- Despite some changes to the quadrivalent live attenuated influenza vaccine (LAIV4) to boost effectiveness, the American Academy of Pediatrics (AAP) advises that children receive inactivated vaccine this coming season.
- All children aged 6 months or older should be vaccinated where not contraindicated.
- Intranasally administered LAIV4 has been a popular choice for children because it avoids an injection.
- LAIV4 has been proven effective against strains of influenza B, less so with A/H3N2 strains, and not effective against A/H1N1 strains.
- CDC and AAP have not recommended LAIV4 in past 2 seasons.
- LAIV4 manufacturer MedImmune (FluMist) switched covered H1N1 strains from A/Bolivia to A/Slovenia, intended to bump antibody response.
- Based on MedImmune data, the CDC greenlighted reintroduction of FluMist for the 2018-2019 season.
- AAP advises that children should still receive the shot with inactivated virus.
- Only when the shot is absolutely declined should LAIV4 be offered with the caution that children could be at higher infection risk with this option.
- The spray is specifically not recommended for children with certain chronic medical conditions or
- The most recent season saw 168 pediatric deaths attributed to influenza.
- The AAP formal policy statement on influenza treatment and prevention is slated for publication in September 2018.