The American Academy of Pediatrics (AAP) recommends that pediatricians offer the injectable form of the influenza vaccine to all children ≥6 months as soon as it becomes available, and “preferably by the end of October,” according to a new policy statement.

According to the Centers for Disease Control and Prevention (CDC), the 2017-2018 flu season was one of the most severe — excluding pandemics — on record. A total of 180 children died of influenza-associated deaths with thousands more hospitalized (as of August 25, 2018). The CDC says that children who did not receive flu vaccination accounted for ~80% of the deaths.

Although the injectable form is the first choice, the nasal spray vaccine (live attenuated influenza vaccine [LAIV4]) is also supported by the AAP and CDC for the 2018-2019 season, specifically in children ≥2 years who would not otherwise receive the flu shot and for whom it is appropriate according to age and health status.

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In February 2018, the Advisory Committee on Immunization Practices voted in favor of renewing the recommendation for the use of LAIV4 for the 2018–2019 influenza season. The recommendation was based on new data which showed that the 2017–2018 H1N1 LAIV post-pandemic strain performed significantly better than the 2015–2016 strain. “The effectiveness of the latest nasal spray vaccine for this upcoming season is more of an unknown against the influenza A/H1N1 strain,” the AAP stated in a press release.

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The AAP recommendations also include the following:

  • The number of doses of influenza vaccine depends on a child’s age and vaccine history. Children 6 months through 8 years need 2 doses when it is the first time they are being vaccinated against influenza. Children ≥9 years require only 1 dose, regardless of prior vaccination history.
  • Children with egg allergy can receive influenza vaccine with no additional precautions than those considered for any vaccine.
  • Pregnant women may receive injected influenza vaccine at any time during pregnancy. Postpartum women who did not receive the vaccine during pregnancy should be encouraged to get the vaccine before hospital discharge.
  • All healthcare professionals should receive an annual influenza vaccine.
  • Antiviral medications are important in the treatment and control of influenza, but are not a substitute for influenza vaccination.

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This article originally appeared on MPR