The Advisory Committee on Immunization Practices (ACIP) has issued new guidelines for the prevention and control of seasonal influenza with vaccines for the 2018–2019 season.

For the 2018–2019 season, the following influenza vaccines will be available:

  • Trivalent influenza vaccines (A/Michigan/45/2015 [H1N1]pdm09–like virus, an A/Singapore/INFIMH-16-0019/2016 [H3N2]-like virus, and a B/Colorado/06/2017–like virus [Victoria lineage])
  • Quadrivalent influenza vaccines (includes 3 viruses + additional influenza B vaccine virus, a B/Phuket/3073/2013–like virus [Yamagata lineage])
  • Standard-dose, unadjuvanted, inactivated influenza vaccines will be available in quadrivalent and trivalent formulations
  • Recombinant influenza vaccine and live attenuated influenza vaccine (LAIV4) will be available in quadrivalent formulations
  • High-dose inactivated influenza vaccine and adjuvanted inactivated influenza vaccine will be available in trivalent formulations

In general, routine annual vaccination is recommended for all patients ≥6 months of age who have no contraindications. Flu vaccine should be offered to patients by the end of October, if possible.

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The major updates for this upcoming flu season include the following:

  • LAIV4 is once again an option for whom it is appropriate. In February 2018, ACIP voted in favor of renewing the recommendation for the use of LAIV4 (Flumist Quadrivalent; MedImmune) 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.
  • Patients with a history of egg allergy of any severity may receive any licensed, recommended, and age-appropriate influenza vaccine (inactivated influenza vaccine, recombinant influenza vaccine, or LAIV4).
  • Afluria Quadrivalent (quadrivalent, inactivated “split virion” influenza vaccine; Seqirus) is now approved for patients aged ≥5 years.
  • Fluarix Quadrivalent (quadrivalent inactivated “split virus” influenza vaccine; GlaxoSmithKline) is now approved for patients aged ≥6 months. Children aged 6 through 35 months may receive Fluarix Quadrivalent at the same 0.5mL dose (containing 15µg of hemagglutinin [HA] per vaccine virus) as is used for older children and adults.

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The full report, which includes guidance for influenza vaccination of specific populations (i.e., children, pregnant women, older patients, immunocompromised individuals), and situations (i.e., history of Guillain-Barré Syndrome, egg allergy) can be found here.

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This article originally appeared on MPR