Influenza

Fluzone High-Dose by Sanofi Pasteur (Quadrivalent Influenza)

Captured 2022-12-09
Document Highlights

Initial U.S. Approval: 20XX*

[I]ndicated for active immunization for the prevention of influenza disease caused by influenza A subtype viruses and type B viruses… [and] approved for use in persons 65 years of age and older.

CONTRAINDICATIONS
Severe allergic reaction to any component of the vaccine, including egg protein.

Unsolicited non-serious adverse events were reported in 279 (15.7%) recipients…

Within 180 days post-vaccination… 4.5%…  experienced a serious adverse event (SAE).

Postmarketing Experience
– Thrombocytopenia, lymphadenopathy
– Anaphylaxis, other allergic/hypersensitivity reactions (including urticaria, angioedema)
– Ocular hyperemia
Guillain-Barré syndrome (GBS), convulsions, febrile convulsions, myelitis (including encephalomyelitis and transverse myelitis), facial palsy (Bell’s palsy), optic neuritis/neuropathy, brachial neuritis, syncope (shortly after vaccination), dizziness, paresthesia
– Vasculitis, vasodilatation
– Dyspnea, cough, wheezing, throat tightness, oropharyngeal pain, and rhinorrhea
– Vomiting
– Stevens-Johnson syndrome
– Pruritus, asthenia/fatigue, chest pain, chills

[P]repared from influenza viruses propagated in embryonated chicken eggs.

[C]hemically disrupted using a non-ionic surfactant, octylphenol ethoxylate (Triton® X-100)**

Fluzone High-Dose Quadrivalent has not been evaluated for carcinogenic or mutagenic potential or for impairment of fertility.

Inactive ingredients include formaldehyde and octylphenol ethoxylate.

Comments

Fluzone High-Dose Quadrivalent was not tested for safety in a placebo-controlled clinical trial.

Why this is important.

*Fluzone High-Dose Quadrivalent was first approved in 2019.

**"Use of alkylphenol ethoxylate (APE) surfactants such as nonylphenol ethoxylates (NPEs) and octylphenol ethoxylates (OPEs), which include Triton X-100, has been banned in the European Union due to their ecotoxicity."

"Because of its property to disrupt the cell membrane's lipid bilayer, Triton X-100 is used for example to permeabilize the membranes of living cells or in cell lysis to extract proteins. Outside of research work it has been used in some pharmaceuticals and vaccines (to inactivate viruses), and also in different cleaning products."

"Triton X-100 is dangerous due to it breaking down relatively easily into octylphenol. The latter is a toxic chemical that can be very persistent in the environment. For humans it can potentially alter reproductive function, increase incidences of breast cancer, affect growth patterns and neurodevelopment in children and also change the immune function."

More information on octylphenol ethoxylate: hereherehere, and here.