August 26, 2019
The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) has released updated recommendations for how to best utilize vaccines for the prevention and control of seasonal influenza in the United States this upcoming season.
Though there are no substantial changes from the 2018-2019 recommendations, the ACIP highlights 2 changes in the 2019-2020 recommendations: vaccine composition and regulatory actions.
First, clinicians should be aware of the vaccine virus composition of the seasonal influenza vaccines that will be available. According to the ACIP, the trivalent influenza vaccines administered during this US flu season will contain hemagglutinin (HA) derived from an A/Brisbane/02/2018 (H1N1)pdm09–like virus, an A/Kansas/14/2017 (H3N2)–like virus, and a B/Colorado/06/2017–like virus (Victoria lineage). Meanwhile, the quadrivalent influenza vaccines will contain HA derived from these 3 viruses and from an additional influenza B vaccine virus, a B/Phuket/3073/2013–like virus (Yamagata lineage).
“This composition includes updates in the influenza A(H1N1)pdm09 and influenza A(H3N2) components of the vaccine,” the ACIP wrote.
Second, clinicians should be aware of 2 recent regulatory actions from the Food and Drug Administration (FDA). The first is that Afluria Quadrivalent (IIV4) is now licensed for individuals aged 6 months or older. This decision came in October 2018. Before that, the vaccine was only indicated for individuals aged 5 years or older.
“The dose volume is 0.25 mL per dose (containing 7.5 µg of HA per vaccine virus) for children aged 6 through 35 months and 0.5 mL per dose (containing 15 µg of HA per vaccine virus) for all persons aged 36 months [or older] (3 years or older),” the ACIP wrote.
The second regulatory action that the FDA took was in January 2019, when it approved a change in dose volume for Fluzone Quadrivalent (IIV4). According to the FDA, children aged 6 through 35 months who receive Fluzone Quadrivalent may now receive either 0.25 mL (containing 7.5 µg of HA per vaccine virus) or 0.5 mL (containing 15 µg of HA per vaccine virus) per dose. Children aged 36 months or older, as well as adults, should receive 0.5 mL per dose. This is a change from the previously approved dose volume of 0.25 mL (containing 7.5 µg of HA per vaccine virus) for children aged 6 through 35 months.
As it has done since 2010, the ACIP is again recommending that everyone aged 6 months or older who does not have contraindications receive the annual influenza vaccine.
Grohskopf LA, Alyanak E, Broder KR, Walter EB, Fry AM, Jernigan DB; Advisory Committee on Immunization Practices. Prevention and control of seasonal influenza with vaccines: recommendations of the Advisory Committee on Immunization Practices — United States, 2019–20 influenza season. MMWR Recomm Rep. 2019;68(No. RR-3):1-21. doi:10.15585/mmwr.rr6803a1.