Prevention and control of seasonal influenza with vaccines : recommendations of the Advisory Committee on Immunization Practices \u2014 United States, 2018\u201319 influenza season

This report updates the 2017\u201318 recommendations of the Advisory Committee on Immunization Practices (ACIP) regarding the use of seasonal influenza vaccines in the United States (MMWR Recomm Rep 2017;66[No. RR-2]). Routine annual influenza vaccination is recommended for all persons aged 656 months who do not have contraindications. A licensed, recommended, and age-appropriate vaccine should be used. Inactivated influenza vaccines (IIVs), recombinant influenza vaccine (RIV), and live attenuated influenza vaccine (LAIV) are expected to be available for the 2018\u201319 season. Standard-dose, unadjuvanted, inactivated influenza vaccines will be available in quadrivalent (IIV4) and trivalent (IIV3) formulations. Recombinant influenza vaccine (RIV4) and live attenuated influenza vaccine (LAIV4) will be available in quadrivalent formulations. High-dose inactivated influenza vaccine (HD-IIV3) and adjuvanted inactivated influenza vaccine (aIIV3) will be available in trivalent formulations.Updates to the recommendations described in this report reflect discussions during public meetings of ACIP held on October 25, 2017; February 21, 2018; and June 20, 2018. New and updated information in this report includes the following four items. First, vaccine viruses included in the 2018\u201319 U.S. trivalent influenza vaccines will be an A/Michigan/45/2015 (H1N1)pdm09\u2013like virus, an A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus, and a B/Colorado/06/2017\u2013like virus (Victoria lineage). Quadrivalent influenza vaccines will contain these three viruses and an additional influenza B vaccine virus, a B/Phuket/3073/2013\u2013like virus (Yamagata lineage). Second, recommendations for the use of LAIV4 (FluMist Quadrivalent) have been updated. Following two seasons (2016\u201317 and 2017\u201318) during which ACIP recommended that LAIV4 not be used, for the 2018\u201319 season, vaccination providers may choose to administer any licensed, age-appropriate influenza vaccine (IIV, RIV4, or LAIV4). LAIV4 is an option for those for whom it is appropriate. Third, persons with a history of egg allergy of any severity may receive any licensed, recommended, and age-appropriate influenza vaccine (IIV, RIV4, or LAIV4). Additional recommendations concerning vaccination of egg-allergic persons are discussed. Finally, information on recent licensures and labeling changes is discussed, including expansion of the age indication for Afluria Quadrivalent (IIV4) from 6518 years to 655 years and expansion of the age indication for Fluarix Quadrivalent (IIV4), previously licensed for 653 years, to 656 months.This report focuses on the recommendations for use of vaccines for the prevention and control of influenza during the 2018\u201319 season in the United States. A Background Document containing further information and a brief summary of these recommendations are available at https://www.cdc.gov/vaccines/hcp/acip-recs/vacc-specific/flu.html.These recommendations apply to U.S.-licensed influenza vaccines used within Food and Drug Administration\u2013licensed indications. Updates and other information are available at CDC\u2019s influenza website (https://www.cdc.gov/flu). Vaccination and health care providers should check CDC\u2019s influenza website periodically for additional information.Suggested citation for this article: Grohskopf LA, Sokolow LZ, Broder KR, Walter EB, Fry AM, Jernigan DB. Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices\u2014United States, 2018\u201319 Influenza Season. MMWR Recomm Rep 2018;67(No. RR-3):1\u201320. DOI: http://dx.doi.org/10.15585/mmwr.rr6703a1.2018ACIPPrevention and Control892