Flu activity is still low in the US, but flu cases have now been reported in several southern states. Because flu is unpredictable, it's not possible to say when, where, or how quickly flu activity might increase, how severe it will be, or which viruses will predominate.
As with each influenza season, the American Academy of Pediatrics (AAP) urges all clinicians to take action to ensure that all children get vaccinated against flu. Clinicians should review influenza prevention and control strategies and take steps to educate others. The AAP has worked with the Centers for Disease Control and Prevention (CDC) to produce messaging and resources, including new letters and a fact sheet for health care providers. The AAP also provides a Web page for parents that explains why the nasal spray flu vaccine (live attenuated influenza vaccine or LAIV4) is not recommended for the second season in a row due to poor vaccine effectiveness the past few years.
2017-2018 Flu Season
The AAP and CDC recommend that all children 6 months and older receive a flu vaccine each year. Vaccination is especially important for children with special health care needs, such as conditions that increase the risk for complications from influenza, including children with chronic medical conditions such as pulmonary diseases like asthma, metabolic diseases like diabetes mellitus, hemoglobinopathies like sickle cell disease, hemodynamically significant cardiac disease, immunosuppression, or neurologic and neurodevelopmental disorders. Children younger than 5 years of age, but particularly children younger than 2, are also at an increased risk of hospitalization and complications attributable to influenza.
Although children with chronic medical conditions are at high risk of influenza complications, their immunization coverage rates are lower than that of the general population. More work is needed to raise awareness about the importance of influenza vaccination for these children. Take steps to increase vaccination rates among children at high risk:
- Talk with parents about the importance of influenza immunization and advise them to vaccinate their child as soon as possible.
- Consider using a tracking mechanism or registry to flag children with certain conditions, as this may be useful for getting high risk patients in to be vaccinated.
- Talk about the importance of "cocooning" or immunizing family members and child care providers who spend time with children who are at high risk or who cannot get vaccinated. Immunization of close contacts of children at high risk reduces their risk of contagion. Immunizing mothers and all family members is especially important to protect infants younger than 6 months, because they are too young to receive an influenza vaccine.
See the AAP policy "Recommendations for Prevention and Control of Influenza in Children, 2017 - 2018" for updated recommendations on the routine use of seasonal influenza vaccines and antiviral medications for the prevention and treatment of influenza in children. Also see the recent AAP News article noting an update to the policy to provide the latest dosage and administration information for intravenous peramivir, a neuraminidase inhibitor.
How to Code for Influenza Vaccine in the 2017-2018 Flu Season
It is important for clinicians to know the specific vaccine product being administered in their office and to ensure that each patient meets the recommended age for each vaccine. See the recent AAP News article for details on code descriptors.
CDC COCA Webinar
On November 7, 2017, the AAP collaborated with CDC to conduct a Clinician Outreach and Communication Activity (COCA) webinar titled, "What's New for the 2017-2018 Flu Season: Recommendations for Children." During this COCA webinar, subject matter experts from the AAP and CDC highlighted critical information about this flu season and discussed strategies that primary care providers and medical subspecialists could use to improve flu prevention and control in children. The PowerPoint slides from the webinar and a recording of the presentation will be posted on the webinar Web page.
Interactive Map Highlights Child Vaccination Rates Across America
The AAP developed an interactive digital map that highlights state immunization rates for vaccine-preventable diseases, as well as state laws regarding vaccine exemptions. The map, available at https://immunizations.aap.org/, includes data on how each state measures up against immunization thresholds that are important to ensure protection for all.
When a high number of people in a community are vaccinated, it is less likely that a virus will spread, lowering the risk posed by that disease for the entire community. This "community immunity" threshold varies for each vaccine-preventable disease, which is illustrated in the map.
The AAP supports increasing immunization rates by raising awareness about the protection vaccines offer not only to the public at large, but also for the most vulnerable people. These include infants younger than 6 months of age who cannot receive some vaccines themselves and children with chronic medical conditions. The map illustrates that much work remains to increase vaccination coverage rates, particularly to guard against influenza.
See the AAP Red Book Online Influenza Resource page, CDC FluView, or the CDC Digital Media Toolkit: 2017-18 Flu Season. Each "What's the Latest with the Flu" messages will be archived.