AAP Issues Flu Vaccine Recommendations 

The American Academy of Pediatrics (AAP) has issued updated recommendations for the use of trivalent seasonal influenza vaccine and antiviral medications for the prevention and treatment of influenza in children. The AAP policy statement, "Recommendations for Prevention and Control of Influenza in Children, 2010-2011," will be published in the October 2010 print issue of Pediatrics and released early online on August 30.The AAP recommends annual trivalent seasonal influenza immunization for all children and adolescents 6 months of age and older. Special efforts should be made to immunize all family members, household contacts, and out-of-home care providers of children who are younger than 5 years; children with high-risk conditions (e.g., asthma, diabetes, or neurologic disorders); health care personnel; and pregnant women. These groups are most vulnerable to influenza-related complications.

Although two influenza vaccines were recommended last year, only a single trivalent vaccine is being manufactured for the current 2010-2011 seasonal influenza vaccine schedule. The 2009 pandemic influenza A (H1N1) strain has replaced last year's influenza A (H1N1) strain in the 2010-2011 trivalent seasonal influenza vaccine, which also includes two other strains of flu virus.

The AAP policy includes a concise flow chart to simplify decision-making about the number of influenza vaccine doses a child needs, which depends on the child's age at the time of the first dose and vaccine history:

• Children younger than 6 months are too young to receive influenza vaccine.

• Children 9 years of age and older need only 1 dose.

• Children younger than 9 years need a minimum of 2 doses of 2009 pandemic H1N1 vaccine. If they did not receive the H1N1 vaccine during last year's flu season, they will need two doses of seasonal influenza vaccine this year.

• Children younger than 9 years who have never received the seasonal flu vaccine before will need 2 doses.

• Children younger than 9 years who received seasonal flu vaccine before the 2009-2010 flu season need only one dose this year if they received at least 1 dose of the H1N1 vaccine last year. They need 2 doses this year if they did not receive at least 1 dose of the H1N1 vaccine last year.

• Children younger than 9 years who received seasonal flu vaccine last year for the first time, but only received 1 dose, should receive 2 doses this year.

• Children younger than 9 years who received a flu vaccine last year, but for whom it is unclear whether it was a seasonal flu vaccine or the H1N1 flu vaccine, should receive 2 doses this year.

• All children who need 2 doses should receive the second dose at least 4 weeks after the first dose.

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