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August 15, 2015

MMWR: Prevention and Control of Influenza with Vaccines 2015/2016

Vaccine Recommendations from CDC Advisory Committee on Immunization Practices

The Centers for Disease Control and Prevention Advisory Committee on Immunization Practices (ACIP) have released guidelines for 2015/2016 seasonal influenza vaccination.

As expected, the recommendations call for vaccination against seasonal influenza for anyone greater than six months old. Live Attenuated Influenza Vaccine (LAIV) and Inactivated Influenza Vaccine (IIV) are available. Both vaccine types are recommended for adults with a few exceptions, while LAIV may be better for children, according to the recommendations.

ACIP calls for vaccination to occur as soon as possible and before flu activity in your area. The recommendations also mentions the possibility of that antibody decline (vaccinating too early) may be more rapid in older adults and should be balanced with risks of vaccinating too late. (related Influenza vaccine overrated?)

The recommendations further state that vaccination of children six months or older "should occur before onset of influenza activity in the community." Children six months to 8 years old will require two doses of vaccine this season; the first dose given as soon as possible - "before onset of flu activity  in the community" - and the second dose after four weeks. The recommendations state that health children ages of 2-8 who have no contraindications, may revive LAIV or IIV.  Please note that LAIV is not recommended for ages less than 2 years or children between 2-7 years who are receiving aspirin or aspirin-containig products. LAIV is not recommended for ages greater than 49 years. 

There is a lot of discussion related to LAIV and asthma/wheezing. The "warnings and precautions" statement for LAIV also states that anyone with asthma, of any age, may be at greater risk for wheezing after receiving LAIV. While kids (ages 2-4 years) with asthma or a wheezing episode within the last 12 months prior to vaccination should not receive LAIV. 

Vaccine or not, its important to remember the non-pharmacolgical interventions for preventing spread of influenza. 

The issue of a two-dose vaccine season for children is worth additional consideration when planning for community events such as Points of Distribution (POD) activity and health care system utilization for routine vaccination. (Related Nurse Triage Line and Improving Service

LAIV is not recommended for those who have sever allergic reaction in the past, those who are pregnant, and people with who are immunocompromised. Further, caregivers of immunocompromised patients should avoid contact for 7 days due to a "theoretical risk of infection" after LAIV.  Anyone who has revived antiviral medications should delay vaccination for 48 hours. 

Please read the full report from CDC/ACIP for detailed information. Visit the CDC flu page and the ACIP page for additional updates. This summary is not intended as sole source of information or vaccination guidelines. 

Related: Three things to know about seasonal flu

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