Resolution No. 02/08-1 
 
ADVISORY COMMITTEE ON IMMUNIZATION PRACTICES 
 
VACCINES FOR CHILDREN PROGRAM 
 
INFLUENZA 
 
VACCINES TO PREVENT INFLUENZA 
 
The purpose of this resolution is to revise the previous resolution to add the expanded age recommendations for the routine use of Influenza Vaccine.

VFC resolution 10/07-1 is repealed and replaced by the following: 
 
Eligible Groups for Inactivated Influenza Vaccine (TIV)
 
All children aged 6 months through 18 years. 
 
Eligible Groups for Live Attenuated Influenza Vaccine (LAIV)
 
All healthy children and adolescents (those who do not have an underlying medical condition that predispose them to influenza complications) aged 2 years through 18 years. 

Recommended Influenza Vaccine Schedule 
Age Group: 6 months – 8 years                       
Number of doses: 1 or 2*

All children ages 6 months to <9 years who receive influenza vaccine for the first time should be given 2 doses. Children who receive only one dose in the first influenza season they receive vaccine should receive two doses, rather than one, in the following influenza season.
 

Recommended Dosage Intervals 

Vaccine interval dose 1 to 2 : Influenza, inactivated 
Minimum Age:6 months 
Minimum (where applicable): 4 weeks
                
Vaccine interval dose 1 to 2 : Influenza, live attenuated 
Minimum Age: 2 years 
Minimum (where applicable): 4 weeks        			
                    			
 
Different influenza vaccine preparations have different age indications.  Please check the package insert for the age indication of the specific vaccine. 
 
Recommended Dosages 
Refer to product package inserts. 
 

Contraindications and Precautions 
 
The following conditions are contraindications to administration of influenza vaccine (TIV or LAIV): 
1. Allergy to vaccine components 
Anaphylactic reaction to the vaccine or a constituent of the vaccine (e.g. eggs). 
 
2. Moderate or severe illnesses with or without fever 
Persons with moderate or severe illness should be immunized as soon as they have recovered from the 
acute phase of the illness. Minor illnesses (e.g., upper respiratory tract infection, allergic rhinitis) with or without fever should not contraindicate the use of influenza vaccine (either inactivated or live, attenuated vaccine). 
 
The following conditions are precautions to administration of influenza virus vaccine (TIV or LAIV): 
1. History of Guillain-Barré Syndrome (GBS) following influenza vaccination. 
If GBS has occurred within 6 weeks of previous influenza vaccination, the decision to give influenza vaccine should be based on careful consideration of the potential risks and benefits.
 
The following conditions are contraindications to administration of LAIV: 
1. Concomitant aspirin therapy*
LAIV is contraindicated in children and adolescent receiving aspirin therapy or aspirin-containing therapy, because of the association of Reye’s syndrome with aspirin and wild-type influenza vaccine.

These persons should receive inactivated influenza vaccine if age > 6 months.

The following conditions are precautions to administration of LAIV: 
1. Risks in Children <24 Months of age
Do not administer LAIV to children <24 months of age because of increased risk of hospitalization and wheezing observed in clinical trials.

2. Asthma/Recurrent Wheezing
LAIV should not be administered to any individuals with asthma and children <5 years of age with recurrent wheezing because of the potential for increased risk of wheezing post vaccination.

3. Altered Immunocompetence
Administration of LAIV, a live virus vaccine, to immunocompromised persons should be based on careful consideration of the potential benefits and risks.

4. Medical Conditions Predisposing to Influenza Complications
Safety has not been established in individuals with underlying medical conditions predisposing them to wild-type influenza complications.

5. Pregnant Women
Safety has not been established in individuals with underlying medical conditions predisposing them to wild-type influenza complications.

These persons should receive inactivated influenza vaccine if age > 6 months.
 
Adopted: February 27, 2008
Effective: July 01, 2008


http://www.cdc.gov/vaccines/programs/vfc/downloads/resolutions/0208influenza.txt