Influenza Vaccine Advisory

WCAAP Immunization Committee

The Immunization Committee of the WCAAP wishes to advise membership about Live Attenuated Influenza Vaccine (LAIV, or “Flu Mist”) availability this coming influenza season.

For the first time in several years, LAIV will be marketed in the U.S. for the 2018-19 flu season.  LAIV use was suspended in 2016, due to poor effectiveness over the three preceding flu seasons.  Earlier this year, the CDC Advisory Committee on Immunization Practices (ACIP) voted to return LAIV to its list of acceptable influenza vaccines for use in children, based on data suggesting that the manufacturing problem thought to be the cause of the vaccine’s ineffectiveness has been resolved.

https://www.cdc.gov/mmwr/volumes/67/wr/mm6722a5.htm

The ACIP does not indicate any preference for use of LAIV versus inactivated injectable influenza vaccine (IIV).  However, the American Academy of Pediatrics (AAP) has issued a statement recommending use of IIV in children, with use of LAIV reserved for those patients/parents that refuse the injectable product and would therefore be unimmunized against influenza.  This recommendation is based on the absence of clinical data on the effectiveness of LAIV (as it has not yet been used during an influenza season).

http://pediatrics.aappublications.org/content/early/2018/08/30/peds.2018-2367

The WVA (Washington Vaccine Association) has committed to making all ACIP-recommended influenza vaccines available for purchase.  However, the number of doses available will be limited, and the timing of delivery unpredictable.  Organizations should take these uncertainties into consideration when ordering vaccine for the 2018-2019 influenza season.