American Academy of Family Physicians

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2012-13 Flu Vaccine Guidance Updates Recommendations for Kids

Statement Also Addresses Febrile Seizures, Egg Allergy

By Matt Brown

The AAFP has adopted the CDC's recommendations for the use of influenza vaccine for the 2012-13 influenza season.
Photo of young girl receiving H1N1 vaccine as a nasal spray
The recommendations describe the virus strains included in the latest U.S. seasonal influenza vaccine and provide usage guidance for the upcoming season. Specifically, the recommendation statement updates the seasonal influenza vaccination schedule for children ages 6 months through 8 years. It also provides
  • descriptions of available vaccine products and indications,
  • a discussion of febrile seizures associated with administration of influenza and 13-valent pneumococcal conjugate vaccines,
  • recommendations for vaccination among people with a history of egg allergy, and
  • information about the development of quadrivalent influenza vaccines (i.e., containing two A and two B viral antigens) for use in future influenza seasons.
The CDC recommends two doses of influenza vaccine -- administered a minimum of four weeks apart -- for children ages 6 months through 8 years during their first season of vaccination to optimize immune response. Two acceptable approaches for determining the number of doses required for these children are illustrated on the agency's website.
According to the CDC, a study of children ages 5 through 8 years who received trivalent inactivated influenza vaccine for the first time showed that a significantly higher portion of subjects generated protective antibody responses after two doses compared with those who received only a single dose.

Children who received the seasonal trivalent vaccine before the 2010-11 season, but did not receive vaccine containing the 2009 influenza A (H1N1) antigen, are recommended to receive two doses this season, regardless of the number of doses they received prior to the 2010-11 season.

The CDC said it expects multiple influenza vaccine presentations to be available for the upcoming season.

The Academy recommends routine annual influenza vaccination for all people ages 6 months and older. To allow adequate time for production of protective antibody levels, vaccination optimally should occur before the onset of influenza activity in the community and should be offered throughout the influenza season.

The new recommendations, generated by the Advisory Committee on Immunization Practices (ACIP), were reviewed and recommended for approval by the AAFP Commission on Health of the Public and Science. ACIP recommendations are considered provisional until they have been approved by the CDC director and HHS and published in Morbidity and Mortality Weekly Report.

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