The American Academy of Pediatrics (AAP) released updated influenza vaccine recommendations in a new policy statement, “Recommendations for Prevention and Control of Influenza in Children, 2014-2015,” in the October 2014 Pediatrics (published online Sept. 22).

The updated policy recommends that all children ages 6 months and older be immunized against influenza with either the trivalent or quadrivalent vaccine once it is available. The quadrivalent vaccine protects against one additional strain of the virus, but neither vaccine is preferred over the other. The vaccine composition for the 2014-2015 season is unchanged from last year for either strain.

Optimal protection is achieved through annual immunization. Antibody titers wane to 50 percent of their original levels 6 to 12 months after vaccination. Although the vaccine strains for the 2014-2015 season are unchanged from last season, a repeat dose this season is critical for maintaining protection in all populations.

Children 6 months through 8 years may require two doses in 2014-2015 to be adequately primed. The dosing algorithm for children in this age group reflects that virus strains in the vaccine have not changed from last season. The live attenuated influenza vaccine (LAIV) should be considered for healthy children 2 through 8 years of age who have no contraindications or precautions to the intranasal vaccine. The inactivated influenza vaccine (IIV) should be given when LAIV is not readily available. No one should delay vaccination waiting for LAIV.

A special effort should be made to vaccinate people in vulnerable groups, including children with chronic health conditions, children of American Indian or Alaska Native heritage, health care personnel, child care providers and staff, women who are pregnant, considering pregnancy, are in the postpartum period, or are breastfeeding, and household contacts and caregivers of children in high-risk populations.

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