(Last updated August 29, 2018)
CDC published Prevention and Control of Seasonal Influenza with Vaccines: Recommendations of the Advisory Committee on Immunization Practices—United States, 2018–19 Influenza Season in an August 24 MMWR Recommendations and Reports. The Summary section is reprinted below.
This report updates the 2017–18 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 ≥6 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 2018–19 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 2018–19 U.S. trivalent influenza vaccines will be an A/Michigan/45/2015 (H1N1)pdm09–like virus, an A/Singapore/INFIMH-16-0019/2016 (H3N2)-like virus, and a B/Colorado/06/2017–like virus (Victoria lineage). Quadrivalent influenza vaccines will contain these three viruses and an additional influenza B vaccine virus, a B/Phuket/3073/2013–like virus (Yamagata lineage). Second, recommendations for the use of LAIV4 (FluMist Quadrivalent) have been updated. Following two seasons (2016–17 and 2017–18) during which ACIP recommended that LAIV4 not be used, for the 2018–19 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 ≥18 years to ≥5 years and expansion of the age indication for Fluarix Quadrivalent (IIV4), previously licensed for ≥3 years, to ≥6 months.
This report focuses on the recommendations for use of vaccines for the prevention and control of influenza during the 2018–19 season in the United States. A background document containing further information and a brief summary of these recommendations are available here.
On February 12, CDC released a new Vaccine Information Statement (VIS) for recombinant zoster (shingles) vaccine, as well as a revised VIS for live zoster (shingles) vaccine. CDC also released final versions of the MMR, MMRV, and varicella (chickenpox) VISs; these VISs were updated from “interim” to “final” versions. CDC encourages providers to begin using these VISs immediately; however, stocks of the previous editions may be used until gone.
IAC has developed Don’t Be Guilty of These Preventable Errors in Vaccine Administration, a 4-page print resource describing common but preventable errors made in vaccine administration. This resource also provides information about what to do when errors are made and links to resources that will help prevent errors in the future.
This new resource is a companion piece to IAC's Don't Be Guilty of these Preventable Errors in Vaccine Storage and Handling!
The changes to the screening checklist for contraindications to vaccines for children and teens were: 1) to incorporate a history of thrombocytopenia or thrombocytopenia purpura as an additional precaution to MMR/MMRV vaccines and 2) to modify the T-lymphocyte criteria for HIV-infected children and receipt of varicella vaccine from counts to percentage at the 6th birthday (The checklist previously read "at the 8th birthday.")
A change to the screening checklist for contraindications to vaccines for adults was made to incorporate a history of thrombocytopenia or thrombocytopenia purpura as an additional precaution to administering MMR/MMRV vaccines.
Immunization Action Coalition (IAC) recently updated the following checklists for vaccine contraindications.
The most current information for health care professionals regarding influenza vaccine recommendations (including persons with egg allergy), vaccine supply, and recommendations for using antiviral agents for influenza can be found on the CDC website at www.cdc.gov/flu/professionals/vaccination/index/htm.
In the September 4 issue of MMWR (pages 944–947), CDC published Intervals Between PCV13 and PPSV23 Vaccines: Recommendations of the Advisory Committee on Immunization Practices (ACIP).
On June 25, 2015, ACIP changed the recommended interval between PCV13 followed by PPSV23 (PCV13–PPSV23 sequence) from 6–12 months to ≥1 year for immunocompetent adults aged ≥65 years. Recommended intervals for all other age and risk groups remain unchanged. The report outlines the rationale for this change and summarizes the evidence considered by ACIP to make this recommendation. The "Summary" section is reprinted below in its entirety.
Summary: What is currently recommended?
The Advisory Committee on Immunization Practices (ACIP) currently recommends that both 13-valent pneumococcal conjugate vaccine (PCV13) and 23-valent pneumococcal polysaccharide vaccine (PPSV23) be given to all immunocompetent adults aged ≥65 years. ACIP recommends that PCV13 be given first followed by PPSV23 6–12 months later. ACIP also recommends that adults aged ≥65 years who already received a dose of PPSV23, should also receive a dose of PCV13 ≥1 year after the dose of PPSV23. Among persons aged ≥2 years with medical indications to receive both PCV13 and PPSV23 in a series, including adults aged ≥65 years with immunocompromising conditions, functional or anatomic asplenia, cochlear implants, or cerebrospinal fluid leaks, a dose of PPSV23 should be given ≥8 weeks after a dose of PCV13.
Why are the recommendations being modified now?
To simplify the recommendations for PCV13 and PPSV23 use among immunocompetent adults aged ≥65 years, ACIP recommended harmonization of recommended intervals between PCV13 and PPSV23 regardless of the order in which the two vaccines are given.
What are the new recommendations?
ACIP recommends that both PCV13 and PPSV23 be given in series to adults aged ≥65 years. A dose of PCV13 should be given first followed by a dose of PPSV23 at least 1 year later to immunocompetent adults aged ≥65 years. The two vaccines should not be co-administered. If a dose of PPSV23 is inadvertently given earlier than the recommended interval, the dose need not be repeated.
Read the full-text article to access the complete recommendations; a PDF version of the entire issue is also available.
ICDC's Vaccine Storage and Handling Toolkit web page for healthcare professionals now contains a link to the newly updated Vaccine Storage and Handling Toolkit PDF guide for 2018. The Vaccine Storage and Handling Toolkit reflects best practices for vaccine storage and handling from Advisory Committee on Immunization Practices (ACIP) recommendations, product information from vaccine manufacturers, and scientific studies.
The 2018 Toolkit is designed to help health care providers find the information they need quickly and easily. The beginning chapters address the three main elements of an effective cold chain: a well-trained staff, reliable storage and temperature monitoring equipment, and accurate vaccine inventory management. The remaining chapters focus on emergency management of vaccine and developing plans and standard operating procedures for routine and emergency storage and handling.
Note: For more detailed information on storage and handling recommendations and guidance for individual vaccines, please refer to manufacturers’ package inserts found on the Immunization Action Coalition (IAC) website.
OPA annually drafts immunization protocols in compliance with the Ohio State Board of Pharmacy’s rules. Updated protocols for 2017 are now available. Use the following link to purchase the protocol package: Immunization Protocol Package form
HealthMap Vaccine Finder (http://flushot.healthmap.org) is a free, online service where users can search for locations offering flu vaccines, as well as other adult vaccines. This service partners with clinics, pharmacies, and health departments to provide accurate and up-to-date information about receiving the flu vaccine.
In 2012, Google passed the baton to HealthMap when it retired Google Flu Vaccine Finder. If you previously provided data to Google Flu Vaccine Finder and would like to still be included in the list of vaccine providers, you will need to register and upload your location data to HealthMap.