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Current time:0:00Total duration:10:53

Two flu vaccines (TIV and LAIV)

Video transcript

so let's say you go out to get your flu shot one of the first things you're going to realize is that there are two types of flu shots available so two types and I'm going to go through them kind of one-by-one so the first one is called TI v and TIV stands for trivalent trivalent refers to the fact that our three strains inactivated inactivated means that the strains are all dead influenza because of course there are three strains of influenza and V is simply vaccine so this is what TIV stands for and on the other side we have la ivy la ivy and this one stands for live live attenuated so this one is a Liz a live virus but it's weakened attenuated just refers to weakened influenza vaccine so just like the other one it has the same three strains we don't put different strains in this one and it's live and attenuated so let me actually just take a moment to step back and talk about this word attenuated specifically you might also hear the word cold adapted and what they do is they literally chemically change the virus around they kind of modify it so that it's still alive technically it's still alive but it can really now only cause problems in your nose because that's the only cold area right so the word cold adapted kind of refers to the fact that it's only going to be able to cause problems in your nose and so if you actually go if the virus goes deeper into your body where it's now warmer it will not have any effect so the virus can cause a runny nose might cause a little congestion and sometimes it does for people that get this vaccine but it won't cause any problems in other places so in your throat you'll be okay and your lungs you'll be okay because it's weakened so let's start back with TIV this one is dead and it's injected and in adults it's usually injected in the upper arm so if you see a picture of people getting injections you know this is the one they're getting right they're getting injected usually in their deltoid muscle and in contrast the le IV we said was alive but weak and we also give this one in a different way we actually squirt this one comes in a liquid and this one gets squirted in the nose and that makes sense because the the virus naturally would go into the nose and so this one would give that way as well so now let's think about groups that cannot get these vaccines which groups would we say no to and the only group really on this side would be anyone that's less than six months so if they're less than six months old they should not get the TIV vaccine unless you're going to just draw a dividing line between these two and on the other side for the le IV who would we say no to this group is a little bit larger a little bit larger so here you would say no to anyone less than two years or I'll put big or here or if they're over 49 years old 49 years old so a 49 year old is okay but let's say they're 50 then you would not give the le IV that's kind of a cut-off right also on this side are pregnant women so pregnant women should not be getting this vaccine and people with chronic diseases so let's say you have asthma or you have kidney disease some sort of a chronic disease that you take medications for you should not be getting the LA IV if that's the case now there are some others actually in this group as well I'm not going to go into all the people that you would not want to get LA IV there are a few other groups but I wanted to point these four out because these are product among the most common and an interesting thing about this is that remember when we talk about high risk groups for influenza we talked about some of these we talked about pregnancy as being a high-risk group people with chronic disease you know very young kids and also the elderly and of course the elderly would be a subgroup of this over 49 group so and these folks let's let's remember these folks are at high risk of getting problems or complications from flu so there's a group that you really want to make sure you vaccinate and as it turns out all of them are probably going to need the TIV the one over here max now let me make a little bit more space and let's talk about a few more groups or things to consider let me just kind of leave this space here now whenever I'm giving vaccines I always want to kind of keep in mind that there are a few questions I should ask people and if they answer these questions in a certain way I'm going to hold off on giving the vaccine so who would I want to hold off on giving the vaccine to well one group and this might sound kind of obvious but one group is someone that's had a bad reaction let's say they've had a bad a severe reaction in the past to the vaccine they've had a severe reaction or an allergic reaction maybe to the vaccine all right allergy then that's a person I may not want to give vaccine to again right and I just want to clarify what was the cause or what happened exactly but if it turns out that they didn't respond well to it either the vaccine itself or to eggs actually because the vaccine is made using eggs and so either these things that they have an allergic reaction severe reaction to eggs or vaccine in the past I'm going to hold off on giving vaccine what's another group you might want to hold off giving vaccine to well there's a syndrome out there you may not have heard of it but I'm going to write it out here and we're going to just kind of briefly discuss it called guillain-barre a gamba right kind of a French Frenchified pronunciation and Gambhir a syndrome is a problem of the nerve so it's actually a nerve disease basically a disease of the nerves that causes muscle weakness that's how I usually kind of explain it to people I want to know what is he on beret how's his muscle weakness and there's a relationship in the past between people getting gamma ray and the vaccine that's why we always want to ask people if they have a hombre and if they do I would hold off on giving the vaccine in most circumstances now a third one and this is probably the most common issue that I've seen come up is when people are moderately ill so sometimes people come into the office and they say well you know I'm here for my flu shot and it turns out that they're having you know a lot of fevers and chills and so if they're having any sort of moderate illness or if they're looking moderately ill then I would not give it now I say moderately and I'm trying to write this on purpose this way because if they have let's say a mild illness a very mild illness then it's okay so this is kind of a judgement call right so you have to actually as a doctor nurse giving the vaccine really think about what is the illness end is it severe enough to really make you want to hold off so mild an illness is okay and that would be something like maybe a runny nose or or a diarrhea that's very mild something that's not too bad so now you know the two vaccines you know who you don't give them to and you also know some things that we always kind of ask to make sure and think about before we give the vaccine things to kind of hold off on so let's actually go down and kind of test our knowledge I actually kind of wrote out a simple example of flu clinic so let's say there's a flu clinic going on and you're in charge so let's take a look at what you might do this person like this is you right this is you and you're smiling because a lot of people showed up to your flu clinic so you got to go through and let's go one by one and figure out who would get what so the ages of the people are on top and any kind of illness they have or any kind of chronic condition they have is written on the bottom so let's go through all these folks one by one and figure out if they can get TIV or LA IV right these are the two vaccines right and I'll put a yellow check if it's okay and I'll put a red X if it's not okay so the three year old and one year old are brought in by their 62 year old grandmother and all three of them are okay with getting the TIV right because there are all over six months and they don't have any illness they don't have gamma ray and they have no evidence of allergies in the past otherwise I would have written it so that whole family is okay with TIV what about the next couple I've got a a man and a woman and the woman is pregnant well both the man and the woman are over six months right and the woman is pregnant but that's not an issue with this vaccine and the man has asthma which is a chronic disease but again that's not a problem with the TIV vaccine what about the last family the 50 the 46 year old woman and her 12 year old son well she has the flu and so she's moderately ill I would not give her the TIV vaccine I'd hold off her son on the other hand has mild diarrhea so if he has mild diarrhea he's still okay to get TIV so that's basically what it would look like if I was only giving up TIV but of course I'm giving out LA IV as well so some people may want that one so let's go through again and now think about LA IV well for the live vaccine you have to be over two years old so the three year olds okay but his one-year-old sister is not okay so she's too young to get this one and you also have to be 49 years or younger you can't be over 50 or 50 or older so grandma who brought them in is also not okay to get this vaccine so in the first family only the three-year-old can get that vaccine now in the second family we've got a man and a woman and the woman is pregnant so we know that's going to make her ineligible for this vaccine and the man has a chronic disease he's got asthma so he also cannot get this vaccine in the last family we have a woman who's 46 and her son now the woman has flu so just as before for the same reason because she's got an illness I'm not going to give her this vaccine either and her son has a mild diarrhea and in this case just as before if he can get the TIV he also can get the le IV because he's not chronically ill with anything right now as a final point it's a really great idea that this boy is going to get flu vaccine because he's around someone who has flu so you want to try to prevent him from getting sick as well so he can't really avoid being around his mom so it's a good idea for him to get vaccinated and the vaccine usually takes about two weeks to take full effect so he has to wait two weeks before he gets the full protection but of course along the way it's going to kind of slowly creep up and hopefully he won't get sick as well