ACIP: FluMist back in the mix for upcoming flu season

  • Grohskopf LA & al.
  • MMWR Recomm Rep
  • 24 Aug 2018

  • curated by Liz Scherer
  • Clinical Essentials
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  • Advisory Committee on Immunization Practices (ACIP) 2018-2019 seasonal influenza recommendations include 4 new items: 1) vaccine viruses included in US trivalent and quadrivalent vaccines, 2) updated recommendations for live attenuated influenza vaccine (LAIV4, FluMist Quadrivalent), 3) guidance for persons with egg allergy histories, and 4) recent licensures/labeling changes.

Why this matters

  • Familiarity with revised ACIP recommendations, including formulations, contraindications, and precautions is essential.
  • Report any adverse events listed by vaccine manufacturers per the Vaccine Adverse Events Reporting System.

Key points

  • Routine annual influenza vaccination in all persons aged >6 months without contraindications recommended.
  • Trivalent vaccines include A/Michigan/45/2015 (H1N1)pdm09-like virus, A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus, and B/Colorado/06/2017-like virus (Victoria lineage); quadrivalent vaccines include all 3, and additional influenza B vaccine virus, a B/Phuket/3073/2013-like virus (Yamagata lineage).
  • Any licensed, age-appropriate inactivated influenza vaccine (IIV), recombinant influenza vaccine (RIV), LAIV4, are now recommended options for appropriate individuals.
  • Egg allergy: IIV, RIV4 may be used if previously recommended; LAIV4 is now an option for persons with egg allergies of any severity.
  • Afluria Quadrivalent (IIV4) now licensed for age >5 years; Fluarix Quadrivalent now licensed for age >6 months, creating a third inactivated vaccine option for ages 6-35 months (i.e., 0.5 mL containing 15 µg hemagglutinin).

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