Practice Guidelines

ACIP Releases Recommendations for Influenza Vaccination, 2015–2016

 


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Am Fam Physician. 2015 Oct 15;92(8):732-740.

Key Points for Practice

• Children six months to eight years of age who have received at least two doses of trivalent or quadrivalent influenza vaccine since the 2010–2011 influenza season need only one dose this season.

• Live attenuated influenza vaccine is no longer recommended over inactivated vaccine for children two to eight years of age.

• Persons with a history of egg allergy who have experienced only hives after exposure to egg should receive inactivated influenza vaccine or trivalent recombinant influenza vaccine.

From the AFP Editors

The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP) has released its yearly recommendations for routine influenza vaccination in the 2015–2016 season. Updates this year include the antigenic composition of seasonal influenza vaccines available in the United States; information on influenza vaccines expected to be available this season; updated information for determining the number of doses required for children six months to eight years of age; and recommendations for the use of live attenuated influenza vaccine (LAIV) when both LAIV and inactivated influenza vaccine are available, including the removal of 2014–2015 preferential recommendation for LAIV in healthy children two to eight years of age.

Routine annual influenza vaccination is recommended for all persons six months and older who do not have contraindications. Vaccination should ideally occur before the onset of influenza activity in the community. Clinicians should offer vaccination by October, if possible, and continue through the influenza season. Children six months to eight years of age who require two doses should receive their first dose as soon as possible after vaccine becomes available, and the second dose no earlier than four weeks later.

For the 2015–2016 influenza season, U.S.-licensed trivalent influenza vaccines will include hemagglutinin derived from an A/California/7/2009 (H1N1)-like virus, an A/Switzerland/9715293/2013 (H3N2)-like virus, and a B/Phuket/3073/2013-like (Yamagata lineage) virus. Quadrivalent vaccines will contain these viruses plus a B/ Brisbane/60/2008-like (Victoria lineage) virus.

Influenza vaccines expected to be available this season are listed in Table 1. New vaccines and updated vaccine indications include the following:

  • The trivalent inactivated influenza vaccine Afluria has been approved for intramuscular administration via a needle-free jet injector in persons 18 to 64 years of age. Afluria is the only inactivated influenza vaccine that can be administered without a needle and syringe.

  • The trivalent recombinant influenza vaccine, Flublok, (for persons with egg allergy) is now indicated for all adults 18 years and older. It was previously approved only for persons 18 to 49 years of age.

  • The quadrivalent intradermal inactivated influenza vaccine, Fluzone Intradermal, is now indicated for adults 18 to 64 years of age. This formulation is expected to replace the previously available trivalent intradermal inactivated vaccine.

View/Print Table

Table 1.

Influenza Vaccines—United States, 2015–2016

Trade nameDispensing methodAge indicationsRoute of administration

Inactivated influenza vaccine, quadrivalent, standard dose*

Fluarix Quadrivalent

0.5-mL single-dose prefilled syringe

≥ 3 years

Intramuscular†

Flulaval Quadrivalent

5.0-mL multidose vial

≥ 3 years

Intramuscular†

Fluzone Quadrivalent

0.25-mL single-dose prefilled syringe

6 to 35 months

Intramuscular†

0.5-mL single-dose prefilled syringe

≥ 36 months

Intramuscular†

0.5-mL single-dose vial

≥ 36 months

Intramuscular†

5.0-mL multidose vial

≥ 6 months

Intramuscular†

Fluzone Intradermal Quadrivalent‡

0.1-mL single-dose prefilled microinjection system

18 to 64 years

Intradermal§

Inactivated influenza vaccine, trivalent, standard dose*

Afluria

0.5-mL single-dose prefilled syringe

≥ 9 years||

Intramuscular†

5.0-mL multidose vial

≥ 9 years via needle||; 18 to 64 years via jet injector

Intramuscular†

Fluvirin

0.5-mL single-dose prefilled syringe

≥ 4 years

Intramuscular†

5.0-mL multidose vial

≥ 4 years

Intramuscular†

Fluzone

5.0-mL multidose vial

≥ 6 months

Intramuscular†

Inactivated influenza vaccine, trivalent, high dose*

Fluzone High-Dose¶

0.5-mL single-dose prefilled syringe

≥ 65 years

Intramuscular†

Inactivated influenza vaccine, cell-culture–based, standard dose*

Flucelvax

0.5-mL single-dose prefilled syringe

≥ 18 years

Intramuscular†

Recombinant influenza vaccine, trivalent, standard dose**

Flublok

0.5-mL single-dose vial

≥ 18 years

Intramuscular†

Live attenuated influenza vaccine, quadrivalent††

Flumist Quadrivalent‡‡

0.2-mL single-dose prefilled intranasal sprayer

2 to 49 years

Intranasal


note: Clinicians should check U.S. Food and Drug Administration–approved prescribing information for 2015–2016 influenza vaccines for the most complete and updated information, including (but not limited to) indications, contraindications,

Coverage of guidelines from other organizations does not imply endorsement by AFP or the AAFP.

This series is coordinated by Sumi Sexton, MD, Associate Deputy Editor.

A collection of Practice Guidelines published in AFP is available at http://www.aafp.org/afp/practguide.



 

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