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AAP issues recommendations for 2021-2022 flu season


The American Academy of Pediatrics (AAP) has issued its recommendations for the upcoming influenza season, including guidance on administering the vaccine to patients with COVID-19.

As we enter the final weeks of summer, the upcoming flu season looms. With many people back to work and in-person school, it means that season may be more typical than what occurred last season. With this in mind, the American Academy of Pediatrics has issued recommendations for the approaching influenza season.1

A flu shot is recommended for all children aged months and older. Any licensed, age-appropriate inactivated influenza vaccine can be administered to infants and toddlers aged 6 to 35 months. For children aged 3 years and older, any available, licensed vaccine should be given in a 0.5 mL dose. Children with an unknown vaccine status, who have only 1 dose of the vaccine by July 1, 2021, or who are aged 6 months to 8 years and are receiving the vaccine for the first time should be given 2 doses of influenza 4 weeks apart, preferably by the end of October. Ideally, children who require just 1 dose of vaccine should receive it by the end of October as well. Egg allergies should not prevent children from receiving the vaccines. Both inactivated influenza vaccine and live attenuated influenza vaccine can both be administered to them.

The recommendations also carried some updates:

  • All seasonal influenza vaccines are quadrivalent.
  • The composition of the vaccine has been updated. The influenza A(H1N1)pdm09 and A(H3N2) components are new, but the influenza B components are the same as last season’s.
  • Any licensed, age-appropriate vaccine can be administered and should be provided without preference for one product over another.
  • The flu shot can be administered at the same time or at any time before or after receiving any available COVID-19 vaccine. However, it’s recommended that providers consult the most current information from the Advisory Committee on Immunization Practices to ensure that this is still best practices.
  • Children who have a mild COVID-19 case may receive a flu shot, but those with an acute moderate or severe case should not be given a dose until after recovery.
  • The importance of vaccination during the continuing COVID-19 pandemic was underscored in the guidance.


1. Committee on infectious diseases. Recommendations for prevention and control of influenza in children, 2021–2022. Pediatrics. September 7, 2021. Epub ahead of print. doi:10.1542/peds.2021-053744

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