The American Academy of Pediatrics (AAP) policy "Recommendations for Prevention and Control of Influenza in Children, 2017-2018" offers updated recommendations for routine use of seasonal influenza vaccine and antiviral medications for the prevention and treatment of influenza in children. Highlights of the updated recommendations include:
- Vaccination is the best available preventive measure against influenza.
- Annual seasonal influenza vaccination is recommended for everyone 6 months and older.
- Both trivalent and quadrivalent inactivated influenza vaccines are available in the US.
- Quadrivalent live attenuated influenza vaccine (LAIV4) is
not recommended for use in any setting in the US during the 2017-2018 influenza season.
- Children should receive vaccine by the end of October, if possible.
- The number of recommended doses of influenza vaccine depends on a child's age at the time of the first administered dose and vaccine history.
- All children with egg allergy of any severity can receive influenza vaccine without any additional precautions beyond those recommended for any vaccine.
- Pregnant women may receive influenza vaccine at any time during pregnancy.
- All health care personnel should receive an annual seasonal influenza vaccine, a crucial step in preventing influenza and reducing health care-associated influenza infections.
- Antiviral medications can reduce the duration of symptoms and prevent serious complications of influenza, but they are not a substitute for influenza vaccination.
For additional information, refer to the updated
Vaccine Status Table and
Influenza Resource Page within
Red Book Online, which have been updated to reflect the 2017-2018 influenza policy statement. Also see the recent
AAP News article for an overview of these expanded recommendations.
Both trivalent and quadrivalent
inactivated influenza vaccines are available in the United States for the 2017-2018 season. To vaccinate as many people as possible for this influenza season, neither
inactivated vaccine formulation is preferred over the other. Although manufacturers anticipate an adequate supply of quadrivalent vaccine, pediatricians should administer whichever formulation is available in their communities. Both formulations contain an A/Michigan/45/2015 (H1N1)pdm09-like virus, an A/HongKong/4801/2014 (H3N2)-like virus, and a B/Brisbane/60/2008-like virus (B/Victoria lineage). Quadrivalent influenza vaccines also contain the B/Phuket/3073/2013-like virus (B/Yamagata lineage). The influenza A (H1N1) virus in both formulations differs from that contained in the 2016-2017 seasonal vaccines.
Some children 6 months through 8 years of age need two doses of flu vaccine if they have never received at least two doses of any trivalent or quadrivalent influenza vaccine before July 1, 2017. A child requires only one dose if they have previously received two or more total doses of any trivalent or quadrivalent influenza vaccine before July 1, 2017. The two previous doses do not need to have been received during the same influenza season or consecutive influenza seasons. See the updated AAP dosing algorithm:
The 2 doses need not have been received during the same season or consecutive seasons.
b Receipt of LAIV4 in the past is still expected to have primed a child's immune system, despite recent evidence for poor effectiveness. There currently are no data that suggest otherwise.
Upcoming Influenza-Focused Webinar
Plan to participate in the Centers for Disease Control and Prevention (CDC)
Clinician Outreach and Communication Activity (COCA) pediatric-focused influenza prevention and control webinar on Tuesday, November 7, 2017, at 2:00pm ET/1:00pm CT. Flor Munoz, MD, FAAP, member, AAP Committee on Infectious Diseases, will present on behalf of the AAP. Angela Campbell, MD, MPH, FAAP, will present on behalf of the CDC. To receive a calendar appointment, e-mail
DisasterReady@aap.org. Additional information will be provided in the next "What's the Latest with the Flu" message.
Flu Deaths in Children for 2016-17 Season
106 flu-associated deaths in children were reported to the CDC during the 2016-2017 influenza season. While full information on the vaccination status of these children is not yet available, in past seasons, between 80% and 85% of flu-associated pediatric deaths have occurred in children who had not gotten a flu vaccine that season. According to a recent
CDC study, flu vaccination can reduce the risk of flu deaths in children.
Article - The Role of Patient Engagement in Addressing Parents' Perceptions About Immunizations
In July 2017, a viewpoint was published in
JAMA Pediatrics titled, "The Role of Patient Engagement in Addressing Parents' Perceptions About Immunizations". The article describes how physicians, nurses, and other health care professionals should increase efforts to build relationships with parents, especially when they express hesitation or have misconceptions about vaccinations.
New Vaccine Adverse Event Reporting System Website
Vaccine Adverse Event Reporting System (VAERS) is a national early warning system to detect possible safety concerns in US-licensed vaccines. This system is co-managed by the CDC and the US Food and Drug Administration (FDA). Anyone can report an adverse event to VAERS. Health care professionals are required to report certain adverse events, and vaccine manufacturers are required to report all adverse events that come to their attention.
Red Book Online Influenza Resource page,
FluView, or the
CDC Digital Media Toolkit: 2017-18 Flu Season. All What's the Latest with t