Who should be vaccinated and who needs two doses?

• Flu vaccine is routinely recommended for everyone 6 months of age and older who does not have a contraindication.
   
• Certain children age 6 months through 8 years need two doses of flu vaccine spaced a minimum of four weeks apart. Here is the specific guidance:
   
  • Children who are being vaccinated for the first time need two doses of vaccine for optimal protection.
     
  • Children who have previously received > 2 total doses of trivalent or quadrivalent influenza vaccine before July 1, 2017, need only one dose for 2017–18. The two doses of influenza vaccine do not have to have been administered in the same season or consecutive seasons.
     
  • Children who have not previously received > 2 doses of trivalent or quadrivalent influenza vaccine before July 1, 2017, need two doses for the 2017–18 season.

What is the optimal timing for vaccination?

• ACIP recommends that you vaccinate your patients by the end of October, if possible.
   
• ACIP also recommends that vaccination should continue through the winter and early spring months as long as influenza viruses are circulating and unexpired vaccine is available.

What types of vaccines are available in 2017–18?

• A variety of influenza vaccine products are available this year — trivalent, quadrivalent, high-dose, and intradermal, and there are two vaccines licensed only for use in people age 65 and older. For a list of all FDA-licensed vaccines with detailed information about each of them, see IAC's one-page table titled "Influenza Vaccine Products for the 2017–2018 Influenza Season."


• There are two vaccine products licensed for use in children age 6 through 35 months and their dose volumes are different. They are:
   
  • 0.5 mL FluLaval® Quadrivalent, GSK, and
  • 0.25 mL Fluzone® Quadrivalent, Sanofi Pasteur
     
• Make sure all clinic staff know the appropriate volume to be administered for each of the products.
   
• ACIP recommends that live attenuated influenza vaccine (FluMist®) not be used during the 2017–18 season for anyone.
   
• To find links to package inserts for all influenza vaccines, visit IAC’s package inserts webpage.

• For a two-page information sheet showing color images of all influenza vaccine packages, syringes and vials, see Pediatric/Adult Influenza Vaccine 2017–18 from the California Department of Public Health.

Looking for a refresher course on how to administer vaccines?

Check out CDC’s new Vaccine Administration e-Learn.

Resources from IAC

There are many IAC resources available on the immunize.org website:

• Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of ACIP—United States, 2017–18 Influenza Season was published in MMWR on August 25. A four-page document that provides an abbreviated review of the guidance for 2017–18 titled Summary of Recommendations was released at the same time.
   
• From IAC: How to Administer Intramuscular and Subcutaneous Vaccine Injections.
   
• From IAC: How to Administer Intramuscular, Intradermal, and Intranasal Influenza Vaccines.
   
• DVD: Immunization Techniques: Best Practices with Infants, Children, and Adults, to train staff — California Department of Public Health, 2010, available for purchase from IAC.
   
• Immunization Techniques: Best Practices with Infants, Children, and Adults, available for free viewing online from the California Department of Public Health.