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Please review the answer to the question: Repetition of H1N1 vaccination

Question
Dear expert team,

Personally, I think that the answer given by Prof. Ellemunter is not correct. The current recommendation for Germany says: children are vaccinated with a half dose rate of the vaccine and receive the second vaccination about three weeks later (the second half dose rate of the cumulative dose). This recommendation applies to the vaccine with adjuvants that is used in Germany. A vaccine without adjuvants is currently not available for the vaccination of children and of the average population in Germany.

Best regards,
C. Röder
Answer
Hello,

Recommendations are different in different countries, but they also depend on the vaccine that is used. Currently, there are only few studies for vaccines according to EMEA (European Medicines Agency).

With regards to Pandemrix® the half dose rate (0,25ml) is sufficient for children in the age of 3 to 9 years. In order to get a higher immune response a second dose can be administered at intervals of 21 days. For children from 6 months to 3 years it is also recommend to use the half dose rate; from age 10, the cumulative adult dose should be used (0,5ml).

If the cumulative dose was used (i.e. 2 x 0,25ml) children from 6 to 35 months showed increased side effects, like general symptoms and fever (among others).

With regards to Focetria® children from 6 months to 17 years should receive the cumulative dose.

With regards to Celvapan® there is no data of the EMEA regarding the vaccination of children. According to the recommendation the cumulative dose should be used for children as well. Since Celvapan® does not contain adjuvants, two vaccinations should be done. This is not necessary for Focetria® and Pandemrix®.

Best regards,
Dr. H. Ellemunter
04.01.2010
29.12.09 (This information in mostly relevant for German citizens):
From the data of the 3.12.2009 on, the German Robert-Koch Institute revised its recommendation: for all age groups one vaccination with the adjuvant vaccine Pandemrix is sufficient: from the age of 6 months to 9 years half a dose is given; from the age of 10 years on a full dose is given. This recommendation was also published in the "Epidemiologisches Bulletin 50/2009" on the 15th of December 2009.
Before the beginning of december, children between 6 months and 9 years were given two half doses with an interval of three weeks of the adjuvant vaccine Pandemrix.
D. d'Alquen