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Seasonal Flu

2008–09 INFLUENZA PREVENTION & CONTROL RECOMMENDATIONS

Overview

Primary Changes and Updates in the 2008 ACIP Recommendations

Note: On December 19, 2008, CDC issued Interim Recommendations for the Use of Influenza Antivirals for the 2008-09 Season.

The 2008 recommendations include five principal changes or updates:

• Beginning with the 2008--09 influenza season, annual vaccination of all children aged 5--18 years is recommended. Annual vaccination of all children aged 5--18 years should begin in September or as soon as vaccine is available for the 2008--09 influenza season, if feasible, but annual vaccination of all children aged 5--18 years should begin no later than during the 2009--10 influenza season.
   
• Annual vaccination of all children aged 6 months--4 years (59 months) and older children with conditions that place them at increased risk for complications from influenza should continue. Children and adolescents at high risk for influenza complications should continue to be a focus of vaccination efforts as providers and programs transition to routinely vaccinating all children.
   
• Either TIV or LAIV can be used when vaccinating healthy persons aged 2--49 years. Children aged 6 months--8 years should receive 2 doses of vaccine if they have not been vaccinated previously at any time with either LAIV or TIV (doses separated by 4 or more weeks); 2 doses are required for protection in these children. Children aged 6 months--8 years who received only 1 dose in their first year of vaccination should receive 2 doses the following year. LAIV should not be administered to children aged <5 years with possible reactive airways disease, such as those who have had recurrent wheezing or a recent wheezing episode. Children with possible reactive airways disease, persons at higher risk for influenza complications because of underlying medical conditions, children aged 6--23 months, and persons aged >49 years should receive TIV.
   
• The 2008--09 trivalent vaccine virus strains are A/Brisbane/59/2007 (H1N1)-like, A/Brisbane/10/2007 (H3N2)-like, and B/Florida/4/2006-like antigens.

Oseltamivir-resistant influenza A (H1N1) strains have been identified in the United States and some other countries. However, oseltamivir or zanamivir continue to be the recommended antivirals for treatment of influenza because other influenza virus strains remain sensitive to oseltamivir, and resistance levels to other antiviral medications remain high.

NOTE: The text above is taken from Prevention & Control of Influenza - Recommendations of the Advisory Committee on Immunization Practices (ACIP) 2008. MMWR 2008 Jul 17; Early Release:1-60. (Also available as PDF, 586K).