Influenza vaccine - ATC code: J07BB02

influenza vaccine (surface antigen, inactivated)

Influenza virus surface antigens (haemagglutinin and neuraminidase), of the following strains*: A/California/7/2009 (H1N1) - derived strain used NYMC X-181 15 micrograms HA** A/Perth/16/2009 (H3N2) - like strain used NYMC X-187 derived from A/Victoria/210/2009 15 micrograms HA** B/Brisbane/60/2008 - derived strain used NYMC BX-35 15 micrograms HA** Per 0.5 ml dose * propagated in fertilized hens' eggs from healthy chicken flocks ** haemagglutinin This vaccine complies with the WHO recommendations (northern hemisphere) and EU decision for the 2011/2012 season.

Suspension for injection in pre-filled syringe. The vaccine appears as a clear liquid.

Prophylaxis of influenza, especially in those who run an increased risk of associated complications.

The use of AGRIPPAL should be based on official recommendations.

Adults and children from 36 months: 0.5 ml

Immunisation should be carried out by intramuscular or deep subcutaneous injection.

Children from 6 months to 35 months: Clinical data are limited. Dosages of 0.25 ml or 0.5 ml have been used.

For children who have not previously been vaccinated, a second dose should be given after an interval of at least 4 weeks.

Hypersensitivity to the active substances, to any of the excipients and to residues, e.g. eggs, chicken proteins, such as ovalbumin.

The vaccine may contain residues of the following substances, e.g. kanamycin and neomycin sulphate, formaldehyde, cetyltrimethylammonium bromide (CTAB) and polysorbate 80.

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.

AGRIPPAL should under no circumstances be administered intravascularly.

Antibody response in patients with endogenous or iatrogenic immunosuppression may be insufficient.

AGRIPPAL 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 results. The transient false positive reactions could be due to the IgM response by the vaccine.

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); rare (1/10,000, <1/1,000); very rare (<1/10,000), including isolated reports.

Nervous system disorders

Common (1/100, <1/10):

Headache*

Skin and subcutaneous tissue disorders

Common (1/100, <1/10):

Sweating*

Musculoskeletal and connective tissue disorders

Common (1/100, <1/10):

Myalgia, arthralgia*

General disorders and administration site conditions

Common (1/100, <1/10):

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, paraesthesiae, febrile convulsions, neurological disorders, such as encephalomyelitis, neuritis and Guillain-Barré syndrome

Vascular disorders:

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

Novartis Vaccines

(POM)

28 March 2012