Practice Guidelines

Influenza Vaccination Recommendations for 2017–2018: Updates from ACIP

 

Am Fam Physician. 2017 Oct 15;96(8):545-546.

Author disclosure: No relevant financial affiliations.

Key Points for Practice

• All persons older than six months without a contraindication should receive annual influenza vaccination. There is no recommendation for a specific vaccine in persons for whom more than one licensed product is available.

• Pregnant women may receive any licensed, age-appropriate vaccine.

• Again this season, live attenuated influenza vaccine is not recommended because of its previous low effectiveness against influenza A(H1N1)pdm09.

From the AFP Editors

The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP) has released its recommendations on influenza vaccination for the 2017–2018 season. In this update, ACIP announces the currently available vaccine products (eTable A), reviews license and labeling changes, and issues recommendations for specific populations. A summary of ACIP's seasonal influenza vaccine recommendations is available at https://www.cdc.gov/flu/professionals/acip/index.htm.

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eTable A.

Influenza Vaccines—United States, 2017–2018

Trade nameDispensing methodAge indicationsRoute of administration

Inactivated influenza vaccine, quadrivalent, standard-dose*

Afluria Quadrivalent

0.5-mL prefilled syringe

≥ 18 years

Intramuscular†

5.0-mL multidose vial

≥ 18 years (needle and syringe)

Intramuscular

18 through 64 years (jet injector)

Fluarix Quadrivalent

0.5-mL prefilled syringe

≥ 3 years

Intramuscular

Flulaval Quadrivalent

0.5-mL prefilled syringe

≥ 6 months

Intramuscular

5.0-mL multidose vial

≥ 6 months

Intramuscular

Fluzone Quadrivalent

0.25-mL prefilled syringe

6 through 35 months

Intramuscular

0.5-mL prefilled syringe

≥ 3 years

Intramuscular

0.5-mL single-dose vial

≥ 3 years

Intramuscular

5.0-mL multidose vial

≥ 6 months

Intramuscular

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

Flucelvax Quadrivalent

0.5-mL prefilled syringe

≥ 4 years

Intramuscular

5.0-mL multidose vial

≥ 4 years

Intramuscular

Inactivated influenza vaccine, quadrivalent, standard-dose, intradermal‡

Fluzone Intradermal Quadrivalent

0.1-mL single-dose prefilled microinjection system

18 through 64 years

Intradermal§

Inactivated influenza vaccine, trivalent, standard-dose*

Afluria

0.5-mL prefilled syringe

≥ 5 years

Intramuscular

5.0-mL multidose vial

≥ 5 years (needle or syringe)

Intramuscular

18 through 64 years (jet injector)

Fluvirin

0.5-mL prefilled syringe

≥ 4 years

Intramuscular

5.0-mL multidose vial

≥ 4 years

Intramuscular

Adjuvanted inactivated influenza vaccine, trivalent, standard-dose*

Fluad

0.5-mL prefilled syringe

≥ 65 years

Intramuscular

Inactivated influenza vaccine, trivalent, high-dose||

Fluzone High-Dose

0.5-mL prefilled syringe

≥ 65 years

Intramuscular

Recombinant influenza vaccine, quadrivalent¶

Flublok Quadrivalent

0.5-mL prefilled syringe

≥ 18 years

Intramuscular

Recombinant influenza vaccine, trivalent¶

Flublok

0.5-mL single-dose vial

≥ 18 years

Intramuscular

Live attenuated influenza vaccine, quadrivalent (not recommended for use during the 2017–2018 season)**

Flumist Quadrivalent

0.2-mL single-dose prefilled intranasal sprayer

2 through 49 years

Intranasal


note: Immunization providers should check U.S. Food and Drug Administration–approved prescribing information for 2017–2018 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 https://www.fda.gov/BiologicsBloodVaccines/Vaccines/ApprovedProducts/ucm093833.htm. Availability of specific products and presentations might change and differ from what is described in this table and in the text of this report.

*—Standard dose intramuscular inactivated influenza vaccines contain 15 mcg of each vaccine HA antigen (45 mcg total for trivalents and 60 mcg total for quadrivalents) per 0.5-mL dose.

†—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 is available in the Advisory Committee on Immunization Practices General Best Practice Guidelines for Immunization, available at https://www.cdc.gov/vaccines/hcp/acip-recs/general-recs/index.html.

‡—Quadrivalent inactivated influenza vaccine, intradermal: a 0.1-mL dose 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 per manufacturer's instructions using the delivery system included with the vaccine.

||—High-dose trivalent inactivated influenza vaccine contains 60 mcg of each vaccine antigen (180 mcg total) per 0.5-mL dose.

¶—Recombinant influenza vaccine contains 45 mcg of each vaccine HA antigen

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.

 

 

Copyright © 2017 by the American Academy of Family Physicians.
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