• Influenza vaccines are not licensed for administration to infants younger than 6 months and should not be used in this age group.
  • Children 9 years and older need only 1 dose, regardless of prior vaccination history.
  • Children 6 months through 8 years of age:
    • Need 2 doses if they have received fewer than 2 doses of any trivalent or quadrivalent influenza vaccine (IIV or LAIV) prior to July 1, 2020. The interval between the 2 doses should be at least 4 weeks. Two doses should be administered to children who receive their first dose before their ninth birthday, even when they turn nine years old during the same season.
    • Require only 1 dose if they have previously received 2 or more total doses of any trivalent or quadrivalent influenza vaccine (IIV or LAIV) prior to July 1, 2020. The 2 previous doses do not need to have been received during the same influenza season or consecutive influenza seasons.
  • Initiation of influenza vaccination before influenza is circulating in the community and continuing to vaccinate throughout the influenza season are important components of an effective influenza vaccination strategy.
  • Complete influenza vaccination by the end of October is recommended by the AAP and CDC. Children who need 2 doses of vaccine should receive their first dose as soon as possible when vaccine becomes available, to allow sufficient time for receipt of the second dose ≥4 weeks after the first, before the onset of the influenza season. Children who require only 1 dose of influenza vaccine should also ideally be vaccinated by end of October; however, recent data (mostly in adults) suggests that very early vaccination (July or August) might be associated with suboptimal immunity before the end of the influenza season.
  • Vaccine Information Statement (VIS) must be offered with every dose of vaccine administered.
  • DO NOT administer influenza vaccine to children younger than 6 months of age. Because the vaccine is not licensed for children under 6 months of age, other methods of protecting this population can be used. Pregnant women are recommended to receive inactivated influenza vaccine in any trimester during pregnancy because, in addition to protecting the mother, maternal flu vaccination also protects the infant through transplacental transfer of antibodies. "Cocooning" is another strategy used—family members and close contacts who receive the vaccine are less likely to get the flu and pass the disease to the infant, creating a protective "cocoon" around them. See the CDC Fact Sheet on Influenza Vaccination During Pregnancy.
  • Minor illnesses, with or without fever, are not contraindications to the use of influenza vaccines, including among children with mild upper respiratory infection symptoms or allergic rhinitis. In children with a moderate to severe febrile illness (eg, high fever, active infection, requiring hospitalization, etc), on the basis of the judgment of the clinician, vaccination should be deferred until resolution of the illness.
  • Children with confirmed COVID-19 can receive influenza vaccine when the acute illness has resolved. Children with an amount of nasal congestion that would notably impede vaccine delivery into the nasopharyngeal mucosa should have LAIV vaccination deferred until resolution.
Last Updated

07/26/2021

Source

American Academy of Pediatrics