What’s New in the Influenza Vaccination Recommendations for the 2016-17 Season?

ACIP continues to recommend routine annual influenza vaccination for all persons 6 months of age and older who do not have a contraindication for vaccination.

Two important new recommendations were made for the 2016-17 season.

• Live attenuated influenza vaccine (LAIV, FluMist®, AstraZeneca) is not recommended to be used in any setting during the 2016-17 influenza season. This recommendation was made because of evidence of low vaccine effectiveness among children 2 through 17 years of age against the H1N1 strain of influenza virus during the 2013-14 and 2015-16 seasons. Only inactivated or recombinant influenza vaccines should be used during the upcoming influenza season.
• A history of egg allergy is no longer considered to be a contraindication or precaution to influenza vaccination. Multiple studies have found that severe allergic reactions to egg-based influenza vaccines in persons with egg allergy are unlikely. For the 2016-17 influenza season, ACIP recommends that people with a history of egg allergy who have experienced only hives after exposure to egg should receive any inactivated influenza vaccine without specific precautions (except for the recommended 15-minute observation period for syncope for any vaccine). People who report having had an anaphylactic reaction to egg may also receive any age-appropriate influenza vaccine. The vaccine should be administered in a medical setting such as a hospital, clinic, health department, or physician office. Vaccine administration should be supervised by a healthcare provider who is able to recognize and manage severe allergic conditions. Although not specifically recommended by ACIP, providers may prefer an egg-free recombinant vaccine (FluBlok®, Protein Sciences) for people age 18 years and older with severe egg allergy. More information on influenza vaccination and egg allergy is available on IAC’s website.

A new influenza vaccine is available for the 2016-17 season. Fluad® (Seqirus) is a trivalent inactivated vaccine approved by the Food and Drug Administration for persons 65 years of age and older. It is the first influenza vaccine licensed in the United States that contains an adjuvant (a substance added to a vaccine to improve its immunogenicity). Several other vaccines have new quadrivalent formulations or age indications. This information is summarized in a handy IAC document titled Influenza Vaccine Products for the 2016-17 Influenza Season. It also includes helpful billing code information.

ACIP continues to state no preference for any brand or formulation of influenza vaccine over another where more than one type of vaccine is appropriate and available.

Vaccination is especially important for people who are at increased risk for severe complications from influenza, or at higher risk for influenza-related outpatient, emergency department, or hospital visits. If the vaccine supply were limited, vaccination efforts should focus on delivering vaccination to the following people:

• All children 6 through 59 months of age
• All people 50 years of age and older
• Adults and children who have chronic pulmonary (including asthma), cardiovascular (excluding isolated hypertension), renal, hepatic, neurologic, hematologic or metabolic disorders
• People with immunosuppression
• Women who are or will be pregnant during influenza season
• Children and teens 6 months through 18 years of age who receive chronic aspirin therapy (because of the risk for Reye syndrome after influenza virus infection)
• American Indians/Alaska Natives
• People who are extremely obese (body mass index of 40 or higher)

Resources

• IAC’s Influenza Handouts web section with free educational materials to download and copy
• IAC’s Influenza Honor Roll for Mandatory Vaccination of Healthcare Personnel
• CDC’s Influenza web section
• Vaccine Education Center’s Influenza web section