Issue: October 2020
Disclosures: Munoz reports having a previous research relationship with BioCryst, and a research relationship with the European Society for Paediatric Infectious Diseases and the International Neonatal and Maternal Immunization Symposium. Please see the study for all other authors’ relevant financial disclosures.
September 08, 2020
2 min read
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AAP issues 2020-2021 flu vaccine recommendations

Issue: October 2020
Disclosures: Munoz reports having a previous research relationship with BioCryst, and a research relationship with the European Society for Paediatric Infectious Diseases and the International Neonatal and Maternal Immunization Symposium. Please see the study for all other authors’ relevant financial disclosures.
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The AAP issued its influenza vaccine recommendations for the 2020-2021 season, still emphasizing the importance of vaccinating everyone aged older than 6 months.

Once again, children can receive either an inactivated influenza vaccine (IIV) in the form of an injection or the live-attenuated vaccine (LAIV), which is administered via a nasal spray.

Source: Shutterstock.com
Source: Shutterstock.com

“This is going to be the third season that [nasal spray vaccination is] back ,” Flor Munoz, MD, associate professor of pediatrics and infectious diseases at Baylor College of Medicine, told Healio. “The CDC and the AAP were able to review data provided by the manufacturer of this vaccine, and also data from other countries that continue to use it. When comparing most recent season data to the influenza shot, they do have actually similar efficacy. So given that there was never really withdrawal of this vaccine’s approval in the United States, the vaccine can be used now.”

However, Munoz noted that children must to be aged at least 2 years to receive LAIV, whereas children as young as 6 months can receive IIV.

Flor Munoz

“The spray could not be given to people or children who have other medical conditions, so you need to be otherwise healthy,” she said. “So, that limits the number of children who can get the vaccine. It also cannot be given usually to people who are around others who have weak immune systems.”

Other AAP recommendations include the following:

  • Children should receive influenza vaccine as soon as it becomes available in their community, preferably by the end of October.
  • All vaccines for children will be quadrivalent vaccines, including two influenza A and two influenza B virus strains, to protect against the four strains of influenza that are expected to circulate this season. “The flu vaccine this year is quite different from the previous year’s vaccine,” Munoz said. “Three of the four strains this year are different from last year's vaccine.”
  • Children aged 6 months to 8 years should receive two doses of influenza vaccine if it is the first time they are receiving it, or if they have had only one dose before July 1.
  • Any child with an egg allergy can receive influenza vaccine without any precautions because egg allergy is not a contraindication.
  • Pregnant mothers may receive the vaccine as an injection during pregnancy. The vaccination can protect infants in the first few months of life, which is important because they cannot receive the vaccine before 6 months of age.
  • All health care personnel should get vaccinated to protect themselves and reduce health care-associated influenza infections.

Munoz said that getting vaccinated against influenza is even more important given the current COVID-19 pandemic.

“Certainly, with the issue of COVID-19 being expected to circulate this winter, it is particularly important that children are vaccinated against the flu, because there is a possibility that these two viruses can infect children, and that one after the other or both happening at the same time may result in more severe illness in children,” she said. “Children who have recovered from COVID-19 can also be vaccinated against the flu if they haven't been vaccinated because we do want to prevent them from having another infection in addition to their COVID-19 infection.”