Respectful Insolence

All is as it should be again

Yes, it’s that time of year again. Time to get my flu shot.

So that’s just what I did yesterday. I decided to brave that evil, toxin-laden, mercury-infused nastiness, all in order to protect myself and my patients against influenze. As you might recall, last year, when I was off to get my flu vaccine, I pointed out that our cancer center required the flu vaccine for all employees who deal with patients, whatever their capacity, from physician to nurse to medical aide to receptionist. Refuse to get the flu vaccine, and you get to wear a mask any time you are in teh presence of a patient. It’s a reasonable policy, particularly at a cancer center, where there are all sorts of patients who are immmunsuppressed due to chemotherapy. As I pointed out before, it’s imperfect (personally, other than medical reasons, I see no reason why employees at a cancer center, where immunosuppressed patients are cared for, should not be required to be up on all their vaccinations, including the flu vaccine every year), but it’s a reasonable compromise between patient safety and personal freedom.

I did have one problem last year, though. There was no thimerosal in the vaccines our cancer center administered, leading me to ask, “Dammit, where’s my thimerosal?” There I was, left to console myself that Glaxo-Smith-Kline’s Fluarix, which was the vaccine administered last year, did still have , formaldehyde, polysorbate 80, and TRITON® X-100, but somehow it just wasn’t the same.

As I headed to the room where they were administering flu vaccines to employees, I wondered. What would happen this year? It turns out that I was in for a pleasant surprise. I looked at the label of the vaccine. It was Novartis’ Fluvirin. And guess what Fluvirin contains?

Yep, thimerosal, baby! Not just thimerosal, though, but also polymyxin, neomycin, betapropiolactone, and nonylphenol ethoxylate. It even contains trace formaldehyde.

My faith in big pharma is restored.

Comments

  1. #1 shawmutt
    October 4, 2011

    They won’t put thimerosal in my flumist :( I tried to get my family shots instead but my son’s afraid of the needle… Now they’ll _never_ catch autism!

  2. #2 Autistic Lurker
    October 4, 2011

    I have my doctor appointment soon and one of my plan is to renew all my vaccines including the flu one; unfortunately, only the one for the flu _may_ contain thimerosal but hell, we gotta do with what we have…

    A.L.

  3. #3 MosesZD
    October 4, 2011

    Ah, a nice, and nicely snarky, reminder.

  4. #4 Todd W.
    October 4, 2011

    Got mine a couple weeks ago. As I was in line, a woman behind me asked if they had thimerosal-free shots, and I wondered if she actually had an allergy or if she had simply fallen for some of the anti-vaccine nonsense. The person organizing the clinic had to check with the nurses, but they did end up having some thimerosal-free flu vaccines. That’s good, because it meant that this woman ended up getting her immunization.

  5. #5 anarchic teapot
    October 4, 2011

    A fine, uplifting story, sir, and one I shall relate to my hapless GP as he struggles through the annual back-to-school jabfest.

    Rest assured I shall also post what’s in my vaccine when I get it this week.

  6. #6 Reuben
    October 4, 2011

    Nothing but full-on “witches’ brew” for me, thank you. Aborted fetuses, formaldehyde, calf serum, thimerosal, eye of newt, the works.

    Alright, so it might not have had eye of newt, but it’s still fun to think that it did… And that it was the eye of newt that keeps me from catching the flu.

  7. #7 Ajax
    October 4, 2011

    I bet it had oxygen or something in it too. Welcome to my autistic world. I welcome you with crossed arms.

  8. #8 MikeMa
    October 4, 2011

    My flu shot is not yet scheduled but with Orac’s reminder, I will make the appointment.

    @Ajax,
    You are out of phase with us on flu shots, yes? Have you already had this variety or will you get this version next year when fall comes down under?

  9. #9 JohnV
    October 4, 2011

    We just got our email notice of the dates when the hospital provides us with free flu shots.

    At this hospital (and the attached research buildings and offices that make up the health system) your ID badge gets a sticker when you get your flu shot and if you don’t have a sticker then there are parts of the hospital that you can’t enter.

  10. #10 Alexis
    October 4, 2011

    I win. I got my flu shot at 36 weeks pregnant, courtesy of my OB, thereby vaccinating my fetus by proxy. (Said fetus is now a week old baby and napping contentedly.) “Too much, too soon” carried to its logical conclusion!

  11. #11 squirrelelite
    October 4, 2011

    I plan to get mine at a shot clinic at my place of work this month.

    FWIW, it looks like we’ll be getting immunized for H1N1 and a couple of Australian strains this year. From the CDC website:

    †† TIV high-dose: A 0.5-mL dose contains 60 µg each of A/California/7/2009 (H1N1)-like, A/Perth/16/2009 (H3N2)-like, and B/Brisbane/60/2008-like antigens.

    At least if the same strains are used in the regular dose version of Fluzone and by the other manufacturers.

  12. #12 Composer99
    October 4, 2011

    We’ll probably be getting flu shots in late October/early November where I live.

    I got my shot last year on general principles; this year with baby Mini-Composer here (two weeks old as of this past Sunday) I will be definitely getting the vaccine (and encouraging others to do so for Mini-Composer’s sake).

  13. #13 Dangerous Bacon
    October 4, 2011

    My wife gets her flu shot today. I’m waiting to hear about when our hospital will have available vaccine.

    I am so hoping that this year’s vaccine will have antifreeze in it. I have such trouble starting up on cold mornings, and antifreeze sounds like just the ticket. No sucrose though. That stuff’ll kill you.

  14. #14 Catherina
    October 4, 2011

    Dangerous Bacon takes the cookie (bacon?)

    I am getting mine tomorrow, hoping for some chicken embryos on top of all the other goodies ;)

  15. #15 Bronze Dog
    October 4, 2011

    I’ll make a note to get mine, soon. Skipped last year since there was a fair bit of stuff going on.

  16. #16 DLC
    October 4, 2011

    Orac : Sorry, I left the thimerosal in the cabinet, next to the tongue depressors.

  17. #17 Dianne
    October 4, 2011

    My institution requires flu shots. They told us that they were required. They told us that we could be suspended if we didn’t get one. They told us that we could get a medical or religious exemption and conveniently provided forms if we wanted to request an exemption. What they did NOT tell us was WHERE THE FLU SHOTS WERE BEING GIVEN! Yes, I figured it out, but it was a very, very silly thing to forget.

  18. #18 Andreas Johansson
    October 4, 2011

    You lucky bastard. I’ve really enjoyed this year’s healthy all-natural influenza, giving me a much-needed week of lost income and plenty of free time to shiver feverishly in.

  19. #19 DaveD
    October 4, 2011

    I got mine at work a couple of weeks ago. But I forgot to ask whether it contained thimerosal or sucrose or anything. I’m so ashamed.

    As for Orac, I’m sure he’ll become autistic any day now.

  20. #20 Denice Walter
    October 4, 2011

    Big Pharma is probably in bed with Big Drug Store Chain:

    This year after shooting me up with all of those yummy toxins that lace the vaccine, the pharmacist-trained jabber informs me that I should stick around *if case I get a reaction* or faint: a likely story!

    We know that the longer you stay in a shop the more likely you are to buy additional items- mostly useless crap. Traipsing around the aisles, viewing the micro-waves, lawn furniture, perfumes, and expensive skin care products ( they sell lawn furniture and real parfums- not just celebrity nonsense) Fortunately, I have will power and hate lawn furniture. Be forewarned!

  21. #21 Beamup
    October 4, 2011

    In my neck of the woods, pharmacies get the vaccine a couple months before doctor’s offices do. And most insurance (including mine) doesn’t cover it from a pharmacy.

    Massive pain in the neck.

  22. #22 Th1Th2
    October 4, 2011

    I decided to brave that evil, toxin-laden, mercury-infused nastiness, all in order to protect myself and my patients against influenze

    So the flu shot is for the sissies now? Must be an off-label indication. I see.

  23. #23 Edith Prickly
    October 4, 2011

    I want monkey cooties in my flu shot! oh sorry, that’s the polio vaccine. Thimerosal it is, baby!

  24. #24 Tsu Dho Nimh
    October 4, 2011

    The Phoenix area has an unholy alliance between BigRetail and BigPharma … I got my flu vaccination from Mollen’s portable clinic set up at Walmart.

    They were taking any sort of health care insurance, credit cards or cash. (They must be in the pay of BigPfinance too)

    But it was the real thing: Drawn straight from a multi-dose vial with thimerosol. I forgot to get the ingredient list, but I know it’s going to weaken and kill me over the next 40 years or so.

    I would have taken the DTP booster, but they had unpredicted demand for it that day and were all out.

  25. #25 Mu
    October 4, 2011

    Psst, need some Mercurochrome for the injection side?

  26. #26 Denice Walter
    October 4, 2011

    -btw-

    Simon Baron Cohen has the ASQ pencil-and-paper test online: so if anyone wants to self-test prior and post- vax. It’s easy, it’s fun!

  27. #27 Roadstergal
    October 4, 2011

    It’s about that time, isn’t it? My Institution of Evil gives the free shots usually around mid-October; they had the tasty, tasty thimerosal flavor last time. I’ll also have to badger my husband to go to Walgreen’s to get his; he procrastinated last year (I wasn’t helping) and got a nasty fecking flu.

  28. #28 Dianne
    October 4, 2011

    Simon Baron Cohen has the ASQ pencil-and-paper test online: so if anyone wants to self-test prior and post- vax

    If I test as already on spectrum pre-vax can I stop worrying and get further vaccines with impunity?

  29. #29 Ajax
    October 4, 2011

    @MikeMa

    We are so out of synch we even call it ‘autumn’. Harsh.

    If the nurse giving you the shot seems a little undereducated tell her you are allergic to horse serum. :D

  30. #30 DaveD
    October 4, 2011

    If I test as already on spectrum pre-vax can I stop worrying and get further vaccines with impunity?

    No, we’re all out of impunity — but you can get it with thimerosal!

  31. #31 Roadstergal
    October 4, 2011

    I’m so glad they took impunity out of the vaccines. Think of the children.

  32. #32 Reuben
    October 4, 2011

    @DaveD

    I LOL’d.

  33. #33 the bug guy
    October 4, 2011

    I’ll get mine during my next semiannual diabetes checkup.

  34. #34 JustaTech
    October 4, 2011

    My office sent out a big email last week to remind us to get your flu shots (even told us when and where!) and said that if we wanted the thimerosal-free, we had to ask beforehand.

    Wee flu shots!

  35. #35 Prometheus
    October 4, 2011

    I got my influenza vaccine today – thimerosal with a Tween 80 chaser. Bracing!

    They didn’t offer me the option of having my vaccine with impunity – maybe that’s not available in my area.

    Prometheus

  36. #36 Liz Ditz
    October 4, 2011

    Usually I get mine at Big Box Pharma Store — no hassle with appointments, waiting etc. My time is worth money & my insurance doesn’t cover it in either case (until next year, I think, when I am officially A Geezerette). This year I have to have some other vaccines to visit the Darling Daughter in Central America, so off I skip to the Travel Medicine department.

    I’ll be sure to ask for the inserts.

    And @Ajax at #7 —

    Welcome to my autistic world. I welcome you with crossed arms.

    Now that made me laugh out loud.

  37. #37 lilady
    October 4, 2011

    @ Liz Ditz: Some of us are already Geezerettes and Medicare does cover the vaccine. You will also be eligible for coverage for the adult Pneumococcal Polysaccharide Vaccine (PPSV) as well…given as a one time dose after age 65.

    I got my influenza vaccine last month during a check-up with my primary care doc…single dose preloaded syringe…so I guess I didn’t boost my serum mercury level.

  38. #38 herr doktor bimler
    October 4, 2011

    What they did NOT tell us was WHERE THE FLU SHOTS WERE BEING GIVEN!

    I’m sure they’ll jab you in the bum if you ask.

  39. #39 Kate
    October 4, 2011

    My doctor told me that people with latex allergy shouldn’t take the flu vaccine, so I’ve been filling out the waiver at my hospital. I’m happy to wear a mask because of this. Are there other options for people with latex allergy?

  40. #40 Chris
    October 4, 2011

    Kate (if you are not a Dochniak sock puppet), get one of the four influenza vaccines without latex:

    Fluzone Intradermal, NO
    FluLava, NO
    Afluria, NO
    FluMist, NO

  41. #41 lilady
    October 4, 2011

    @ Kate: If you have only a contact (topical) allergy to latex…not a history of anaphylaxis-type reaction, it is not a contraindication to receiving influenza vaccine or any other vaccines.

  42. #42 Beth
    October 5, 2011

    I still need to get mine. Plan to this month, fingers crossed. (Can’t do it the same way as last year, so I have to figure that out.)

    It’s always interesting getting my flu shot. Several years ago, I got a horrid reaction of severely limited use of the injected arm for around a week. This might not be such a big problem for most people, but with my mobility disabilities, it meant I could hardly get around. Because of that, I come prepared (shorts under my pants) and ask for my flu shot in my leg. Every time yet, the nurse that was going to do the injection has went to ask someone else if it was ok for me to get it in my leg. Every time, the answer has been yes and, half the time, the nurse higher up comes to give the injection. I’ve never had problems with it but I know when I go in that I’ll be the impetus for some production. :)

  43. #43 Wookie Monster
    October 5, 2011

    Bad experience with the flu shot last year:

    I got mine during my lunch break. Doctor asked whether I was right- or left-handed. I said “right-handed” without thinking about it and he gave me the shot in my left arm.

    That afternoon I had to analyze about 80 samples in the flow cytometer. Which means vortexing each one for a few seconds before analysis. Due to the set-up of the instrument and computer in the lab, I had to do the vortexing with my left hand.
    OUCH.

  44. #44 alison
    October 5, 2011

    Herr Doktor – I seem to remember that way back in your past that was indeed your injection site (something to do with diving headfirst into a chair to avoid the friendly needle-wielding GP)??

    I got my flu shot back in April (NZer, dontcha know) – & then proceeded to pick up whatever was circulating in Taipei in July. Oh joy. Three days flat on my back & another week reclining in a lazy-boy chair :-(

  45. #45 herr doktor bimler
    October 5, 2011

    Alison has revealed my secret anti-vax past.

  46. #46 Dianne
    October 5, 2011

    Why don’t we give injections in the butt anymore? It’s certainly got enough subcutaneous tissue on most people and a fair amount of muscle too. Pure social embarrassment? It’s quicker to roll your sleeve up than to drop your drawers?

  47. #47 Julian Frost
    October 5, 2011

    Dianne:

    Why don’t we give injections in the butt anymore? It’s certainly got enough subcutaneous tissue on most people and a fair amount of muscle too. Pure social embarrassment?

    Umm, I think it’s because your butt is a lot more sensitive than your arm.

  48. #48 rob
    October 5, 2011

    i get mine next week. i am gonna ask for the one with thimerasol and baby harp seal DNA.

    harp seals are sooooo cuuuute.

  49. #49 Todd W.
    October 5, 2011

    Re: Butt vs. Deltoid

    I recall reading somewhere that some vaccines actually have a decrease in efficacy when given in the butt rather than in the deltoid. I’ll have to try to find that info again, unless someone else pulls it up.

  50. #50 Dianne
    October 5, 2011

    I recall reading somewhere that some vaccines actually have a decrease in efficacy when given in the butt rather than in the deltoid.

    Wild. Too much chance of giving subq rather than IM maybe? If you could find the article without too much work I’d be interested.

  51. #51 Denice Walter
    October 5, 2011

    @ Dianne: re your question ( @ 28) yesterday-
    I have a suspicion that you ( and many here) can make the ASQ say whatever you’d like it to say, if you catch my drift. Thus we might generate some “test scores” to show anti-vaxxers: they would hate our conclusions but would admire the “methodology”- so familiar to them.

    In other news: CNBC announces that Walgreen’s, despite the current economy, managed to make 3.1% last month! I rest my case.

  52. #52 RTContracting
    October 5, 2011

    The only childhood vaccine that children get that still contains thimerosal is the flu vaccine, which is given in the autumn.

    Now I understand why it’s called autism.

    I guess “fallism” sounded too silly.

  53. #53 Todd W.
    October 5, 2011

    Well, this isn’t where I first saw it, but a CDC publication on vaccine administration (PDF) states:

    Deviation from the recommended route may reduce vaccine efficacy or increase local adverse reactions.

    I also found a study on PubMed titled “Deltoid versus buttock as preferred site of injection for hepatitis B vaccine” (PMID: 2529345) which says:

    The site may be important in provoking an appropriate antibody response. The deltoid is recommended rather than the gluteal. It is suggested that recipients of gluteal vaccinations receive revaccination in the deltoid.

    I can keep looking for other info, but IIRC, I first saw it in one of the Pink Book chapters on one of the vaccine preventable diseases.

  54. #54 Chris
    October 5, 2011

    RTContracting:

    The only childhood vaccine that children get that still contains thimerosal is the flu vaccine, which is given in the autumn.

    Actually there are several available without thimerosal. Each and every pediatric vaccine has a form available without thimerosal.

  55. #55 Dianne
    October 5, 2011

    I have a suspicion that you ( and many here) can make the ASQ say whatever you’d like it to say, if you catch my drift.

    Indeed, self-assessment tools are notorious for over and under-diagnosis, especially when the person filling them out has an agenda. And this one appears to have no internal controls to ensure the patient isn’t simply presenting a “sick profile” (exaggerating their symptoms to make sure you take them seriously: a common and entirely natural tendency that’s a real pain in the butt-even without flu vaccines in the gluteal region.) It’s pretty easy to figure out, for example, that if you say “yes” to “I find it difficult to know what others are thinking by watching them” you’re going to get an aspie point.

    But I’d still like to see what an anti-vaxxer would say if you said, “But I’ve already scored a 36 on the autism scale so why should I worry about the vaccine anymore, even if it does cause autism? Been there, done that.” Whether the score represents a true diagnosis or not.

    The only childhood vaccine that children get that still contains thimerosal is the flu vaccine, which is given in the autumn.

    Most healthy kids are given the inhaled live vaccine which, naturally, has no thimerosal.

  56. #56 Denice Walter
    October 5, 2011

    @ Dianne:

    I would bet real money that they would say that it’s dangerous to everyone, making people more “autistic”, and would probably include a laundry list of other problems it would cause *a la* the Canary Party.

  57. #57 lilady
    October 5, 2011

    I think you will find the answers to proper routes of administration of vaccines and the reasons for recommended routes of administration of vaccines in the CDC Pink Book:

    Appropriate Vaccine Administration-Pink Book Appendix D

    The reason why IM vaccines are not given in the buttocks is the potential of injury to to the sciatic nerve. Many of the inactivated vaccines contain adjuvants that can cause an exaggerated (pain, swelling and redness) reaction if given SC rather than the recommended IM route.

  58. #58 Dianne
    October 5, 2011

    @55: Probably. I wonder if they include the risk of turning into the Incredible Hulk or Wonder Woman in their list. It was in VAERS…

  59. #59 Brian34OSU
    October 5, 2011

    The other reason not to give it in the buttocks is that it is a intramuscular injection. Most americans have more of a problem with the needle reaching their muscle through their butt than the needle hitting their sciatic nerve. Plus this year the flu shot needles are smaller than ever. As for latex, as an allergist I would be worried about giving a health care worker a vaccine that does come in a package that contains latex but there are many available that do not. This includes Fluria (CSL Biotherapies), FluLaval (GSK), and Flumist (Medimmune). As for egg allergies, while this was previously a contraindication, it has been shown that most severely egg allergic patients can get the flu shot without issue, though use of a low egg content vaccine would be preferable (Fluarix). I hope that helps increase immunization levels.

  60. #60 Mi Dawn
    October 5, 2011

    I am scheduled for my flu shot at work on the 18th. The consent asks about thimerosal allergic reactions, so hopefully I’ll get my mercury dose. I’ve been so lacking since they pulled Mertiolate off the market.

  61. #61 Monado, FCD
    October 5, 2011

    I got my two flu shots (swine & regular) at the same time at City Hall last year. They asked us to sit down for 15 minutes in case we had any reaction, but there was no merchandise to browse.

    The mercury was taken out of most Canadian childhood inoculations ten years before the U.S. did it, with no effect on our autism rates. So there ha!

    I certainly hope that any exemption for religious reasons carries the reminder that if you get the flu, it will be unpaid sick leave.

  62. #62 lilady
    October 5, 2011

    @ Monado, FCD: Just a small correction to your excellent post; The H1N1 strain of influenza was first incorporated into the seasonal 2010-2011 influenza vaccine used in the USA and Canada.

    There was a shortage of the separate H1N1 flu vaccine during calendar year 2009…and most people were not eligible to receive it. During January 2010, after the shortage of the vaccine was past, it was then offered to the general population.

  63. #63 Tina S
    October 5, 2011

    I got mine!! Last month, early I believe. Didn’t even feel it but the nice lady still had to tell me to breathe.

  64. #64 Cath the Canberra Cook
    October 6, 2011

    I got mine last autumn. But I later found out that it didn’t take – no antibodies. So everybody else plz have yours to keep me safe kthks!

    Maybe it didn’t have enough thimerosal. Or impunity.

  65. #65 herr doktor bimler
    October 6, 2011

    Or impunity.
    Who knows what change those imps could achieve if only they would rise above their factionalism for once and learn to act in a coordinated way.

  66. #66 Knightly Q. Blowguns
    October 6, 2011

    You mention personal freedom, but is there really anyone working at a cancer center who doesn’t believe in vaccinations? And if so, are they allowed to care for actual, real people?

    Oh well. More thimerosal for you, right?

  67. #67 Todd W.
    October 6, 2011

    @Knightly Q. Blowguns

    I touched on the subject of mandatory vaccination of health care workers over at Harpocrates Speaks. One thing I mentioned was that if a person who works at a health care facility (doctor, nurse, janitor, greeter) wants to eschew the vaccine, they should be required to wear an N95 respirator from before they enter any patient area (exam room, hallway, elevator, lobby) until they leave a patient area.

  68. #68 Chris
    October 6, 2011

    Knightly Q. Blowguns:

    You mention personal freedom, but is there really anyone working at a cancer center who doesn’t believe in vaccinations?

    The health of the patients is much more important than your beliefs. If you do not wish to participate in valid public health measures, then stay away from immune compromised persons.

    Or, did you not know that those undergoing cancer treatment often have suppressed immune systems? They don’t need unwanted illnesses in their midst.

    Do you also believe washing your hands is an assault on your freedom?

  69. #69 Todd W.
    October 6, 2011

    @Chris

    I think you’re reading Knightly’s comment the wrong way.

  70. #70 Chris
    October 6, 2011

    Ack! I think you are right. My most sincerest apologies.

    Okay, time for more coffee.

  71. #71 Knightly Q. Blowguns
    October 6, 2011

    @Chris: Not a problem. :)

    I myself am a cancer patient and have had to deal with a compromised immune system. Going to the mall in the middle of a course of Temodar was fun. Little kids started to look suspiciously like plague rats.

  72. #72 Knightly Q. Blowguns
    October 6, 2011

    Todd, thanks for the link (and for clarifying things with Chris).

    By the way, might be the wrong place to ask but how do I link my name to my blog, as yours is?

  73. #73 Chris
    October 6, 2011

    Thanks.

    I still need more coffee.

  74. #74 Chris
    October 6, 2011

    Put the link in the box under “URL:”, the one below where you put your email address.

  75. #75 Knightly Q. Blowguns
    October 6, 2011

    Hmm. Tried that but it doesn’t seem to be working.

    I could probably use a little coffee too.

  76. #76 Chris
    October 6, 2011

    Oh, argh. Is it Friday yet?

  77. #77 Todd W.
    October 6, 2011

    @Knightly

    Are you including “http://” before the actual url?

  78. #78 Knightly Q. Blowguns
    October 6, 2011

    I’ve tried it both ways. It automatically appends http:// when I leave it out (at least in the preview).

  79. #79 khan
    October 7, 2011

    I was donating blood (#176) Sep 17 and noticed a small sign saying “Free Flu Shot”.
    Got the shot after they pulled out the donor needle.

  80. #80 Kate
    October 7, 2011

    @Chris and lilady –
    Thank you very much! (:

  81. #81 lilady
    October 7, 2011

    @ Todd W.

    You can find the updated ACIP Recommendations at:

    MMWR General Recommendations on Immunization January 28, 2011

    Under the header “Nonstandard Vaccination Practices”

    Variation from the recommended route and site can result in inadequate protection. In adults (but not in infants) (117), the immunogenicity of hepatitis B is substantially lower when the gluteal rather than the deltoid site is used for administration (90). Hepatitis B administered intradermally might result in a lower seroconversion rate and final titer of hepatitis B surface antibody than when administered by the deltoid intramuscular route (118,119). Hepatitis B administered by any route other than intramuscular, or in adults at any site other than the deltoid or anterolateral thigh, should not be counted as valid and should be repeated. Similarly, doses of rabies vaccine administered in the gluteal site should not be counted as valid doses and should be repeated (120). MCV4 should be administered intramuscularly; however, revaccination is not necessary if a vaccine dose is administered subcutaneously (121). Inactivated influenza vaccine is immunogenic when administered in a lower than standard dose by the intradermal route to healthy adult volunteers (122). However, the immunogenicity for persons aged ≥60 years is inadequate, and varying the recommended route and dose is not recommended.

    I believe it was about 15 years ago when ACIP changed their Recommendations to limit “invalid route” immunizations to just the Rabies and Hepatitis B vaccine; prior to that all the childhood and adult vaccines when administered via a wrong route were considered “invalid”.

    Sorry about not linking.

  82. #82 anarchic teapot
    October 8, 2011

    I’ve posted the ingredients in my flu vaccine. No mercury, bit of a comedown, but the story of how I acquired the damn thing might raise a few hackles.

    Blog post here

  83. #83 anarchic teapot
    October 14, 2011

    OOOOHHHH Jackpot! I had Side Effects!

    Woke up next morning with a headache that nothing would relieve and a runny nose. It lasted all day, gone now.

    Mind you, I’m prone to headaches of that sort, so no big surprise, and I had a bit of a sniffle beforehand as well.

    Still not dead, though.

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