The American Academy of Pediatrics (AAP) has updated its prevention and treatment recommendations, entitled Recommendations for Prevention and Control of Influenza in Children, for the 2019-20 influenza season. The guidelines include 7 main updates, while continuing to urge annual vaccination for patients 6 months and older.
Updates to the document included the following:
The report also indicated that the FDA has approved new formulations of licensed, inactivated flu vaccines with a volume of 0.5 mL per dose for children 6 to 36 months of age. Children 6 to 35 months of age may receive either the 0.25 mL or 0.5 mL dose of IIV, and children 36 months of age and older should continue to receive a 0.5 mL dose.
Furthermore, all pediatric influenza vaccines available this season are quadrivalent vaccines; however, the age indication for some of them has been expanded. There are 4 egg-based quadrivalent IIVs licensed by the FDA for children aged 6 months and older; one cell-based quadrivalent IIV for children 4 years and older; and 1 quadrivalent LAIV for children 2 years and older who are otherwise healthy.
The AAP document states that pregnant women may receive IIV at any time during pregnancy to protect themselves and their infants, who benefit from the transplacental transfer of antibodies. Postpartum women not vaccinated during pregnancy are encouraged to receive influenza vaccine before hospital discharge. Additionally, influenza vaccination during breastfeeding is safe for mothers and their infants, according to the AAP.
Any hospitalized child with suspected or confirmed influenza, any child (inpatient or outpatient) with severe, complicated or progressive illness attributable to influenza, and any child with influenza infection of any severity at high risk of complications of influenza are to be offered antiviral treatment as early as possible, regardless of influenza status.
The document advises offering antiviral treatment to these individuals:
The 2018-19 influenza season was moderately severe and the longest-lasting U.S. influenza season in the past decade, at 21 consecutive weeks. Influenza A (H1N1) viruses predominated from October to mid-February and drifted strains of influenza A (H3N2) viruses from February to May.
There were 116 laboratory-confirmed pediatric deaths (median age 6 years) in the previous influenza season. Among the 104 children with known medical history, nearly half of the deaths occurred in previously healthy patients. Most had not been vaccinated against influenza.
Munoz, Flor. Updated AAP flu policy offers more options this year. AAP News website. Published September 2, 2019. https://www.aappublications.org/news/2019/09/02/flupolicy090219. Accessed September 6, 2019.