Technically Speaking: What’s New for Flu This Season?

The Advisory Committee on Immunization Practices' (ACIP) 2018–19 influenza recommendations were published in Morbidity and Mortality Weekly Report on August 24, 2018.

Changes for the 2018–19 season include:

• Vaccine composition for this season (a change in the H3N2 and B [Victoria] components)
• Recent FDA labeling changes, including expansion of the age indication for Afluria® Quadrivalent (Seqirus) to 5 years and older (previously licensed for people age 18 years and older), and Fluarix® Quadrivalent (GSK) to age 6 months and older (previously licensed for people age 3 years and older)
• A recommendation that live attenuated influenza vaccine (LAIV, FluMist®; AstraZeneca) may be used when appropriate for age and health condition
• A recommendation that people with a history of egg allergy of any severity may receive any recommended and age-appropriate influenza vaccine (inactivated influenza vaccine (IIV), recombinant influenza vaccine (RIV), or live attenuated influenza vaccine (LAIV)

The full guidance document, as well as a four-page summary and extensive background information, are available on CDC’s Influenza ACIP Vaccine Recommendations webpage.

This season, three injectable inactivated influenza vaccines are available for children 6 through 35 months of age:

• Fluzone® (Sanofi Pasteur)
• FluLaval® (ID Biomedical)
• Fluarix® (GlaxoSmithKline)

Clinicians need to be careful to avoid vaccine dosing errors with these vaccines. The dose for Fluzone® for children 6 through 35 months of age is 0.25 mL — half the dose recommended for people age 36 months and older. In contrast, the dose for FluLaval® and Fluarix® is 0.5 mL the same for people of all ages.

FluMist®, which is approved for healthy people age 2 through 49 years, also is the same dose for all ages.

For a list of all influenza vaccine products available in the United States this flu season, the Immunization Action Coalition (IAC) provides a one-page table titled "Influenza Vaccine Products for the 2018–2019 Influenza Season."

To access package inserts for all currently available influenza vaccines, visit IAC’s Package Inserts webpage.

The Vaccine Information Statements (VISs) for IIV and LAIV for the 2018–19 season are unchanged from the 2017–18 season (dated August 7, 2015). The VISs for both IIV and LAV in English and many other languages are available on IAC’s VIS web section.

Updated standing order templates for influenza vaccine, screening checklists for contraindications and precautions, and many other helpful influenza-related educational materials and patient handouts are available from IAC in its Influenza Vaccine Handouts web section.