Current Influenza Situation
Although flu activity is winding down in most of the country, it's important to appreciate that flu viruses continue to circulate at low levels even during the summer. Providers should continue to encourage annual influenza vaccination through June 30, when this season's vaccine expires. With 174 pediatric deaths from influenza already reported this season, it is wise to be vigilant. According to a recent AAP News article, about 80% of the children who died were not vaccinated.
Use of Live Attenuated Influenza Vaccine Use for the 2018-2019 Influenza Season
The American Academy of Pediatrics (AAP) recommends intramuscular inactivated influenza vaccine (IIV) for children in the 2018-2019 season as it has been more consistently effective against most strains of flu in recent seasons, but says the nasal vaccine (LAIV) may be an option for kids who otherwise will not be vaccinated.
In February 2018, the Centers for Disease Control and Prevention (CDC) Advisory Committee on Immunization Practices reviewed MedImmune data as well as past seasons' vaccine effectiveness data and voted to recommend LAIV4 as an option for the 2018-2019 season. However, the data on whether or not LAIV4 will be effective are not known, which contributed to the AAP recommendation that children receive IIV, administered intramuscularly, for the upcoming influenza season. While IIV effectiveness varies each season, it has been consistently better than LAIV in recent years. Review the AAP News article for additional information.
Formulation of Flu Vaccines
In March 2018, the US Food and Drug Administration (FDA) Vaccines and Related Biological Products Advisory Committee convened an expert panel to review the World Health Organization (WHO) recommendations for the Northern Hemisphere flu vaccines and global influenza surveillance data to confirm the composition of US seasonal flu vaccines. For the 2018-2019 influenza season, the trivalent flu vaccines will contain:
an A/Michigan/45/2015 (H1N1)pdm09-like virus;
an A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus; and
a B/Colorado/06/2017-like virus (B/Victoria/2/87 lineage).
The quadrivalent flu vaccine will also include a B/Phuket/3073/2013-like virus (B/Yamagata/16/88 lineage), in addition to the viruses listed above.
Prepare for the Next Flu Season!
The AAP Influenza Implementation Guidance has gone digital. The comprehensive guide assists pediatricians, nurses, office managers and staff with steps to help ensure a smooth flu season. Get answers to practice management questions on vaccine ordering and storage, patient scheduling, payment and coding, and more. Find links to the current AAP influenza policy statement and practice policies on health care worker vaccination and liability and risk management. Access parent-friendly materials and speaking points to share influenza messages with families.
This year marks 100 years since the 1918 influenza pandemic, the most severe pandemic in recent history. Reflecting back reminds us that it's always important to prepare in advance for severe flu seasons, including pandemics. To prepare for next flu season, initiate team meetings on the following topics:
Discuss what worked or didn't work in the office this past season and determine what improvements might be made to increase influenza immunization rates.
Develop or update written infection control measures or office protocols for minimizing transmission of influenza and other infectious diseases.
Plan and schedule staff training on standard precautions, infection control, seasonal and pandemic influenza, and the importance of immunization.
For more information, see section 9 in the AAP Preparedness Checklist for Pediatric Practices.
Now is a good time to lay the groundwork for requiring that health care personnel get vaccinated for the flu next season. Take steps to implement a mandatory influenza immunization policy for your clinic staff. See the AAP policy statement "Influenza Immunization for All Health Care Personnel: Keep It Mandatory" for more information.
See the AAP Red Book Online Influenza Resource page or CDC FluView for additional information. Each "What's the Latest with the Flu" messages will be archived. Also see the AAP Seasonal Flu Collection.
This will be the last "What's the Latest with the Flu" message for the 2017-2018 influenza season. The AAP Disaster Preparedness Advisory Council and the AAP Committee on Infectious Diseases would like to thank everyone for their influenza prevention and control efforts. For more information, e-mail DisasterReady@aap.org.