ACIP Releases Recommendations for Influenza Vaccination, 2015-2016.

A collection of Practice Guidelines published in AFP is available at http:// www.aafp.org/afp/ practguide. The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) has released its yearly recommendations for routine influenza vaccination in the 2015-2016 season. Updates this year include the antigenic composition of seasonal influenza vaccines available in the United States; information on influenza vaccines expected to be available this season; updated information for determining the number of doses required for children six months to eight years of age; and recommendations for the use of live attenuated influenza vaccine (LAIV) when both LAIV and inactivated influenza vaccine are available, including the removal of 2014-2015 preferential recommendation for LAIV in healthy children two to eight years of age. Routine annual influenza vaccination is recommended for all persons six months and older who do not have contraindications. Vaccination should ideally occur before the onset of influenza activity in the community. Clinicians should offer vaccination by October, if possible, and continue through the influenza season. Children six months to eight years of age who require two doses should receive their first dose as soon as possible after vaccine becomes available, and the second dose no earlier than four weeks later. For the 2015-2016 inf luenza season, U.S.-licensed trivalent influenza vaccines will include hemagglutinin derived from an A/California/7/2009 (H1N1)-like virus, an A/Switzerland/9715293/2013 (H3N2)like virus, and a B/Phuket/3073/2013-like (Yamagata lineage) virus. Quadrivalent vaccines will contain these viruses plus a B/ Brisbane/60/2008-like (Victoria lineage) virus. Influenza vaccines expected to be available this season are listed in Table 1. New vaccines and updated vaccine indications include the following: • The trivalent inactivated influenza vaccine Afluria has been approved for intramuscular administration via a needle-free jet injector in persons 18 to 64 years of age. Afluria is the only inactivated influenza vaccine that can be administered without a needle and syringe. • The trivalent recombinant influenza vaccine, Flublok, (for persons with egg allergy) is now indicated for all adults 18 years and older. It was previously approved only for persons 18 to 49 years of age. • The quadrivalent intradermal inactivated influenza vaccine, Fluzone Intradermal, is now indicated for adults 18 to 64 years of age. This formulation is expected to replace the previously available trivalent intradermal inactivated vaccine. Children six months to eight years of age require two doses of influenza vaccine during their first season of vaccination. Since the emergence of influenza A(H1N1)pdm09 (the 2009 H1N1 pandemic virus), recommendations for determining the number of doses needed have been based on whether a child previously received vaccine containing influenza A(H1N1)pdm09. Because this strain continues to circulate as the predominant H1N1 virus, and because of the inclusion of an A/California/7/2009(H1N1)-like virus in seasonal influenza vaccines available in the Practice Guidelines