Presidential Proclamation- National Influenza Vaccination Week

January 11, 2010 by kalic · Leave a Comment

The White House
Office of the Press Secretary

For Immediate Release

January 09, 2010

Presidential Proclamation- National Influenza Vaccination Week

A PROCLAMATION

Since the first United States cases were identified in April of last year, our Nation has witnessed the worldwide spread of the H1N1 influenza virus. To date, tens of millions of Americans have contracted this virus. While the vast majority of those affected have recovered without incident, an unusually high proportion of children and younger adults have developed serious complications, resulting in hospitalization or even death. We know that influenza vaccination is the best way to protect ourselves against the flu, and my Administration moved swiftly to respond to this threat by assisting in the development of a vaccine, which is now widely available and has shown to be both safe and effective.

Every American has a role to play in fighting the H1N1 flu. Expectant mothers, children, young adults, and all those under the age of 65 with chronic health conditions are at high risk for H1N1 flu-related complications and should get the vaccine as soon as possible. Those not at high risk can protect themselves and prevent the virus from spreading to more vulnerable members of their families and communities by getting vaccinated as well.

This week presents a window of opportunity for us to prevent a possible third wave of H1N1 flu in the United States. I strongly encourage those who have not yet received the H1N1 flu vaccine to do so. Visit flu.gov to find vaccination sites in communities across our country and to stay informed. Together, we can all fight the H1N1 flu and help protect our families, friends, and neighbors.

NOW, THEREFORE, I, BARACK OBAMA, President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim the week of January 10-16, 2010, as National Influenza Vaccination Week. I encourage all Americans to observe this week by getting the H1N1 flu vaccine if they have not yet done so, and by asking their families, friends, and co-workers to do the same.

IN WITNESS WHEREOF, I have hereunto set my hand this eighth day of January, in the year of our Lord two thousand ten, and of the Independence of the United States of America the two hundred and thirty-fourth.

BARACK OBAMA

CDC

Filed Under: H1N1 Flu Information, Infectious Disease
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What is H1N1 Flu?

January 4, 2010 by kalic · Leave a Comment

•H1N1 flu is a new influenza virus causing illness in people. It has two genes from flu viruses that normally circulate in pigs in Europe and Asia, plus avian genes and human genes. Scientists call this a “quadruple reassortant” virus. •H1N1 flu is contagious. This new virus was first detected in people in the United States in April 2009. The virus is spreading from person-to-person, in the same way that regular seasonal influenza viruses spread.

•H1N1 flu is NOT caused by eating pork or pork products. H1N1 flu is not a foodborne disease, it is a respiratory disease. The USDA continues to remind consumers that all meat and poultry products are safe to eat when properly prepared and cooked.

•Illness with the new H1N1 flu virus has ranged from mild to severe. While the vast majority of people who have contracted H1N1 flu have recovered without needing medical treatment, hospitalizations and deaths have occurred.

•About 70 percent of people who have been hospitalized with H1N1 flu have had one or more medical conditions that placed them in the “high risk” category for serious seasonal flu-related complications. These include pregnancy, diabetes, heart disease, asthma and kidney disease.

•Seniors (adults 65 years and older) are prioritized for antiviral treatment to limit risk of complication if they get flu. While your age means you have a lower risk of getting the flu, certain risk conditions (COPD, diabetes, etc.) mean if you get sick, you may have higher risk of complications from any influenza.

flu.gov

Filed Under: H1N1 Flu Information
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Voluntary Non-Safety-Related Recall of Specific Lots of Nasal Spray Vaccine for 2009 H1N1 Influenza

December 28, 2009 by kalic · Leave a Comment

December 22, 2009, 7:00 PM ET

Why are some lots of the nasal spray 2009 H1N1 flu vaccine being recalled from the market?

First, it is important to point out that the recall is not safety-related. As part of its quality assurance program, the manufacturer of the nasal spray monovalent 2009 H1N1 flu vaccine, MedImmune, performs routine, ongoing stability testing of the vaccine. Stability testing means measuring the strength (also called potency) of the vaccine over time to make sure it does not go below a pre-specified limit during the vaccine’s “shelf life.” On December 18 and 21, the manufacturer notified CDC and FDA that the potency in 13 batches (called “lots”) of nasal spray vaccine had decreased below the pre-specified limit or were at risk of falling below that limit within the upcoming week. The vaccine was within the specified range at the time the vaccine was distributed. The slight decrease in potency should not affect how the vaccine works. However, the manufacturer will send providers directions for returning any unused vaccine from these lots.

What does potency mean for the nasal spray 2009 H1N1 vaccine?

Potency (or strength) is determined by the measurement of the concentration of the active component in the 2009 H1N1 vaccine.

Are there any concerns about safety of vaccines from these lots?

No. There are no safety concerns with these lots of 2009 H1N1 vaccine. All lots successfully passed pre-release testing for safety, purity and potency.

Should people who received vaccines from these lots be revaccinated?

No. The vaccine potency is or will soon be only slightly below the limit. In addition, much of this vaccine has already been administered while fully potent and within specifications. The vaccine in these lots is still expected to be effective in stimulating a protective response. There is no need to re-administer a dose to those who received vaccine from these lots.

What action(s) should persons who have received vaccine from the recalled lots take?

Persons who received vaccine from the recalled lots do not need to take any special actions. As is recommended for all 2009 H1N1 vaccines, all children younger than 10 years old should get the recommended two doses of 2009 H1N1 vaccine approximately a month apart for the optimal immune response. Therefore, children younger than 10 years old who have only received one dose of the nasal spray vaccine thus far should still receive a second dose of 2009 H1N1 vaccine. It is best to use the same type of vaccine for the first and second dose.

What are the affected lot numbers?

The affected lot numbers are:

500754P
500751P
500756P
500757P
500758P
500759P
500760P
500761P
500762P
500763P
500764P
500765P
500776P

How many doses are in these lots?

There were approximately 4.7 million doses in these lots that were distributed to providers. Most of the doses were shipped to vaccine providers in October and early November, during a time when the vaccine potency was still at or above the recommended level. The manufacturer is recalling any doses from these lots that may still be unused.

Is the potency issue related to this recall isolated to just the 13 lots of nasal spray vaccine?

The voluntary recall described here is specific to the 13 lots of nasal spray 2009 H1N1 flu vaccine noted above. Subsequent lots of the vaccine were produced with a slightly higher potency to decrease the chance that they would fall “below specification” before their expiration dates. As per their routine practice, the manufacturer will continue to monitor the potency of those lots, and will notify healthcare providers if the shelf life of any additional lots is shorter than expected.

This recall does not affect 2009 H1N1 vaccine produced by other manufacturers. However, a similar recall was conducted recently which involved lots of Sanofi Pasteur’s pediatric 2009 H1N1 vaccine in 0.25 mL pre-filled syringes.

What testing was performed on these lots of vaccine before they were released?

Before they were shipped, the lots being recalled now passed all quality controls and met all specifications for safety, purity, and potency.

What is being done to notify providers who received vaccine from the affected lots?

The manufacturer will send a notification to providers who received doses from any of the 13 lots of vaccine so that they can return any unused vaccine.

Where were the affected lots of vaccine distributed?

Vaccine from these 13 lots was distributed throughout the United States.

CDC

Filed Under: H1N1 Flu Information
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2009 H1N1 in Companion Animals

December 11, 2009 by kalic · Leave a Comment

2009 H1N1 in Companion Animals

What animals can be infected with the 2009 H1N1 virus?

In addition to humans, live swine and turkeys, we know that ferrets (which are highly susceptible to influenza A viruses) and a domestic cat have been infected with 2009 H1N1 virus. CDC is working closely with domestic and international public and animal heath partners to continually monitor this situation and will provide additional information to the public as it becomes available.

How do companion animals become infected with 2009 H1N1?

All available information suggests that the ferrets and domestic cat with 2009 H1N1 infections acquired the virus through close contact with ill humans. Transmission of 2009 H1N1 virus from humans to animals appears similar to human-to-human transmission

Can I get 2009 H1N1 influenza from my pet?

Available evidence suggests that transmission has been from ill humans to their companion animals. No evidence is available to suggest that animals are infecting humans with 2009 H1N1 virus.

What do I do if I am sick with flu-like symptoms and I have pets?

If you are sick with influenza-like-illness, take the same precautions with your pets that you would to keep your family and friends healthy:

•Cover your coughs and sneezes

•Wash your hands frequently

•Minimize contact with your pets until 24 hours after your fever is gone

What should I do if I suspect my pet has 2009 H1N1 influenza virus?

If members of your household have flu-like symptoms, and your pet exhibits respiratory illness, contact your veterinarian.

Is there a vaccine available for my pet?

Currently, there is not a licensed and approved 2009 H1N1 vaccine for companion animals. (There is a canine influenza vaccine, which protects dogs from the H3N8 canine flu virus, but it will not protect pets against the 2009 H1N1 virus and should not be used in any species other than dogs.)

How serious is this disease in companion animals?

Pet ferrets with naturally occurring 2009 H1N1 infection have exhibited illness similar in severity as seen with ferrets exposed to seasonal influenza viruses and 2009 H1N1 virus in laboratory settings, including sneezing, inactivity, and weight loss. The single confirmed cat exhibited respiratory illness and recovered with supportive care.

CDC

Filed Under: H1N1 Flu Information
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Influenza Diagnostic Testing During the 2009-2010 Flu Season

December 11, 2009 by kalic · Leave a Comment

Influenza Diagnostic Testing During the 2009-2010 Flu Season

September 29, 2009, 6:00 PM ET

For the Public

How will I know if I have the flu this season?

You may have the flu if you have one or more of these symptoms: fever, cough, sore throat, runny or stuffy nose, body aches, headache, chills, fatigue and sometimes, diarrhea and vomiting. Most people with 2009 H1N1 have had mild illness and have not needed medical care or antiviral drugs, and the same is true of seasonal flu. (More information is available on What To Do If You Get Sick this flu season.) Most people with flu symptoms do not need a test for 2009 H1N1 because the test results usually do not change how you are treated.

How can I know for certain if I have the flu this season?

To know for certain, a test specific for flu would need to be performed. But most people with flu symptoms do not need a test for 2009 H1N1 flu because the test results usually does not change how you are treated.

What kinds of flu tests are there?

A number of flu tests are available to detect influenza viruses. The most common are called “rapid influenza diagnostic tests” that can be used in outpatient settings. These tests can provide results in 30 minutes or less. Unfortunately, the ability of these tests to detect the flu can vary greatly. Therefore, you could still have the flu, even though your rapid test result is negative. In addition to rapid tests, there are several more accurate and sensitive flu tests available that must be performed in specialized laboratories, such as those found in hospitals or state public health laboratories. All of these tests are performed by a health care provider using a swab to swipe the inside of your nose or the back of your throat. These tests do not require a blood sample. For more information, see Seasonal Influenza Testing.

How well can these tests detect the flu?

Rapid tests vary in their ability to detect flu viruses. Depending on the test used, their ability to detect 2009 H1N1 flu can range from 10% to 70%. This means that some people with a 2009 H1N1 flu infection have had a negative rapid test result. (This situation is called a false negative test result.) Rapid tests appear to be better at detecting flu in children than adults. None of the rapid tests currently approved by the Food and Drug Administration (FDA) are able to distinguish 2009 H1N1 flu from other flu viruses.

Will my health care provider test me for flu if I have flu-like symptoms?

Not necessarily. Your health care provider may diagnose you with flu based on your symptoms and their clinical judgment or they may choose to use an influenza diagnostic test. Depending on their clinical judgment and your symptoms, your healthcare provider will decide whether testing is needed and what type of test to perform. CDC has provided recommendations for clinicians this season to help with testing decisions. This season, most testing will be done in people who are seriously ill (hospitalized patients) and patients where testing may impact treatment decisions. In most cases, if a healthcare provider suspects you have the flu, the test results will not change their treatment decisions.

Who is being tested for flu this season?

This season CDC has provided Interim Recommendations for Clinical Use of Influenza Diagnostic Tests During the 2009-10 Influenza Season which recommends that the following people receive influenza diagnostic testing: 1) people who are hospitalized with suspected flu and 2) people such as pregnant women or people with weakened immune systems, for whom a diagnosis of flu will help their doctor make decisions about their care. CDC expects that most people with flu symptoms this season will not require testing for 2009 H1N1 because the test results usually do not change how you are treated. Additional people may be recommended for testing based on the clinical judgment of their health care provider.

How will I know what strain of flu I have or if it’s 2009 H1N1 (formerly known as Swine Flu)?

You may not be able to find out definitively what flu virus you have. Currently available rapid influenza diagnostic tests cannot distinguish between 2009 H1N1 and seasonal influenza A viruses. Most people with flu symptoms this season will not require testing for 2009 H1N1 because the test results usually do not change how you are treated. As of September 2009, more than 99% of circulating influenza viruses in the United States are 2009 H1N1. Therefore, at this time, if your health care provider determines that you have the flu, you most likely have 2009 H1N1. As the season progresses, different influenza viruses may circulate and updated national information on circulating influenza viruses is available in the FluView U.S. Weekly Influenza Surveillance Report.

There are laboratory tests available that can tell the difference between 2009 H1N1 and other strains of flu, but these can take one to several days to provide results and this season, CDC has recommended that this testing be focused on 1) people who are hospitalized with suspected flu; 2) people such as pregnant women or people with weakened immune systems, for whom a diagnosis of flu will help their doctor make decisions about their care.

Why can’t I get a more accurate laboratory test to find out if I had flu or what kind of flu I had?

The most accurate laboratory tests, such as real-time reverse transcriptase polymerase chain reaction (rRT-PCR) are only available in certain laboratories, and these tests can take several days to obtain results. This season, CDC is focusing use of these tests on people who are hospitalized or for other reasons explained in the question “Who is being tested for flu this season?”

CDC

Filed Under: H1N1 Flu Information, Infectious Disease
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Quick Facts for the Public on Antiviral Treatments for 2009 H1N1

December 11, 2009 by kalic · Leave a Comment

Quick Facts for the Public on Antiviral Treatments for 2009 H1N1
Questions to Ask Your Doctor

Here are a few questions to consider asking your health care provider about flu antivirals

•Do I need antiviral treatment if I have flu symptoms?

•When should I call back if I don’t feel better?

•What do I do if my child is prescribed oseltamivir and can’t swallow capsules? Click here for instructions on how to open capsules and mix the medicine with liquids.

Treatment Is Important for High Risk Groups
People in high risk groups should talk to their health care provider as soon as possible if they think they may have the flu because they have a greater chance of getting serious flu complications than other persons. Flu antiviral drugs can make you feel better, shorten the time you are sick, and prevent serious flu complications, especially if treatment is begun within 2 days of getting sick. Flu antiviral drugs must be prescribed by a physician.

Don’t Delay Treatment
If your doctor prescribed Tamiflu® (oseltamivir) or Relenza® (zanamivir) for you, don’t delay filling the prescription, and start taking the medication as soon as you get it. This way you will get the most benefit. It’s very important that antiviral drugs be started as soon as possible for the flu, ideally within 2 days of getting sick.

Don’t Confuse Tamiflu® (oseltamivir) with Theraflu®
Tamiflu® is the brand name and oseltamivir is the generic name of a prescription antiviral drug used to treat the flu and should not be confused with Theraflu®, which is an over-the-counter medication. Antiviral drugs are not sold over-the-counter. You can only get them if you have a prescription from your health care provider.

Side Effects of Flu Antiviral Drugs
The most common side effects of oseltamivir (Tamiflu®) are nausea and vomiting, which can also be symptoms of the flu. Nausea and vomiting can be minimized by taking the medication with food. The most common side effects of zanamivir (Relenza®) are dizziness, sinusitis, runny or stuffy nose, cough, diarrhea, nausea, or headache, also symptoms that can be due to the flu. Zanamivir may also cause wheezing and trouble breathing in people with lung disease; therefore, persons with a history of asthma or another lung disease should not be prescribed zanamivir.

Treatment May Be Needed Even if Test Results are Negative
Your health care provider may diagnose you with flu based on your symptoms and their clinical judgment or they may choose to use an influenza diagnostic test. Health care providers can use rapid flu tests (15 minutes or less) to test a specimen from your nose or throat in their offices. Unfortunately, these tests are less than perfect in telling who really has the flu. Therefore, you could still have the flu, even though your rapid flu test result is negative. Health care providers may prescribe antivirals if they suspect flu, even if the rapid flu test is negative.

CDC

Filed Under: H1N1 Flu Information, Infectious Disease
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More Frequently Asked Questions about Pregnancy and the H1N1 Vaccine

December 8, 2009 by djw · Leave a Comment

2009 H1N1 Influenza Shots and Pregnant Women: Questions and Answers for Patients

November 2, 2009, 10:30 AM ET

General Public

Why does CDC advise pregnant women to receive the 2009 H1N1 influenza (flu) vaccine (shot)?

Getting the flu shot is the single best way to protect against the flu. It is important for a pregnant woman to receive both the 2009 H1N1 flu shot and the seasonal flu shot. A pregnant woman who gets any type of flu has a greater chance for serious health problems. Compared with people in general who get 2009 H1N1 flu (formerly called “swine flu”), pregnant women with 2009 H1N1 flu are more likely to be admitted to hospitals. Pregnant women are also more likely to have serious illness and death from 2009 H1N1 flu. When a pregnant woman gets a flu shot, it can protect both her and her baby. Research has found that pregnant women who had a flu shot get sick less often with the flu than do pregnant women who did not get a flu shot. Babies born to mothers who had a flu shot in pregnancy also get sick with flu less often than do babies whose mothers did not get a flu shot.

Will the seasonal flu shot also protect against the 2009 H1N1 flu?

Seasonal flu and 2009 H1N1 flu are caused by different viruses. The seasonal flu vaccine will not protect against the 2009 H1N1 flu. Also, the 2009 H1N1 flu vaccine will not protect against seasonal flu.

Are there flu vaccines that pregnant women should not get?

The seasonal and 2009 H1N1 flu vaccines can be given by shot or by nasal spray. Pregnant women should get the "flu shot"—a vaccine made with killed flu virus. This one is given with a needle, usually in the arm. The other type of flu vaccine—a nasal spray—is not approved for pregnant women. This vaccine is made with live, weakened flu virus. Nasal spray flu vaccine should be used only in healthy people 2-49 years of age who are not pregnant. The nasal spray vaccine is safe for women after they have delivered, even if they are nursing.

Can the seasonal flu shot and the 2009 H1N1 flu shot be given at the same time?

Seasonal and 2009 H1N1 flu shots can be given on the same day but should be given at different sites (e.g., one shot in the left arm and the other shot in the right arm). If a woman is getting her vaccines after delivery, she can get the nasal spray flu vaccine. However, she should not get the seasonal and 2009 H1N1 nasal sprays on the same day; they should be given 4 weeks apart.
Is the 2009 H1N1 flu shot safe for pregnant women?

The seasonal flu shot has been given to millions of pregnant women over many years. Flu shots have not been shown to cause harm to pregnant women or their babies. The 2009 H1N1 flu vaccine is being made in the same way and at the same places where the seasonal flu vaccine is made.

What studies have been done on the 2009 H1N1 flu shots and have any been done in pregnant women?

Studies to test the 2009 H1N1 flu shots in healthy children and adults and pregnant women are being done now. Results are available from some of the studies done in non-pregnant adults and children. These results show that the immune system responded well to the 2009 H1N1 vaccine, and the safety results were very similar to those seen in studies of seasonal flu vaccine. These studies are being conducted by the National Institute of Allergy and Infectious Diseases (NIAID) and the vaccine manufacturers.

Does the 2009 H1N1 flu shot have mercury in it?

There is no evidence that thimerosal (a mercury preservative in vaccine that comes in multi-dose vials) is harmful to a pregnant woman or a fetus. However, because some women are concerned about thimerosal during pregnancy, vaccine companies are making preservative-free seasonal flu vaccine and 2009 H1N1 flu vaccine in single-dose syringes for pregnant women and small children. CDC advises pregnant women to get flu shots either with or without thimerosal.

Does the 2009 H1N1 flu shot have an adjuvant or squalene in it?

Adjuvants are agents that are sometimes added to a vaccine to make it more effective. There are no adjuvants (such as squalene) in either the 2009 H1N1 or seasonal flu shot used in the United States.

Can the 2009 H1N1 flu shot be given at any time during pregnancy?

Both seasonal flu shots and 2009 H1N1 flu shots are recommended for pregnant women at any time during pregnancy.

How many 2009 H1N1 flu shots will a pregnant woman need to get?

The U.S. Food and Drug Administration (FDA) has approved the use of one shot for full protection for persons 10 years and older. Therefore, a pregnant woman is recommended to get one dose of the 2009 H1N1 vaccine.

Should the 2009 H1N1 flu shot be given to a pregnant woman who had flu between April 2009 and now? Do I need a test to know if I need the shot or not?

A pregnant woman who had a flu-like illness at any time in the past should still get the 2009 H1N1 shot because she cannot assume that the illness she had was caused by the 2009 H1N1 virus. Pregnant women who had flu symptoms in the past do not need to be tested now, but should get the vaccine.

What are the possible side effects of the 2009 H1N1 flu shots?

The side effects from 2009 H1N1 flu shots are expected to be like those from seasonal flu shots. The most common side effects after flu shots are mild, such as being sore and tender and/or red and swollen where the shot was given. Some people might have headache, muscle aches, fever, and nausea or feel tired. If these problems happen, they usually begin soon after the shot and may last as long as 1-2 days. Some people may faint after getting any shot. Sometimes, flu shots can cause serious problems like severe allergic reactions. But, life-threatening allergic reactions to vaccines are very rare. A person who has a severe (life-threatening) allergy to eggs or to anything else in the vaccine should not get the shot, even if she is pregnant. Pregnant women should tell the person giving the shots if they have any severe allergies or if they have ever had a severe allergic reaction following a flu shot.

Is the 2009 H1N1 flu shot expected to be associated with Guillain-Barre Syndrome (GBS)?

In 1976, an earlier type of swine flu vaccine was associated with cases of a severe paralytic illness called Guillain-Barre Syndrome (GBS) at a rate of approximately 1 case of GBS per 100,000 persons vaccinated. Some studies done since 1976 have shown a small risk of GBS in persons who received the seasonal influenza vaccine. This risk is estimated to be no more than 1 case of GBS per 1 million persons vaccinated. Other studies have shown no increase in risk of GBS. Pregnant women should tell the person giving the shots if they have ever had GBS.

Can family members or other close contacts of a pregnant woman receive the nasal spray vaccine?

Pregnant women should not receive nasal spray for the seasonal or 2009 H1N1 flu vaccine, but it is okay for a pregnant woman to be around a family member or another close contact who has received nasal spray flu vaccine. The nasal spray vaccine can be used in healthy people 2-49 years of age who are not pregnant and in women after they deliver, even if they are nursing.

Can a pregnant healthcare provider give the live nasal spray flu vaccine?

Yes. No special precautions are needed. Nurses and doctors should wash their hands or use an alcohol-based hand rub before and after giving the vaccine.

What if a pregnant woman gets the live nasal spray flu vaccine instead of the flu shot?

The nasal spray flu vaccine has not been approved for pregnant women. It differs from the flu shot because it is made with live, weakened virus. However, sometimes a pregnant woman might get the nasal spray flu vaccine—for example, before she knew she was pregnant. If this happened, she would not be expected to have any additional problems. The weakened, live flu virus has never been shown to be passed to the unborn baby. However, if a woman does get the nasal spray vaccine while she is pregnant, she should talk to her healthcare provider.

If a pregnant woman delivers her baby before receiving her seasonal flu shot or her 2009 H1N1 flu shot, should she still receive them?

Yes. Besides protecting her from infection, the shot may also help protect her infant. Flu shots are only given to infants 6 months of age and older. Everyone who lives with or gives care to an infant less than 6 months of age should get both the seasonal flu and 2009 H1N1 vaccines. A woman can get either the shots or the nasal spray after she delivers.

Can a breastfeeding mother receive the flu shot or the nasal spray?

Yes. Both seasonal and 2009 H1N1 flu vaccines should be given to breastfeeding mothers and breastfeeding women can receive either the shot or the nasal spray form of the vaccine. Breastfeeding is fully compatible with flu vaccination, and preventing the flu in mothers can reduce the chance that the infant will get the flu. Also, by breastfeeding, mothers can pass on to the infant the antibodies that their bodies make in response to the flu shots, which can reduce the infant’s chances of getting sick with the flu. This is especially important for infants less than 6 months old, who have no other way of receiving vaccine antibodies, since they are too young to be vaccinated.

CDC

November 2, 2009, 10:30 AM ET

General Public

Why does CDC advise pregnant women to receive the 2009 H1N1 influenza (flu) vaccine (shot)?

Will the seasonal flu shot also protect against the 2009 H1N1 flu?

Are there flu vaccines that pregnant women should not get?

The seasonal and 2009 H1N1 flu vaccines can be given by shot or by nasal spray. Pregnant women should get the “flu shot”—a vaccine made with killed flu virus. This one is given with a needle, usually in the arm. The other type of flu vaccine—a nasal spray—is not approved for pregnant women. This vaccine is made with live, weakened flu virus. Nasal spray flu vaccine should be used only in healthy people 2-49 years of age who are not pregnant. The nasal spray vaccine is safe for women after they have delivered, even if they are nursing.