Atlanta—Pharmacists who remain unclear on the safety of coadministering seasonal flu shots with other vaccines might appreciate new guidance from the CDC.

The CDC recently released a summary of 2019-20 influenza vaccination recommendations for health professionals.

Among the topics addressed was administration of influenza vaccine with other vaccines. Public health officials advise that inactivated influenza vaccine and recombinant influenza vaccines may be administered concurrently or sequentially with other inactivated or live vaccines. The guidance cautions, however, that vaccines administered simultaneously should be given at separate anatomic sites.

Live attenuated influenza vaccine may be administered simultaneously with other inactivated or live vaccines, according to the information, but, if not given simultaneously, 4 weeks or more should elapse between administration of LAIV4 and another live vaccine.

The CDC advises, however, that the immunogenicity and safety of simultaneous or sequential administration of two vaccines containing novel (nonaluminum) adjuvants has not yet been evaluated.

Information also was provided on another issue of great concern to pharmacists: storage and handling of influenza vaccines.

The CDC says that, in all cases, manufacturer packaging information should be consulted for authoritative guidance regarding storage and handling of influenza vaccines. If a situation not addressed in packaging materials comes up, the manufacturer should be contacted directly.

In general, public health officials say vaccines should be protected from light and stored at recommended temperatures, i.e., refrigerated between 2° to 8°C (36°-46°F), and vaccine that has frozen should be discarded.

Guidance also was offered on how to use single- and multidose vials. The CDC emphasizes that single-dose vials should not be accessed for more than one dose and that multidose vials should be returned to recommended storage conditions between uses, and once initially accessed, should not be kept beyond the recommended period of time.

Some multidose vials have a labeled Beyond Use Date (BUD) in addition to the expiration date, according to the summary. The BUD specifies the number of days the vaccine may be used once accessed for the first time. If no BUD is provided, the listed expiration date should be used, the CDC says.

It also points out that package information might specify a maximum number of doses that should be taken from multidose vials, regardless of remaining volume, and that label information should be followed.

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