ATLANTA – The 2012-2013 influenza vaccination statement from the Centers for Disease Control and Prevention’s vaccine advisory panel is expected to contain a new algorithm for children aged 6 months through 8 years to determine whether they need one or two doses.
The CDC’s Advisory Committee on Immunization Practices voted to approve the same algorithm approved by the American Academy of Pediatrics’ Committee on Infectious Disease earlier this year:
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The new flu vaccine algorithm was designed to be simple, the AAP’s liaison Dr. Michael T. Brady said. "You’d like to make it so that any child who needs two gets two [doses of the flu vaccine]."
• First, has the child ever received influenza vaccine?
• If yes, did the child receive two or more total doses of seasonal vaccine since July 2010?
• If yes, give one dose. If not, or if the information isn’t known, give two doses.
• If the child has never received influenza vaccine or the information isn’t known, give two doses.
The algorithm was necessary because children younger than 9 years of age need two doses of seasonal vaccine in order to establish immune system priming, and two out of the three influenza strains included in the 2012-2013 influenza vaccine – A/Victoria/361/2011 (H3N2) and B/Wisconsin/1/2010 – are different from those of the 2011-2012 vaccine. The one that remains the same is the 2009 pandemic strain A/California/7/2009, which was available in 2009 as a monovalent vaccine and then was included in the seasonal 2010-2011 and 2011-2012 flu vaccines, said Dr. Lisa Grohskopf of the CDC’s Influenza Division.
The algorithm was designed to be simple, the AAP’s liaison Dr. Michael T. Brady said in an interview. "Thirty-five percent or so of children receive vaccines outside of their medical home. That creates a problem with access to the information. Also, many pediatricians will set up vaccine clinics designed to move children through quickly. ... You’d like to make it so that any child who needs two gets two [doses of the flu vaccine]."
Dr. Michael Brady
But, he said, if the information is available, then the option is still there to use it. "The option is, do you want to put the onus on the pediatrician to try to track everything down, or do you want to try to make it more fail-safe so that it’s easier? What this does in general is make it simple. But if you want to get the information and avoid an extra dose, that’s fine," said Dr. Brady, professor and chair of pediatrics at the Ohio State University and Nationwide Children’s Hospital, both in Columbus.
Once adopted by the CDC and published in the CDC’s Morbidity and Mortality Report, the influenza vaccine statement will also contain information about the strains selected for 2012-2013, a reiteration of the universal recommendation for flu vaccine for all individuals aged 6 months and older, and an acknowledgement of the recently-approved quadrivalent live attenuated vaccine, which is expected to be available for the 2013-2014.
The statement also will include an update of an investigation into an increased risk for febrile seizures associated with receipt of the trivalent inactivated influenza vaccine (TIV) in conjunction with the 13-valent pneumococcal conjugate vaccine. The elevated risk was seen for seizures following TIV in children aged 6-23 months in surveillance data for 2011-2012 among children aged 6-23 months, but not in those aged 24-59 months.
At the meeting, the committee also voted use of the vaccine via the new algorithm into the federal Vaccines for Children Program.
As a CDC employee, Dr. Grohskopf has no disclosures. Dr. Brady stated that he has no relevant financial disclosures.