ACIP includes LAIV4 in 2018-2019 influenza vaccination recommendations

  • Grohskopf LA & al.
  • MMWR Morb Mortal Wkly Rep
  • 8 Jun 2018

  • curated by Liz Scherer
  • Clinical Essentials
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Takeaway

  • Because overall influenza vaccination coverage in U.S. children (age, 2-17 years) remains suboptimal, the Advisory Committee on Immunization Practices (ACIP) is including Quadrivalent Live Attenuated Influenza Vaccine (LAIV4) as an option for the 2018-2019 season.

Why this matters

  • Data demonstrate that LAIV4 effectiveness against A(H1N1)pdma09-like virus A/Slovenia/2903/2015 is significantly higher than for its predecessor A/Bolivia/559/2013, with seroconversion rates in children comparable with those obtained in response to prepandemic influenza H1N1 LAIV strains.
  • For 2018-2019 season, clinicians can choose any licensed, age-appropriate vaccine (inactivated influenza vaccine [IIV], recombinant influenza vaccine, LAIV4).

Key points

  • Data from 2010-2011 through 2016-2017 seasons demonstrate effectiveness of LAIV3 and its replacement LAIV4 against influenza B, A(H3N2) viruses comparable with IIV vaccines.
  • Due to poor effectiveness in U.S. children against A(H1N1), ACIP did not recommend LAIV4 for use during the 2017-2018 season.
  • New data demonstrate that LAIV4 influenza A(H1N1)pdm09-like virus A/Slovenia/2903/2015 was shed by a higher proportion of children from days 4 to 7 after the first vaccine dose.
  • LAIV4 also induced significantly higher antibody responses vs its predecessor A/Bolivia/559/2013.
  • Additionally, the manufacturer will use new methods to evaluate/select candidate vaccine viruses for inclusion, present those to FDA, and analyze replicative fitness in human nasal epithelial cell culture.

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