Influenza Guidelines

Updated: Oct 26, 2018
  • Author: Hien H Nguyen, MD, MS; Chief Editor: Michael Stuart Bronze, MD  more...
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CDC Guidelines on 2017-2018 Influenza Vaccination

Routine annual influenza vaccination is recommended for all persons aged ≥6 months who do not have contraindications. A licensed, recommended, and age-appropriate vaccine should be used. [99, 100]

For the 2017-2018 influenza season, quadrivalent and trivalent influenza vaccines will be available. Inactivated influenza vaccines (IIVs) will be available in trivalent (IIV3) and quadrivalent (IIV4) formulations. Recombinant influenza vaccine (RIV) will be available in trivalent (RIV3) and quadrivalent (RIV4) formulations.

Live attenuated influenza vaccine (LAIV4; FluMist Quadrivalent) was not recommended for use during the 2017-2018 influenza season owing to concerns about its effectiveness against (H1N1)pdm09 viruses during the 2013-2014 and 2015-2016 seasons. The ACIP has recommended return of LAIV4 in the United States for the 2018-2019 season based on results positive results from a US study in children aged 2 years to younger than 4 years that evaluated the shedding and antibody responses of the H1N1 strain following LAIV4 administration. [55]

Vaccine viruses included in the 2017-2018 US trivalent influenza vaccines will be an A/Michigan/45/2015 (H1N1)pdm09–like virus, an A/Hong Kong/4801/2014 (H3N2)–like virus, and a B/Brisbane/60/2008–like virus (Victoria lineage).

Quadrivalent influenza vaccines will contain these 3 viruses and an additional influenza B vaccine virus, a B/Phuket/3073/2013–like virus (Yamagata lineage).

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

Afluria (IIV3; Seqirus, Parkville, Victoria, Australia) may be used for persons aged 5 years or older, consistent with FDA-approved labeling.


American Academy of Pediatrics Guidelines on Influenza Vaccination in Children

The following are the American Academy of Pediatrics guidelines on influenza vaccination in children: [101]

  • Children should receive their vaccination or vaccinations by the end of October, if possible.
  • Children who require 2 vaccines (children aged 6 months through 8 years who have not previously been completely vaccinated) should receive their first vaccine early during the season for the best protection.
  • For the 2017-2018 influenza season, the AAP supports the recommendation of the CDC to not use the live attenuated intranasal influenza vaccine, which provided poor protection against influenza A (H1N1) pdm09 viruses during recent influenza seasons.
  • Clinicians should make special effort to vaccinate all children aged 6 months and older who have medical conditions that put them at increased risk for influenza complications. These include babies born preterm; those with chronic medical conditions, such as asthma and other chronic lung disorders, cardiac disease, diabetes, and other metabolic problems; and those with weakened immune systems.
  • All women who are pregnant, considering pregnancy, postpartum, or breastfeeding during influenza season should receive the influenza vaccine. Studies have shown that infants born to vaccinated mothers have better influenza outcomes if they contract the disease.
  • All those who care for children should also receive an influenza vaccine.
  • Influenza vaccine is not contraindicated in children with mild febrile or afebrile illness, especially those with mild upper respiratory tract infection symptoms or allergic rhinitis. Children in whom the clinician diagnoses a moderate to severe febrile illness should wait until resolution of the illness to be vaccinated with inactivated influenza vaccine (IIV). Infants younger than 6 months should also not receive the IIV vaccine.
  • The only antiviral medications recommended during the 2017-2018 influenza season for chemoprophylaxis or treatment of influenza in children are the neuraminidase inhibitors oral oseltamivir (Tamiflu) and inhaled zanamivir (Relenza).