EMS: Live Attenuated Virus (Flu-Mist®) H1N1 Vaccination
From: Ritu Sahni, MD, MPH, Medical Director, Oregon EMS/Trauma System
There has been considerable discussion regarding the use of the nasal live attenuated influenza vaccine (LAIV) for H1N1 influenza among health care workers. In general, there is no contraindication to health care workers receiving LAIV. In addition, there is no requirement that health care workers who received LAIV should be prevented from caring for patients. CDC states, “LAIV may be administered to healthy healthcare personnel 49 years of age or younger, except those who have contact with severely immunosuppressed persons who require hospitalization and care in a protective environment (i.e., in isolation because of sever immunosuppression).”
It is a local agency/medical director decision to determine the likelihood of health care workers coming into contact with these patients and to determine if LAIV is appropriate. H1N1 influenza is widely circulating in Oregon and unvaccinated EMS workers may pose a risk to the general population. It is a local decision to determine the risk/benefit of obtaining the vaccine at the earliest possible opportunity vs. waiting for the larger availability of injectable vaccine.
The Oregon EMS/Trauma Office has no authority or intent to sanction any First Responder/EMT who is vaccinated with LAIV and then cares for patients, nor will our office sanction agencies employing such First Responders/EMTs. CDC states that it is not recommended that the use of LAIV be avoided by health care workers. Obviously, all contraindications to LAIV that apply to the general population also apply to health care workers.
Department of Human Service
Public Health Division
800 NE Oregon Street
Portland, OR 97232-2162