Severe Asthma Research Program (SARP)
A National Institutes of Health/ National Heart, Lung & Blood Institutes
sponsored network
Please
ask yourself (or your child) these questions before confirming your appointment
for the HI1N vaccine. Please
call 1-866-804-5278 if you answer “yes”
to any of these questions as you may not be currently eligible for this vaccine
study. In some cases your appointment
may just be delayed.
1)
Do you have an allergic reaction when eating eggs ?
2)
Are you pregnant or breastfeeding ?
3) Do you have active cancer or have you received chemotherapy or radiation
treatment in the last 3 years ?
4)
Have you been diagnosed with schizophrenia or manic depression ?
5)
Do you take any of the following medications:
Aripiprazoleà Abilify Ò
Clozapineà Clozaril Ò
Ziprasidone à Zyprexa Ò
Haloperidol à Haldol Ò
Molindone à Moban Ò
Loxapine à Loxapack, Loxitane Ò
Thioridazine à Mellaril Ò
Thiotixineà Navane Ò
Pimozide à Orap Ò
Fluphenazineà Prolixin Ò
Resperidoneà Risperdal Ò
Mesoridazine à Serentil Ò
Quetiapine à Seroquel Ò
Trifluopromazine
à Flexyx Ò
Olanzapine à Zyprexa Ò
Carbamazepine
à Tegretol Ò
Divalproex
sodium à Depakote Ò
Lithium citrate or Lithium carbonate à Lithobid or
Eskalith Ò
6)
Are you taking more than 2 antidepressant medications ?
7)
Have you had the regular flu vaccine within the past 2 weeks ?
8)
Have you had a serious reaction to the regular flu vaccine ?
9)
Have you had a fever over 100 degrees in
the past 7 days ?
11)
Have you been diagnosed with rheumatoid arthritis (RA), multiple sclerosis
(MS), Lupus (SLE), Guillain-Barré Syndrome or a neuropathy ?
12)
Have you had a seizure within the past year
?
13)
Do you have HIV, Hepatitis B or C ?
14)
Do you have a history of drug or alcohol abuse ?