Flu activity is low in the United States at this time. It is not possible to say when influenza activity will increase, which virus(es) will predominate, or who will be most severely impacted by influenza infection. Vaccination is still the most important step in protecting children against influenza. The Centers for Disease Control and Prevention (CDC) advises clinicians to expect sporadic vaccine delays, but no shortages. A recent AAP News Breaking News article shares additional information regarding potential influenza vaccine delays.
Everyone 6 months of age and older needs an influenza vaccine each year. It takes about two weeks after vaccination to develop antibodies for protection against influenza. Vaccination of people at higher risk of developing serious influenza-related complications is especially important to decrease their chance of severe illness. This includes children with chronic medical conditions, such as asthma, diabetes mellitus, hemodynamically significant cardiac disease, immunosuppression, or neurologic and neurodevelopmental disorders. Everyone should be vaccinated as soon as the vaccine is available in their area, especially anyone who plans to visit or travel during this holiday season.
Last year, H3N2 viruses predominated. The composition of this season’s vaccine has been updated to better match those virus strains anticipated to circulate. Two of the four strains in the vaccine have changed from last influenza season. This year, the trivalent vaccine includes an A/California/7/2009 (H1N1) pdm09-like virus, an A/Switzerland/9715293/2013 (H3N2)-like virus, and a B/Phuket/3073/2013-like virus (B/Yamagata lineage). The quadrivalent vaccine contains an additional B virus (B/Brisbane/60/2008-like virus [B/Victoria lineage]). There is no preference for trivalent or quadrivalent vaccine.
In October 2015, the American Academy of Pediatrics (AAP) collaborated with the CDC to conduct a webinar titled “How To Prevent and Control Pediatric Influenza“. Presenters discussed strategies that clinicians should consider to improve influenza prevention and control in children at highest risk. The archived version of the webinar, a transcript, and presentation materials/resources can be viewed online.
The AAP policy on “Recommendations for Prevention and Control of Influenza in Children, 2015-2016” emphasizes that special effort be made to vaccinate specific groups, such as all child care providers and staff and all women who are pregnant, are considering pregnancy, are in the postpartum period, or are breastfeeding during the influenza season.
Child Care Providers and Staff
In the US, more than two-thirds of children younger than 6 years and almost all children 6 years and older spend significant time in child care or school settings outside the home. Exposure to groups of children increases the risk of contracting infectious diseases. Partnerships between health professionals and child care providers to encourage vaccination of all children, staff, and caregivers are beneficial. Consider sharing some strategies with child care centers to increase influenza vaccination, including offering free flu immunizations to employees (onsite, via gift cards) or having a nurse from an office or a health center come to offer flu vaccinations on site. The AAP has several influenza prevention and control resources available for child care providers.
Flu is more likely to cause severe illness in pregnant women than in those women not pregnant. Studies show that a confident and routine vaccine recommendation from a health care provider is influential. Pediatricians play a crucial role in promoting vaccination to help keep women and their newborns healthy. The AAP recommends annual seasonal influenza immunization of all women who are pregnant, are considering pregnancy, are in the postpartum period, or are breastfeeding during the influenza season. Pediatric offices may choose to serve as an alternate venue for providing influenza immunization for parents and other care providers of children. Medical liability issues and medical record documentation requirements need to be considered before a pediatrician begins immunizing adults in the office.
Be sure to check out the free Influenza 2015-2016 Course Series. These online courses deliver valuable information for clinicians to help keep children healthy during flu season. For more information, see the AAP Red Book Online Influenza Resource page or the CDC FluView. The Protect Children from Influenza infographic identifies actions pediatricians can take to help protect children, especially those at highest risk. All What’s the Latest with the Flu messages will be archived. Members of the AAP also have access to Flu Vaccine Recommendations Speaking Points and updates relating to the 2015-16 Influenza Vaccine Supply.