Pediatrics Group Recommends Inactivated Flu Vaccine Over Live Version

By Kelly Young

Edited by David G. Fairchild, MD, MPH, and Jaye Elizabeth Hefner, MD

While live attenuated influenza vaccine is returning this season, the American Academy of Pediatrics is continuing to recommend the inactivated influenza vaccine (IIV) over the live version for children and adolescents.

In its guidance in Pediatrics, the group notes that the intranasal live vaccine has been less effective in youth in recent years, and its efficacy is unknown for this season. The vaccine has been reformulated with a new H1N1 component for 2018–19.

They recommend that the live vaccine be used for children "who would not otherwise receive an influenza vaccine (e.g., refusal of an IIV) and for whom it is appropriate because of age (2 years of age and older) and health status (i.e., healthy and without any underlying medical conditions)."

Among the other recommendations:

• For children receiving the IIV, either trivalent or quadrivalent is acceptable.

• Pregnant women should receive an inactivated vaccine.

• Children with egg allergy have no restrictions on which flu vaccine they may receive.