Citing a lack of evidence of efficacy, the AAP’s Committee on Infectious Diseases recommends that clinicians not administer the FluMist quadrivalent live-attenuated vaccine during the upcoming influenza season.
The committee still recommends all persons aged 6 months and older receive an annual seasonal influenza vaccination, including children, adolescents and health care personnel, according to a recent policy statement.
Committee Chairwoman Carrie L. Byington, MD, FAAP, professor of pediatrics at the University of Utah, and colleagues wrote several key points in the update for the 2016-2017 influenza season that reiterate guidelines from the 2015-2016 season, along with additional recommendations.
“The vaccine strains are predicted to be well-matched to circulating strains with the intent of providing optimal protection,” Byington and colleagues wrote. “Vaccination is effective in reducing outpatient medical visits for illness caused by circulating influenza viruses by 50% to 75%.”
For the 2016-2017 season, the AAP recommended or updated the following:
- Influenza vaccine composition in both trivalent and quadrivalent inactivated vaccines differs from the 2015-2016 vaccine, in that this season’s influenza B strain includes the Victoria lineage in the trivalent vaccine as opposed to the Yamagata lineage in last season’s strain for influenza B.
- Quadrivalent live-attenuated vaccine (LAIV4, MedImmune) is discouraged for use due to lack of efficacy during the last 3 seasons, chiefly against influenza A (H1N1)pdm09 viruses.
- Children with egg allergy can receive influenza vaccine without additional precautions similar to routine vaccinations.
- Health care personnel should receive annual seasonal influenza vaccine in an effort to prevent influenza spread and reduce health care-associated influenza infections.
- Pediatricians should identify children suspected with influenza and rapidly treat them with the neuraminidase inhibitor antiviral medications Tamiflu (oseltamivir, Roche Laboratories) and Relenza (zanamivir, GlaxoSmithKline).
- All pregnant women, women who are planning to become pregnant, women postpartum and women who are breast-feeding during the influenza season should be vaccinated.
“Continued evaluation of the safety, immunogenicity and effectiveness of influenza vaccine, especially for children younger than 2 years, is important,” the researchers wrote. “The potential role of previous influenza vaccination on overall vaccine effectiveness by vaccine formulation, virus strain and subject age in preventing outpatient medical visits, hospitalizations and deaths continues to be evaluated.” – by Kate Sherrer
Byington CL, et al. Pediatrics. 2016;doi:10.1542/peds.2016-2527.
Disclosure: The researchers report no relevant financial disclosures.