American Academy of Pediatrics issues recommendations for flu season

Flu vaccine recommended for everyone 6 months and older

The flu vaccine should be given to everyone 6 months and older, as it is the best option for protection during the upcoming season, according to the American Academy of Pediatrics.

The annual flu vaccine significantly reduces a child's risk of severe influenza and death.

During the 2016-17 season, more than 100 U.S. children died of the flu, and thousands more were hospitalized for severe illness or complications from the virus. Historically, more than 80 percent of children who died of influenza were not vaccinated.

In its policy statement, "Recommendations for Prevention and Control of Influenza in Children, 2017-2018," the AAP recommends that pediatricians offer influenza vaccine to all children 6 months of age and older, as soon as the vaccine becomes available, in order to complete vaccination and provide protection before the flu season starts. The statement will appear in the October 2017 issue of Pediatrics (published online Sept. 4, 2017).

"Getting a flu shot as soon as the vaccine is available in your community should be on every parent's checklist, along with other back-to-school routines," said Flor Munoz, MD, FAAP, co-author of the report. "We know that the flu should not be taken lightly. Everyone in the household, including pregnant women, grandparents, and child care providers, should be vaccinated to help prevent its spread."

The Academy recommends:

  • Children receive influenza vaccinations by the end of October, if possible. Children who need two doses (those 6 months through 8 years, who have not previously been fully vaccinated) should receive the first vaccine early in the season for optimal protection.
  • For the second consecutive year, the Academy supports a recommendation by the CDC not to use the live attenuated intranasal influenza vaccine, which performed poorly against influenza A (H1N1) pdm09 viruses in recent influenza seasons.
  • Special effort should be made to vaccinate all children 6 months and older who have conditions that increase their risk of complications of flu. This includes infants born preterm and those with chronic medical conditions, including asthma and other chronic lung diseases, heart disease, diabetes and other metabolic problems, and weakened immune systems, among others
  • Influenza vaccine should be given to all women who are pregnant, considering pregnancy or are in the postpartum period or are breastfeeding during the flu season.
  • All health care personnel, child care providers and staff also should receive their annual flu shot because they often care for individuals at high risk for influenza-related complications.

"Vaccination is the best available preventive measure we have against influenza." said Dr. Henry Bernstein, co-author of the recommendations. "Yet, there is lots of room for improvement in influenza vaccination because overall influenza vaccination rates have been suboptimal in both children and adults during the past 7 seasons."

The influenza vaccine is given by injection into the muscle and is inactivated, meaning it does not contain a live flu virus and cannot cause the flu. The vaccine comes in either a trivalent or quadrivalent form, which protect against three strains (2 A and 1 B) or four strains (2 A and 2 B) of the virus, respectively. While the influenza A (H1N1) virus in both formulations differs from that contained in the 2016-2017 seasonal vaccines, the influenza A (H3N2) vaccine strain and influenza B vaccine strains are the same.

In addition, antiviral medications are important in the control of influenza, but are not a substitute for influenza vaccination. Pediatricians should promptly identify children suspected of having influenza for timely initiation of antiviral treatment, when indicated, to reduce morbidity and mortality. "Clinical judgment is an important factor in treatment decisions for children who present with influenza-like illness," said Bernstein. "The best results are seen when treatment is started within 48 hours of symptom onset."