New Clinical Practice Guidelines, September 2017

John Anello; Brian Feinberg; Richard Lindsey; Cristina Wojdylo; Olivia Wong, DO; Yonah Korngold; John Heinegg. Sam Shlomo Spaeth


September 15, 2017

In This Article

Flu Vaccine in Children

Guidelines on flu vaccination by the American Academy of Pediatrics[1]

  • Children should receive their vaccination or vaccinations by the end of October, if possible.

  • Those who require 2 vaccines (children aged 6 mo through 8 yr who have not previously been completely vaccinated) should get their first vaccine early during the season for the best protection.

  • This year, for the second year in a row, the AAP supports the recommendation of the Centers for Disease Control and Prevention to not use the live attenuated intranasal influenza vaccine, which provided poor protection against influenza A (H1N1) pdm09 viruses during recent influenza seasons.

  • Clinicians should make special effort to vaccinate all children aged 6 mo and older who have medical conditions that put them at increased risk for influenza complications. These include babies born preterm; those with chronic medical conditions, such as asthma and other chronic lung disorders, cardiac disease, diabetes, and other metabolic problems; and those with weakened immune systems.

  • All women who are pregnant, considering pregnancy, postpartum, or breastfeeding during influenza season should receive the influenza vaccine. Studies have shown that infants born to vaccinated mothers have better influenza outcomes if they contract the disease.

  • All those who care for children should also receive an influenza vaccine.

  • Influenza vaccine is not contraindicated in children with mild febrile or afebrile illness, especially those with mild upper respiratory tract infection symptoms or allergic rhinitis. Children in whom the clinician diagnoses a moderate to severe febrile illness should wait until resolution of the illness to be vaccinated with inactivated influenza vaccine (IIV). Infants younger than 6 mo should also not receive the IIV vaccine.

  • The only antiviral medications recommended during the 2017-2018 season for chemoprophylaxis or treatment of influenza in children are the neuraminidase inhibitors oral oseltamivir (Tamiflu) and inhaled zanamivir (Relenza).

For further reading, see Pediatric Influenza