Updates to the 2013 recommendations from the CDC’s Advisory Committee on Immunization Practices regarding seasonal influenza vaccines were published in a recent MMWR report.
At the June 2014 meeting, the ACIP voted unanimously, 14-0, to recommend preferred use of live attenuated intranasal influenza vaccine (LAIV) for healthy children 2 to 8 years of age who have no contraindications or precautions.
This was the first time a recommendation has been made for a specific influenza vaccine.
The committee’s decision reflects findings from a randomized controlled trial that indicated a 55% reduction in influenza among children who received LAIV compared with inactivated influenza vaccine (IIV). The study cohort consisted of 7,852 children aged 6 to 59 months. LAIV had greater efficacy against antigenically drifted and well-matched influenza viruses, compared with IIV.
LAIV provided 32% increased protection in preventing culture-confirmed influenza among children aged 6 to 17 years with asthma compared with IIV. Further, LAIV had 52% increased protection among children aged 6 to 71 months who had a history of recurrent respiratory tract infections.
In addition to these findings, the ACIP reviewed data on relative efficacy of LAIV and IIV among healthy children and concluded LAIV is more effective than IIV against laboratory-confirmed influenza among younger children.
Risk for adverse events, such as fever and wheezing, are similar for LAIV and IIV.
There are insufficient data to determine at what age or with how many successive seasons of vaccination the greater efficacy of LAIV diminishes among children aged 6 to 18 years, according to the report.
For the 2014-2015 influenza season, the ACIP recommended the following:
- All individuals aged older than 6 months should receive influenza vaccine. Influenza vaccination should not be delayed to procure a specific vaccine preparation if an appropriate one is already available;
- When available, LAIV should be used for healthy children aged 2 to 8 years who have no contraindications or precautions. LAIV is not indicated for patients aged younger than 2 years or older than 49 years;
- If LAIV is not immediately available, inactivated influenza vaccine should be used. Vaccination should not be delayed in order to procure LAIV.
Disclosure: The researchers report no relevant financial disclosures.