ACIP Updates Influenza Vaccine Recommendations
The Center for Disease Control and Prevention’s (CDC’s) Advisory Committee on Immunization Practices (ACIP) is updating its recommendations for the 2010-11 influenza season in the United States in light of data suggesting:
- increased risk of febrile seizures in children aged 6 months through 4 years following 2010 Fluvax or Fluvax Jr.;
- higher frequency of reported fever in children aged 5 years through 8 years following Fluvax compared to previous seasons; and
- higher frequency of fever in children aged 5 years through 8 years following Afluria in one clinical trial in 2009.
- Afluria should not be used in children aged 6 months through 8 years.
- Other age-appropriate, licensed seasonal influenza vaccine formulations should be used for prevention of influenza in children aged 6 months through 8 years.
- If no other age-appropriate, licensed seasonal influenza vaccine is available for a child aged 5 years through 8 years old who has a medical condition that increases their risk for influenza complications, Afluria may be given, and providers should discuss the benefits and risks of influenza vaccination with the parents or caregivers before administering Afluria.
The ACIP met Aug. 5 to discuss recommendations for United States use of seasonal influenza trivalent inactivated vaccine (TIV) [Afluria] manufactured by CSL Limited during 2010-11.
A clinical trial conducted in the United States of 2009 Northern Hemisphere TIV reported a higher frequency of fever following Afluria among children aged 6 months through 8 years old compared to a different TIV. A warning was added July 30 to the Afluria package insert to inform U.S. health care practitioners that administration of CSL’s 2010 Southern Hemisphere seasonal influenza vaccine has been associated with an increased number of reports relative to previous years of fever and febrile seizures following influenza vaccination in children predominantly below the age of 5 years.
There are two types of seasonal influenza vaccines for children: TIV (the flu shot) and the live attenuated vaccine (nasal spray).
The following vaccines will be available for children and adults this season:
|Vaccine||Trade Name||Manufacturer||Age Group|
|TIV||Fluzone||Sanofi Pasteur||≥6 mos|
|TIV||Fluvirin||Novartis Vaccine||≥4 yrs|
|TIV||Agriflu||Novartis Vaccine||≥18 yrs|
|TIV||FluLaval||ID Biomedical Corp. of Quebec(a subsidiary of GlaxoSmithKline)||≥18 yrs|
|TIV||Afluria||CSL Biotherapies||≥9 yrs|
|TIV High Dose||Fluzone High Dose||Sanofi Pasteur||≥65 yrs|
A more detailed table is available on the CDC website.
In other news, the World Health Organization (WHO) International Health Regulations (IHR) Emergency Committee and the WHO Director-General, Dr. Margaret Chan, declared, Aug. 10, an end to the 2009 H1N1 influenza pandemic. The U.S. Public Health Emergency determination for 2009 H1N1 Influenza expired June 23. Current influenza outbreaks, including those primarily caused by the 2009 H1N1 virus, show an intensity similar to that seen during seasonal epidemics, the U.S. Department of Health and Human Services (HHS) said in an Aug. 10 news release. More information about the WHO declaration and recommendations for the post pandemic period are available on the WHO website.
Although H1N1 and seasonal flu activity is down, the CDC issued Aug. 4 an advisory to health professionals, alerting them to an increase in cases of influenza A(H3N2) virus. A strain of the virus is included in this season’s flu vaccine. The CDC urges physicians in the report to consider influenza as a possible diagnosis when evaluating patients with acute respiratory illness and to use antivirals oseltamivir (Tamiflu) and zanamivir (Relenza) to treat the flu virus. Physicians should not use the antivirals amantadine and reimantadine because of high levels of resistance to these drugs among recently circulating influenza viruses, the CDC said.
Sources: CDC Aug. 6 Media Statement, HHS Aug. 10 news release, American Medical News