The American Academy of Pediatrics (AAP) has released its 2017–2018 updated recommendations for the routine use of the seasonal influenza vaccine and antiviral medications for the prevention and treatment of influenza in children.
The guidelines, published in Pediatrics, include a strong recommendation for annual seasonal influenza immunization for everyone 6 months and older. The recommendations apply to routine circumstances, but any guidance may change on the basis of updated recommendations from the Centers for Disease Control and Prevention (CDC) in accordance with antiviral availability, local resources, clinical judgment, recommendations from local or public health authorities, risk of influenza complications, type and duration of exposure contact, and change in epidemiology or severity of influenza.
The AAP’s recommendations for the 2017-2018 influenza season include the following:
- Annual universal influenza immunization is indicated with either a trivalent or quadrivalent inactivated vaccine.
- The 2017–2018 influenza A (H1N1) vaccine strain differs from that contained in the 2016–2017 seasonal vaccines.
- The 2017–2018 influenza A (H3N2) vaccine strain and influenza B vaccine strains included in the trivalent and quadrivalent vaccines are the same as those contained in the 2016–2017 seasonal vaccines.
- Quadrivalent live attenuated influenza vaccine (LAIV4) is no longer recommended for use during the 2017–2018 influenza season.
- This recommendation, originally made in 2016, followed observational data from the US Influenza Vaccine Effectiveness Network revealing that LAIV4 performed poorly against influenza A (H1N1) viruses in recent influenza seasons.
- All children with an egg allergy of any severity can receive an influenza vaccine without any additional precautions.
- All healthcare personnel treating children and adolescents with the influenza vaccine should receive an annual seasonal influenza vaccine, which reduces health care–associated influenza infections.
- Pediatricians should attempt to promptly identify children suspected of having influenza infection for initiation of antiviral treatment to reduce potential morbidity and mortality.
The Committee on Infectious Diseases notes that a universal influenza vaccine that induces broader protection and eliminates the need for annual vaccination is necessary, and efforts to develop the vaccine are under way. In addition, creation of a safe, immunogenic vaccine for infants younger than 6 months is essential.
- Committee on Infectious Diseases. Recommendations for prevention and control of influenza in children, 2017 – 2018. Pediatrics. 2017 Sep 4. doi: 10.1542/peds.2017-2550