AAP guidelines favor injectable influenza vaccine for kids

  • AAP Committee on Infectious Diseases
  • Pediatrics
  • 4 Sep 2018

  • curated by Liz Scherer
  • Clinical Essentials
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  • American Academy of Pediatrics (AAP) has released its 2018-2019 influenza season vaccination recommendations, reinforcing prevention for all children aged >6 months.

Why this matters

  • Clinicians should discuss recommendation with parents/caregivers, reinforcing severity of 2017-2018 season.
  • Children aged >6 months, especially those at high risk for complications, should be vaccinated as soon as vaccine is available (preferably by end of October).

Key points

  • Either trivalent or quadrivalent inactivated influenza vaccine (IIV3, IIV4, respectively) is the first-line option for influenza vaccination in children; selection is based on whatever is available locally.
    • IIV3 contains influenza A(Michigan/45/2015[H1N1]) pdm09-like virus, influenza A(Singapore/INFIMH-16-0019/2016[H3N2])-like virus (updated), and influenza B (Colorado/60/2017)-like virus (B/Victoria lineage; updated), and updated influenza A(H3N2, Singapore lineage) and influenza B (Victoria lineage) strains.
    • IIV4 contains an additional B virus (Phuket/3073/2013-like virus; B/Yamagata lineage).
  • Live attenuated influenza vaccine (LAIV) is an option for healthy children, >2 years, not otherwise receiving a vaccine (CDC recommends LAIV for all children). 
  • Number of doses to be delivered depends on age at the time of first administered dose, vaccine history.
  • Egg allergy is not a contraindication for influenza vaccination.
  • Any IIV3 or IIV4 vaccine may be used in pregnant women at any time during pregnancy.
  • Antivirals are not a substitute for vaccination.

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