in particular people with respiratory disease) are at an increased risk from the complications of swine flu infection and are more likely to be hospitalised.

If you suffer from a condition that affects your immune system, the people you live with can also get the swine flu vaccination to help to protect you. Please try to encourage the people in your household to contact their GP to discuss getting themselves vaccinated against swine flu.

Will my regular seasonal flu jab protect me against swine flu? No, because seasonal flu and swine flu are caused by different flu viruses.

Will there be any side effects? All vaccinations can produce side effects such as soreness and swelling at the site of the injection. This vaccine is not live so cannot cause flu. Some vaccines, including vaccines similar to the swine flu vaccine, can cause flu-like symptoms but they are very much milder than having the flu itself and only last for a day or so.

Can the swine flu vaccine be given to people with an egg allergy? The GSK vaccine Pandemrix is prepared in hens’ eggs (the same as seasonal flu vaccines) and so should not be given to individuals who have had a confirmed anaphylactic reaction (shock or acute difficulty in breathing) to egg products; they should receive Celvapan.

Further Questions If you have any further questions relating to having this vaccination you should talk to your GP.

image credit

Swine Flu - H1N1 flu

posted: 15/10/2009

Updated 16 October. Swine Flu is still about and the Chief Medical Officer has pointed to a spike in new cases last week.

Vaccination schedule
• 21 October 415,000 doses of the vaccine Pandremix will be given to high-risk patients in hospitals and to frontline health workers.
• Week beginning 26 October 4.4 million doses of Pandremix to be delivered to GPs. Doctors will inoculate patients in priority groups – such as those with compromised immune systems (eg HIV) and pregnant women.
• At the same time 236,500 doses of Pandremix and 49,200 doses of another vaccine, Celvapan, will be sent to NHS primary care trusts.
• The World Health Organisation has backed the use of Pandremix for pregnant women despite claims ingredients have not been sufficiently tested on expectant mothers-to-be
 

NAM have a Swine Flu page that they keep updated regularly here. They have also produced this factsheet. 

And here, Terrence Higgins Trust's medical director answers common swine flu questions.

Swine Flu Vaccine by October

posted: 18/08/2009

People with HIV will be among the first to be offered vaccination to help protect against for swine flu when the vaccine is ready, probably before early October. The Secretary of State for Health announced that individuals with underlying health conditions, including HIV, would be first in line for the vaccination.

The UK guidance is to also vaccinate everyone living in the same home as someone diagnosed with HIV. Pregnant women and individuals aged over 65 with underlying health conditions are also priority groups under the plan.

Vaccination is different from treatment for swine flu. Vaccination aims to stop people from getting it. If you do get swine flu, treatment for it with Tamiflu may help shorten the illness and reduce the symptoms.  

There is no sign that people with HIV are more likely to get swine flu or will have problems as a result of getting it, unless the CD4 cell count is low.

Each year people with HIV are advised to have the annual seasonal flu vaccine. What is different this year is this particular flu (H1N1) will probably affect very large numbers of people, and there is also a fair chance that it will evolve so it is more powerful than normal winter flu. So far most cases of swine flu have not caused severe illness or led to life-threatening complications, but flu is a virus that evolves fast. Like seasonal flu, this flu causes unpleasant symptoms, most notably a high temperature.

Underlying health problems risks

As with any flu, swine flu can have more serious implications for people with conditions such as lung disease, heart disease or diabetes. Individuals with a suppressed immune system, including people with HIV, especially if the CD4 cell count is below 200 cells/mm3 can also have an increased risk of complications. There is no evidence that the current form of swine flu is causing problems in people with low CD4 counts. Nevertheless, people with CD4 counts below 200 should always seek medical advice from their HIV clinic if flu symptoms persist or worsen despite antiviral treatment for flu, not least because symptoms of an opportunistic infection (such as the type of pneumonia called PCP) may be mistaken for flu.

Two doses of vaccine from your GP

The swine flu vaccine will be provided at GPs' surgeries. You will need two doses. The programme of vaccination will start immediately the product has been approved as safe and effective. This is expected to be early October at the latest.

Department of Health vaccination guidance

Source

Swine Flu - Prepare Now

posted: 13/08/2009

The latest (August) i-Base HIV Treatment Bulletin recommends you stock up now on HIV treatment drugs, so you have enough to last through to January. It is better to avoid having to visit the HIV clinic during the flu peak months.

The i-Base bulletin also has swine flu protocols from two leading HIV clinics in London (which NW clinics may adapt), and a useful Questions and Answers page with other helpful advice.

Be prepared

People living with HIV should be prepared - the flu epidemic is fading right now, but experience from past epidemics is very clear. The flu numbers will almost certainly rise steeply in the autumn when schools and colleges restart and people return to work from holidays. The peak of the epidemic is likely to be in October and November.

If large numbers of people have swine flu at once, all services could come under severe strain with staff off sick. So it is recommended you keep at least one months HIV drugs at all times during the autumn and winter.

i-Base say

During August or September, arrange to get enough meds to last you until January. You want to avoid having to visit your clinic in October or November when the flu outbreak is likely to be at it’s peak.

Key points from the i-Base flu questions and answers are:

Q. Will flu meds work in people who are HIV positive?
A. Antiviral medications used to treat flu (for example, oseltamivir (Tamiflu) and zanamivir (Relenza ) will work in HIV-positive people. The main reason to take them is to reduce how infectious you are.

Q. Will flu treatments interact with my HIV drugs?
A. There is a potential for interactions between Tamiflu, boosted PIs and some nukes (3TC, FTC and tenofovir) but the benefits outweigh this small risk. Your pharmacist will advise you on this.

Q. Will I still get my HIV meds?
A. If the flu outbrteak is severe this could limit routine services. To prepare for this ALWAYS KEEP AT
LEAST ONE MONTH’S SUPPLY of HIV meds at home. Some clinics will give you an additional month supply or ask you to return earlier for a new prescription. During August or September, arrange
to get enough meds to last you until January. You want to avoid having to visit your clinic in October
or November when the flu outbreak is likely to be at it’s peak.

Q. What do I do if I think I have swine flu symptoms?
A. If you have internet go to the NHS advice site
If you have symptoms call: 0800 15 13 100 This is the number to access flu meds. You should get these if you are HIV-positive.

Do not visit your GP, hospital or clinic unless you are asked to.

Q. Should I have the flu vaccine?
A. HIV-positive people are routinely recommended to have the seasonal flu vaccine. You need to
be registered with a GP to get this and any new vaccinations. Your clinic can help with this.

Latest (August) i-Base HIV Treatment Bulletin with swine flu Questions and Answers and HIV clinic protocols (good practice guides to how HIV clinics should prepare for and deal with swine flu).