Influenza Vaccine

AAP Issues 2018-2019 Flu Vaccine Recommendations

Although the quadrivalent live attenuated influenza vaccine (LAIV4)—otherwise known as the nasal spray vaccine—will be made available during the 2018-2019 influenza season, the American Academy of Pediatrics (AAP) recommends that parents opt for their children to receive the inactivated influenza vaccine (IIV) instead.

During the 2016-2017 and 2017-2018 influenza seasons, LAIV4 was not recommended by the Advisory Committee on Immunization Practices (ACIP) and the Centers for Disease Control and Prevention because it was deemed ineffective against H1N1 strains and less effective than expected against the H3N2 virus.

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However, following a review of indirect study data from the manufacturer of LAIV4 suggesting their new formulation would be effective, along with other published research, the ACIP has decided to make LAIV4 available during the 2018-2019 season.

Despite this, the AAP Board of Directors emphasized that, based on available data, IIV has been more consistently effective against most strains of influenza over the past several influenza seasons compared with LAIV4 and is preferred over LAIV4 for children during the 2018-2019 influenza season.

LAIV4 can be administered as a last resort to children who would otherwise receive no vaccine, the AAP said. However, their risk for influenza will be higher compared with those who receive IIV.

The AAP noted that LAIV4 is not recommended for children younger than age 2 years or for children with chronic medical conditions such as asthma.

—Christina Vogt


American Academy of Pediatrics advises parents to choose flu shot for 2018-2019 flu season [press release]. Itsaca, IL. American Academy of Pediatrics. May 21, 2018. Accessed on May 22, 2018.


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Dr Angela Campbell, a pediatric infectious disease specialist in Atlanta, Georgia, and a medical officer in the Centers for Disease Control and Prevention's Influenza Division, speaks with us about this year's influenza season, as well as what health care providers should know about diagnosing patients with influenza.

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