Guideline Update: Influenza Immunization Recommendations for 2017-2018
Due to efficacy concerns, the live attenuated influenza vaccine is not recommended for use.
The Advisory Committee on Immunization Practices (ACIP) has issued new guidelines for the prevention and control of seasonal influenza with vaccines for the 2017–2018 season.1
For the 2017–2018 season, the following influenza vaccines will be available:
- Trivalent influenza vaccine (A/Michigan/45/2015 (H1N1)pdm09–like virus, an A/Hong Kong/4801/2014 [H3N2]-like virus, and a B/Brisbane/60/2008–like virus [Victoria lineage])
- Quadrivalent influenza virus (includes three viruses listed for Trivalent vaccine + additional B vaccine virus [B vaccine virus, a B/Phuket/3073/2013–like virus])
- Recombinant influenza vaccine (both trivalent and quadrivalent)
Due to concerns about its effectiveness, live attenuated influenza vaccine (FluMist® Quadrivalent; MedImmune) is NOT recommended for use during the 2017–2018 season. According to Penn State College of Medicine researchers,2 influenza vaccination rates for the 2016–2017 flu season among children decreased by 1.6% (compared to 2015-2016 rates) after this recommendation was made. "We worried that there was going to be a huge drop off in vaccination rates without the nasal spray available," said study co-author Benjamin N. Fogel, MD, MPH, assistant professor of pediatrics at Penn State College of Medicine and medical director of Penn State Pediatric Primary Care. "We saw a drop off but I would not call it huge, which is reassuring."
In general, routine annual vaccination is recommended for all patients ≥6 months of age who have no contraindications. Flu vaccine should be offered to patients by the end of October, if possible.
The major updates for this upcoming flu season include the following:
- A change in the influenza A(H1N1)pdm09 virus component from the previous season
- The availability of Afluria® Quadrivalent (Seqirus), an inactivated influenza vaccine indicated for active immunization against influenza A subtype viruses and type B viruses for patients 18 years of age and older
- The availability of Flublok® Quadrivalent (Protein Sciences), a recombinant protein-based vaccine for active immunization against disease caused by influenza A virus subtypes and influenza B virus in patients 18 years of age and older
- An expanded age range for FluLaval® Quadrivalent (GlaxoSmithKline) to include use in children aged ≥6 months (previously approved in patients aged ≥3 years)
- Pregnant women may receive any FDA-approved, recommended, age-appropriate influenza vaccine
- Patients 5 years of age and older may now receive Afluria® (Seqirus), a trivalent, inactivated “split virion” influenza vaccine
- While still a licensed product, the ACIP does not recommend use of live attenuated influenza vaccine
The full report, which includes guidance for influenza vaccination of specific populations (ie, children, pregnant women, older patients, immunocompromised individuals), and situations (history of Guillain-Barré Syndrome, egg allergy) can be found on the CDC website.1
- Grohskopf LA, Sokolow LZ, Broder KR, et al. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices — United States, 2017-18 influenza season. MMWR Morbid Mortal Wkly Rep. 2017;66(No. RR-2):1-20. doi:10.15585/mmwr.rr6602a1
- Fogel B, Hicks S. Influenza vaccination rates in children decline when the live attenuated influenza vaccine is not recommended [published online July 29, 2017]. Vaccine. doi:10.1016/j.vaccine.2017.07.067