2016/17 Influenza vaccination recommendations for children

Advisory Alert

November 1, 2016

*Cette information est seulement disponible en anglais.

As you are aware, there have been recent changes in the recommendations for the live attenuated influenza vaccine (LAIV) FluMist® for children and adolescents in both Canada and the United States. This advisory alert outlines these changes, the reasons for the changes, and the current National Advisory Committee on Immunization (NACI) recommendations regarding LAIV and the inactivated influenza vaccine (IIV) for children 6 months up to and including 17 years of age, for the 2016/17 seasonal influenza.

2016/17 NACI Recommendations

Children 6 months to 17 years should receive a quadrivalent influenza vaccine which is composed of two influenza A and two influenza B strains. Protection against the extra B strain in the quadrivalent vaccine compared to the trivalent vaccine is particularly important for children and adolescents, who are more likely to acquire influenza B than adults. Several quadrivalent vaccines are publicly funded in Ontario for eligible children without contraindications, depending on their age. Efficacy of available quadrivalent vaccines is considered equal with the decision of vaccine product choice resting primarily on the age/eligibility of the child and provider/patient preference. Vaccines offered as part of the Ontario influenza publicly funded program include:

• IIV for children 6 months up to and including 17 years of age (Fluzone® Quadrivalent or Flu Laval Tetra®); OR
• LAIV for children 2 years up to and including 17 years of age, given by nasal spray (FluMist®)

Previously, NACI had preferentially recommended LAIV over IIV for children 2 to 6 years of age and suggested it may also be more effective for children in older age groups, with the exact age when it is no longer more effective being unknown. This preferential recommendation was made based on three randomized controlled trials.

However, recent studies have shown LAIV and IIV to have similar vaccine effectiveness against influenza A(H3N2) and B, and in some studies but not others, IIV performs somewhat better than LAIV against influenza A(H1N1)pdm09. Based on this information, the National Advisory Committee on Immunization (NACI) removed the preferential recommendation for LAIV over IIV and recommends any quadrivalent product for the 2016/17 season. Further details about these studies is available on the Public Health Ontario website http://www.publichealthontario.ca/en/eRepository/LAIV_IIV_Factsheet_for_HCP_2016.pdf? (Public Health Ontario)

Should you have any questions about the recommended influenza vaccines for children, please contact the immunization program as per below.

For all reporting, inquiries or comments, please contact the Sudbury & District Health Unit at 705.522.9200, ext. 301.

This item was last modified on November 1, 2016