The American Academy of Pediatrics (AAP) will advise families to vaccinate their children against influenza next season with either the flu shot or the nasal spray vaccine for the best protection against the virus during the 2019-2020 flu season.
The recommendation differs slightly from last year, when AAP cited a preference for the injected vaccine over the nasal spray – except in cases where a child refused the shot – based on questions about its effectiveness in previous seasons. This fall, AAP will support patients’ use of any licensed influenza vaccine, in harmony with guidance from the US Centers for Disease Control and Protection.
“All children six months and older should receive the flu vaccine, in whatever form their pediatrician recommends,” said Bonnie Maldonado, MD, FAAP, chair of the AAP Committee on Infectious Diseases. “Every year, we are never sure if the vaccine strains are going to be perfectly matched up with incoming flu strains, but based on the information that we have now, we believe the nasal spray is an acceptable option.”
The AAP Board of Directors approved both options on March 14, after reviewing the latest data on the Inactivated vaccine (IIV), which is injected, and the quadrivalent live attenuated influenza vaccine (LAIV4), which is a nasal spray given to healthy patients ages 2 through 49. AAP will publish its formal policy statement on flu prevention and treatment later this year. This decision was announced now because physicians are placing orders for the vaccine.
AAP did not recommend the nasal spray during the 2016-17 and 2017-18 flu season since the spray did not work as well against influenza A/H1N1 strain during the 2013-2014 and 2015-2016 flu seasons. Vaccine effectiveness can vary from one flu season to the next.
In 2017, the manufacturer of the nasal spray made changes to the formulation to include a new A/H1N1 strain, and this year infectious disease experts are encouraged by new data from Great Britain that – while dependent on a limited number of cases in other countries – supports the spray’s effectiveness against some strains of influenza.
“The flu virus is unpredictable and can cause serious complications even in healthy children,” said Flor M. Munoz, MD, FAAP, a member of the AAP Committee on Infectious Diseases. “Children who have been immunized are less likely be hospitalized due to flu.”
Over all, more children were vaccinated for the flu last fall compared to the prior year, although much work needs to be done to raise vaccination rates, according to AAP. About 45 percent of children received the vaccine by November 2018, compared to 38 percent in November 2017, according to the academy.
The AAP recommends families talk with their pediatrician if they have any questions about their child’s immunizations.