Practice Guidelines

ACIP Updates Influenza Vaccination Recommendations for 2016–2017

 


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Am Fam Physician. 2016 Oct 15;94(8):668-671.

Author disclosure: No relevant financial affiliations.

Key Points for Practice

• LAIV is not recommended this season because of its low effectiveness in recent years.

• Patients at risk of complications from influenza include persons 65 years and older, children younger than five years, and persons of any age who are immunosuppressed or have chronic medical conditions such as pulmonary disease.

• Persons with a history of egg allergy who have experienced only hives after exposure to egg should receive any of the recommended age-appropriate influenza vaccines.

From the AFP Editors

The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP) has released its annual recommendations for routine influenza vaccination in the 2016–2017 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, including newly licensed products (Table 1); a recommendation against the use of live attenuated influenza vaccine (LAIV); and revised recommendations for vaccination of persons with egg allergy.

View/Print Table

Table 1.

Influenza Vaccines—United States, 2016–2017

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

0.5-mL single-dose prefilled syringe

≥ 3 years

Intramuscular†

5.0-mL multidose vial

≥ 3 years

Intramuscular†

Fluzone Intradermal Quadrivalent‡

0.1-mL single-dose prefilled microinjection system

18 to 64 years

Intradermal§

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†

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

Flucelvax Quadrivalent

0.5-mL single-dose prefilled syringe

≥ 4 years

Intramuscular†

Inactivated influenza vaccine, trivalent, standard dose*

Afluria

0.5-mL single-dose prefilled syringe

≥ 9 years||

Intramuscular†

5.0-mL multidose vial

≥ 9 years (needle and syringe)||

Intramuscular†

18 to 64 years (jet injector)

Fluvirin

0.5-mL single-dose prefilled syringe

≥ 4 years

Intramuscular†

5.0-mL multidose vial

≥ 4 years

Intramuscular†

Adjuvanted inactivated influenza vaccine, trivalent, standard dose*

Fluad

0.5-mL single-dose prefilled syringe

≥ 65 years

Intramuscular†

Inactivated influenza vaccine, trivalent, high dose¶

Fluzone High-Dose

0.5-mL single-dose prefilled syringe

≥ 65 years

Intramuscular†

Recombinant influenza vaccine, trivalent**

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: Immunization providers should check U.S. Food and Drug Administration–approved prescribing information for 2016–2017 influenza vaccines for the most complete and updated information, including (but not limited to) indications, contraindications, warnings, and precautions. Package inserts for U.S.-licensed vaccines are available at http://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm093833.htm. Availability of specific products and presentations may change and differ from what is described in this table.

*—A 0.5-mL dose of standard-dose intramuscular inactivated influenza vaccine contains 15 mcg of each vaccine HA antigen (45 mcg total for trivalents and 60 mcg total for quadrivalents).

†—For adults and older children, the recommended site for intramuscular influenza vaccination is the deltoid muscle. The preferred site for infants and young children is the anterolateral aspect of the thigh. Specific guidance regarding site and needle length for intramuscular administration may be found in the Advisory Committee on Immunization Practices (ACIP) general recommendations on immunization at http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6002a1.htm.

‡—A 0.1-mL dose of intradermal quadrivalent inactivated influenza vaccine contains 9 mcg of each vaccine HA antigen (36 mcg total).

§—The preferred injection site is over the deltoid muscle. Fluzone Intradermal Quadrivalent is administered using the delivery system included with the vaccine.

||—Age indication per package insert is ≥ 5 years; however, ACIP recommends that Afluria not be used in children 6 months to 8 years of age because of increased risk for febrile reactions noted in this age group with Seqirus' 2010 Southern Hemisphere trivalent inactivated influenza vaccine. Afluria can be used if no other age-appropriate, licensed inactivated seasonal influenza vaccine is available for a child 5 to 8 years of age who has a medical condition that increases the risk of influenza complications; however, clinicians should discuss

Author disclosure: No relevant financial affiliations.

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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