Influenza Vaccine in Children: Recommendations From the AAP

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The number of recommended doses of influenza vaccine depends on a child's age at the time of the first administered dose and vaccine history.
The number of recommended doses of influenza vaccine depends on a child's age at the time of the first administered dose and vaccine history.

In an American Academy of Pediatrics (AAP) policy statement published in Pediatrics, annual seasonal influenza vaccination was recommended for all individuals age 6 months or older, including patients with egg allergies. The recommendations emphasized the importance of prompt identification of children suspected of having influenza for initiation of antiviral treatment.

In the policy statement, the AAP Committee on Infectious Diseases summarized the current knowledge and recommendations regarding influenza, influenza immunization, and influenza treatment for the 2017-2018 season. The committee summarized their recommendations in 12 key points.

For the 2017-2018 influenza season, immunization is the best available measure for preventing influenza and is recommended for everyone age 6 months and older. Both the trivalent vaccine (containing 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 [B/ Victoria lineage]) and the quadrivalent vaccine (containing an additional B virus) are recommended by the AAP, without preference.

Based on data indicating poor efficacy for the 2016 influenza season, the quadrivalent live attenuated influenza vaccine is not recommended for use in any setting in the 2017-2018 season.

Children with suspected influenza should be identified in a timely manner so as to initiate treatment with antiviral therapy. Oral oseltamivir, inhaled zanamivir, and intravenous peramivir are all treatment options for influenza in children. Antiviral treatment, however, is not intended to replace influenza vaccination.

The recommendations emphasized that "efforts should be made to facilitate optimal distribution of the vaccine so that more people are immunized."

Reference

Committee on Infectious Diseases. Recommendations for Prevention and Control of Influenza in Children, 2017 – 2018Pediatrics. 2018;141: e20173535. doi:10.1542/peds.2017-3535 

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