Flu Vaccine Recommendations for Upcoming Season issued by AAP

The American Academy of Pediatrics has released its updates on the recommendations for the routine use of influenza vaccine and antiviral medications in the prevention and treatment of influenza in children during the 2020–2021 season.

Children consistently have the highest attack rates of influenza in the community during seasonal influenza epidemics. influenza vaccination is particularly important during the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) pandemic to reduce the burden of respiratory illnesses and hospitalizations and preserve the capacity of the health care infrastructure.

The key updates are as follows.

The composition of the influenza vaccines for 2020–2021 has been updated. The recommended influenza A(H1N1)pdm09 and A(H3N2) components and the influenza B/Victoria component of the vaccine are new for this season.

All pediatric vaccines — including inactivated (delivered by intramuscular injection) and live attenuated — are quadrivalent. Afluria Quadrivalent will be the only vaccine for children 6 through 35 months of age with a dosing volume of 0.25 mL

The live attenuated influenza vaccine, delivered via nasal spray, is again an option for children aged 2 years and up.

The contraindications for live attenuated influenza vaccine (LAIV) have been updated to harmonize with recommendations of the Advisory Committee on Immunization Practices (ACIP).

Children 6 months through 8 years of age who are receiving influenza vaccine for the first time or who have received only 1 dose, before July 1, 2020, or whose vaccination status is unknown, should receive 2 doses of influenza vaccine, ideally by the end of October, and vaccines should be offered as soon as they become available.

The importance of influenza vaccination during the SARS-CoV-2 pandemic has been focused on.

A Summary of Recommendations has been provided below.

1. The AAP recommends annual influenza vaccination for everyone 6 months and older, including children and adolescents, during the 2020–2021 influenza season.

2. For the 2020–2021 influenza season, the AAP recommends that any licensed influenza vaccine appropriate for age and health status can be used for influenza vaccination in children. Inactivated influenza vaccine (IIV) and live attenuated vaccine (LAIV) are options for children for whom these vaccines are appropriate.

3. The AAP does not have a preference for any influenza vaccine product over another for children .

4. Children 6 through 35 months of age may receive any licensed, age-appropriate IIV available this season, at the dose indicated for the vaccine. Children 36 months (3 years) and older should receive a 0.5-mL dose of any available, licensed, age-appropriate inactivated vaccine.

5. The number of seasonal influenza vaccine doses recommended to be administered to children in the 2020–2021 influenza season remains unchanged and depends on the child's age at the time of the first administered dose and vaccine history .

6. Efforts should be made to ensure vaccination for children in high-risk groups and their contacts, unless contraindicated.

7. Product-specific contraindications must be considered when selecting the type of vaccine to administer.

8. Pregnant women may receive inactivated influenza vaccine at any time during pregnancy, to protect themselves and their infants, who benefit from the transplacental transfer of antibodies. Women in the postpartum period who did not receive vaccination during pregnancy should be encouraged to receive influenza vaccine before discharge from the hospital.

9. The AAP supports mandatory vaccination of health care personnel as a crucial element in preventing influenza and reducing health care-associated influenza infections.

10. Antiviral medications are important in the control of influenza but are not a substitute for influenza vaccination.

11. Antiviral treatment should be offered as early as possible to the following individuals, regardless of influenza vaccination status:

• Any hospitalized child with suspected or confirmed influenza disease, regardless of duration of symptoms.

• Any child, inpatient or outpatient, with severe, complicated, or progressive illness attributable to influenza, regardless of duration of symptoms.

• Influenza infection of any severity in children at high risk of complications of influenza infection , regardless of duration of symptoms.

12. Antiviral chemoprophylaxis is recommended after known or suspected exposure influenza in the following situations:

• For children at high risk of complications from influenza for whom influenza vaccine is contraindicated.

• For children at high risk during the 2 weeks after influenza vaccination, before optimal immunity is achieved.

• For family members or HCP who are unvaccinated and are likely to have ongoing, close exposure to:

o unvaccinated children at high risk;

o unvaccinated infants and toddlers who are younger than 24 months.

• For control of influenza outbreaks for unvaccinated staff and children in a closed institutional setting with children at high risk (eg, extended-care facilities).

• As a supplement to vaccination among children at high risk, including children who are immunocompromised and may not respond with sufficient protective immune responses following influenza vaccination.

• As post exposure antiviral chemoprophylaxis for family members and close contacts of an infected person if those people are at high risk of complications from influenza.

• For children at high risk of complications and their family members and close contacts, as well as HCP.

The authors noted: "Influenza vaccination is particularly important during the [COVID-19] pandemic to reduce the burden of respiratory illnesses and hospitalizations and preserve the capacity of the health care infrastructure."

Primary source; Pediatrics

For full article click on link: https://doi.org/10.1542/peds.2020-024588