The American Academy of Pediatrics has released its recommendations for the upcoming flu season, with this year’s recommendation once again including the live, intranasal vaccine.
The American Academy of Pediatrics (AAP) published its recommendations in Pediatrics, and match the recommendations issued this year by the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP).
Flor M. Munoz, MD, MSc, associate professor of pediatrics and molecular virology and microbiology at Baylor College of Medicine and medical director for the transplant infectious diseases program at Texas Children’s Hospital in Houston, helped draft the new recommendations and says this is the first year since the live vaccine was reinstated that the AAP and CDC’s recommendations match. Last year, CDC offered the live, intranasal version of the influenza vaccine as an option for children, but the AAP held back on recommending the vaccine in favor of a longer surveillance period.
“The difference this year is that the AAP and the CDC recommendations match, meaning that they both agree that either the injectable or intranasal influenza vaccine can be used,” Munoz says. “There is not a strong argument to recommend one over the other.”
The ACIP made a preferential recommendation for the intranasal vaccine, FluMist, in 2014 for children aged 2 to 8 years because it appeared to offer better protection. The recommendation was reversed in 2015 over concerns about the vaccine’s efficacy against the 2009 H1N1 strain of influenza. The ACIP reinstated its recommendation for FluMist in 2018, after the vaccine manufacturer was able to demonstrate improved efficacy. The AAP, however, withheld its recommendation in favor of reinstating FluMist, noting that it would prefer to observe the new formulation’s efficacy for a longer period of time before making a decision.
Munoz says AAP’s decision to recommend FluMist is the result of better data showing similar efficacy results between the intranasal and injectable influenza flu vaccines. She notes that protection against H3N2 wasn’t great in either formulation of the vaccine, but both were effective against H1N1.
“This year we do anticipate the majority of the vaccine used will be injectables,” Munoz says, adding that children aged younger than 2 years cannot receive the live, intranasal vaccine.