CDC Releases Prevention and Control of Seasonal Influenza With Vaccines, 2013-2014
September 30, 2013
The CDC recently released its annual publication of Prevention and Control of Seasonal Influenza With Vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2013–2014. This CAHAN publication communicates important information that will be useful to manage this year’s influenza season.
Routine annual influenza vaccination is recommended for all persons aged ≥6 months who do not have contraindications. Healthcare providers should begin offering vaccination soon after vaccine becomes available and, if possible, by early October. Vaccination efforts should continue throughout the season, as the duration of the influenza season varies and influenza activity might not occur until February or March.
Six newly approved influenza vaccines have been available since August 2013. No preferential recommendation is made for one influenza vaccine product over another for persons for whom more than one product is otherwise appropriate.
For the 2013–14 influenza season, the live attenuated influenza vaccine (LAIV3) in nasal spray formulation is a quadrivalent LAIV vaccine (LAIV4). Inactivated influenza vaccines (IIVs) will be available in both trivalent (IIV3) and quadrivalent (IIV4) formulations. Vaccine virus strains included in the 2013–14 U.S. trivalent influenza vaccines will be an A/California/7/2009 (H1N1)–like virus, an H3N2 virus antigenically like the cell-propagated prototype virus A/Victoria/361/2011, and a B/Massachusetts/ 2/2012–like virus.
Quadrivalent vaccines will include an additional influenza B virus strain, a B/Brisbane/60/2008–like virus, intended to ensure that both influenza B virus antigenic lineages (Victoria and Yamagata) are included in the vaccine. The CDC report describes recently approved vaccines, including LAIV4, IIV4, trivalent cell culture-based inactivated influenza vaccine (ccIIV3), and trivalent recombinant influenza vaccine (RIV3). These recommendations and other information are available at CDC's influenza website; updates may also be found on this website.
Additionally, please remember that it is important for all healthcare professionals to obtain influenza vaccinations. Last influenza season, 65 deaths were reported to the County of San Diego. Few of these cases were vaccinated. Vaccination of healthcare personnel will significantly contribute to the reduction of morbidity and mortality.
Influenza Vaccination of Children With Neurologic and Neurodevelopmental Conditions
Among 336 pediatric deaths related to the 2009 influenza pandemic, 146 deaths occurred in children with underlying neurologic disorders, most commonly intellectual disability (76%) and epilepsy (51%). However, a recently published study in CDC’s Morbidity and Mortality Weekly Report (MMWR) concluded that many physicians do not recognize these conditions as associated with higher risk for influenza-related complications. Only 46% of surveyed physicians recognized intellectual disability as a high-risk condition, and only 52% recognized epilepsy as a high-risk condition. Furthermore, among 1,005 children with neurologic or neurodevelopmental (NND) conditions, parents reported that only 50% of children were vaccinated for influenza or had a vaccine appointment scheduled. This vaccination rate is similar to rates observed in the general pediatric population.
As a result of this study, a letter from the CDC and other agencies was written to healthcare providers to encourage the following:
- Annual influenza vaccination for everyone 6 months of age and older, especially people at high risk for serious complications, including young children, and anyone with chronic medical conditions, including children with neurologic and neurodevelopmental disorders.
- Annual influenza vaccination for adults (caregivers, health care providers, and child care providers) who come in contact with children at high-risk for influenza complications, including those with neurologic or neurodevelopmental disorders.
- Prompt antiviral treatment for suspected influenza, even without testing, for children at high-risk for influenza complications, including those with neurologic or neurodevelopmental disorders. Antiviral treatment is most effective when started within 48 hours of illness onset, but may still provide some clinical benefit when started later.
Click here for a copy of the CDC letter to providers. Click here for the MMWR article about the study.