Flu activity remains elevated, albeit overall decreasing in the United States. Influenza viruses are still causing disease, and have been known to still circulate into May and June. To date, 107 pediatric deaths have been reported this season.
Vaccination is the most effective solution for protecting children from influenza and its complications. In February 2015, the AAP collaborated with the Centers for Disease Control and Prevention (CDC) to conduct a 1-hour Clinician Outreach and Communication Activity (COCA) call/webinar titled “Protecting Children: Influenza Updates for Clinicians”. During this webinar, clinicians learned about the current state of flu activity, the importance of continued vaccination despite the mismatch and low vaccine effectiveness, and strategies for using antiviral therapy early to treat influenza. Henry (Hank) Bernstein, DO, MHCM, FAAP; John S Bradley, MD, FAAP; and Alicia Fry, MD, MPH, presented. An archived version of the webinar, a transcript, and presentation materials are available online via the link above.
Planning for next flu season is underway. The influenza strains to be incorporated into the 2015-16 influenza vaccine were recently announced. The H3N2 strain and one of the two B strains for the 2015-16 influenza vaccine will differ from those strains in the current influenza vaccine. In particular, a review of surveillance data showed that there has been substantial genetic change and antigenic drift among circulating H3N2 viruses. Hence, the recommended H3N2 virus for the US 2015-2016 vaccine is A/Switzerland/9715293/2013, which is anticipated to protect people against most circulating H3N2 viruses. For AAP guidance, see “Recommendations for Prevention and Control of Influenza in Children, 2014–2015”.
After reviewing data from recent flu seasons indicating that the live attenuated influenza vaccine (LAIV) did not provide cross protection against circulating influenza strains that are not in the vaccine, the CDC Advisory Committee on Immunization Practices removed its preference for LAIV. In the 2015-16 season, either inactivated influenza vaccines (IIV) or LAIV is recommended. The AAP continues to express no preference for one product over the other. The AAP encourages pediatric practices to preorder vaccine that best suits the needs of their patient population. For more information, see the AAP News article.
National Infant Immunization Week (NIIW) is slated for April 18-25, 2015. This special week provides an opportunity for clinicians to double-check that all children (especially those at high risk of complications) were immunized for influenza this year and to discuss the timing and importance of flu vaccination during the 2015-2016 influenza season. Conversations now will help clarify any questions from parents about the strain mismatch this year.