Flu vaccine should be offered to the eligible groups set out in the table below (Annex A, page 9 in the annual flu letter): Eligible groups Further detail
All patients aged
"Sixty-five and over" is defined as those aged 65 years and over on 31 March 2014
65 years and over (i.e. born on or before 31 March 1949).
Asthma that requires continuous or repeated use of inhaled or systemic steroids or
respiratory
with previous exacerbations requiring hospital admission.
Chronic obstructive pulmonary disease (COPD) including chronic bronchitis and
emphysema; bronchiectasis, cystic fibrosis, interstitial lung fibrosis,
pneumoconiosis and bronchopulmonary dysplasia (BPD). Children who have previously been admitted to hospital for lower respiratory tract disease.
Chronic heart
Congenital heart disease, hypertension with cardiac complications, chronic heart
failure, individuals requiring regular medication and/or follow-up for ischaemic heart
Chronic kidney
Chronic kidney disease at stage 3, 4 or 5, chronic kidney failure, nephrotic
Chronic liver
Cirrhosis, biliary atresia, chronic hepatitis
disease aged six months or older
Stroke, transient ischaemic attack (TIA). Conditions in which respiratory function
neurological
may be compromised, due to neurological disease (e.g. polio syndrome sufferers).
Clinicians should consider on an individual basis the clinical needs of patients
including individuals with cerebral palsy, multiple sclerosis and related or similar
conditions; or hereditary and degenerative disease of the nervous system or muscles; or severe neurological disability.
Diabetes
Type 1 diabetes, type 2 diabetes requiring insulin or oral hypoglycaemic medicines,
Immunosuppression
Immunosuppression due to disease or treatment. Patients undergoing
chemotherapy leading to immunosuppression. Asplenia or splenic dysfunction, HIV infection at all stages. Individuals treated with or likely to be treated with systemic steroids for more than a month at a dose equivalent to prednisolone at 20mg or more per day (any age) or for children under 20kg a dose of 1mg or more per kg per day. It is difficult to define at what level of immuno-suppression a patient could be considered to be at a greater risk of the serious consequences of flu and should be offered flu vaccination. This decision is best made on an individual basis and left to the patient’s clinician. Some immunocompromised patients may have a suboptimal immunological response to the vaccine. Consideration should also be given to the vaccination of household contacts of immunocompromised individuals, i.e. individuals who expect to share living accommodation on most days over the winter and therefore for whom continuing close contact is unavoidable. This may include carers (see below).
Pregnant women
Pregnant women at any stage of pregnancy (first, second or third trimesters).
People in long-stay
Vaccination is recommended for people living in long-stay residential care
residential or homes
homes or other long-stay care facilities where rapid spread is likely to follow introduction of infection and cause high morbidity and mortality. This does not include, for instance, prisons, young offender institutions, or university halls of residence.
Those who are in receipt of a carer’s al owance, or those who are the main carer, or the carer of an elderly or disabled person whose welfare may be at risk if the carer falls ill.
Health and Social Care
Professional health and social care workers who are in direct contact with
patients/clients should be vaccinated by their employer as part of an occupational health programme
The list above is not exhaustive, and the healthcare practitioner should apply clinical judgement to take into account the risk of flu exacerbating any underlying disease that a patient may have, as well as the risk of serious illness from flu itself. Flu vaccine should be offered in such cases even if the individual is not in the clinical risk groups specified above.
24 Hour Esophageal pH Monitoring Purpose : This test measures the amount of acid in your esophagus (that is, the swallowing tube) over a 24 - hour period. It will show how often stomach contents back up, or reflux, into your esophagus. If you are taking medicine for acid reflux, it will help determine how well the medicine is working. It will help the doctor decide on the best treatment f
CullenaghPortlaoiseCo. Laois20th January 2011Thank you for forwarding a copy of Tony Holohanʼs letter regarding Gardasil vaccination and thank you for taking the time to consider my argument on this important subject. I would like to lay out my reply to Dr. Holohan quite simply in this letter and I would also like to backup my statements with relevant references and additional information below