AAP issues annual influenza season recommendations


The 2020-2021 influenza season is fast approaching and the American Academy of Pediatrics (AAP) has issued their annual recommendations.

Although COVID-19 may be the disease at the forefront of most people’s mind, the annual influenza season is due to start in the near future. How it will look when running concurrently with a pandemic is unknown at this point, but the disease could further tax the health care system with the hospitalizations and deaths caused by the illness annually. The American Academy of Pediatrics (AAP) has issued their influenza immunization as well as treatment recommendations for the 2020-2021 influenza season.1

The AAP continues its recommendation of routine influenza immunizations for every child who has no medical contraindications, starting at age 6 months. A child should be given any licensed, recommended, age-appropriate vaccine that is available without regard to product or formulation. For children who either have a suspected or confirmed case of influenza and is hospitalized, has severe disease, or an underlying condition that could increase the risk of complications, antiviral treatment should be administered. For children who are not at high risk of complications from influenza, antiviral medication may be used if it can be started within 48 hours of the disease’s onset or if the child has someone in the household who is either aged younger than 6 months or who has a condition that predisposes them to complications from influenza.

The recommendations included the following update:

  • The components for influenza A(H1N1)pdm09 and A(H3N2) and the influenza B/Victoria are new for the influenza vaccine this season, but the influenza B/Yamagata component has not changed from the 2019-2020 influenza vaccine. Trivalent influenza vaccines do not have the influenza B/Yamagata component.
  • Every pediatric influenza vaccine is quadrivalent. No trivalent influenza vaccine is available for children.
  • Vaccine formulation options for children aged 6 to 35 months have changed. The Afluria Quadrivalent vaccine will be the only one indicated for the age group with a dosing volume of 0.25 mL. Although the Fluzone Quadrivalent is licensed in a 0.25 mL dosing volume, it likely will only be available in the 0.5 mL dosing volume for this season.
  • Children aged 6 months to 8 years who are receiving the influenza vaccine for the first time, who have only ever been administered 1 dose before July 1, 2020, or have unknown vaccination status should have the vaccine administered as soon as it becomes available and should also be administered 2 doses, preferably before the end of October.
  • The live attenuated influenza vaccine’s contraindications have been brought into line with the recommendations from the Advisory Committee on Immunization Practices.


1. Committee on Infectious Diseases. Recommendations for prevention and control of influenza in children, 2020–2021. Pediatrics. September 8, 2020. Epub ahead of print. doi:10.1542/peds.2020-024588

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