CDC's ACIP Issues Influenza Vaccine Recommendations for 2019-2020 Season

As we approach the start of the 2019-2020 influenza season in the United States, the US Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP) has issued updated recommendations on the use of the seasonal vaccine.

Published in the August 23rd Morbidity and Mortality Weekly Report, the update urges annual influenza vaccination for all persons ages >6 months who do not have a contraindication, such as history of a severe allergic reaction.

The crux of new information centers around the vaccine virus composition for the 2019-2020 season, and recent labeling changes for previously licensed vaccines.

“2019—20 US trivalent influenza vaccines will contain hemagglutinin (HA) derived from an A/Brisbane/02/2018 (H1N1)pdm09–like virus, an A/Kansas/14/2017 (H3N2)–like virus, and a B/Colorado/06/2017–like virus (Victoria lineage),” the committee wrote in the report. “Quadrivalent influenza vaccines will contain HA derived from these 3 viruses and from an additional influenza B vaccine virus, a B/Phuket/3073/2013–like virus (Yamagata lineage). This composition includes updates in the influenza A(H1N1)pdm09 and influenza A(H3N2) components of the vaccine.”

Since the 2018-19 ACIP Influenza Vaccine Statement was issued, the US Food and Drug Administration (FDA) has issued 2 regulatory actions, including an expanded age indication and a change in dose volume.

In October 2018, the agency approved an expanded age indication for Afluria Quadrivalent, which was previously licensed for persons aged <5 years, and is now licensed for persons aged >6 months. “The dose volume is 0.25 mL per dose (containing 7.5 µg of HA per vaccine virus) for children aged 6 through 35 months and 0.5 mL per dose (containing 15 µg of HA per vaccine virus) for all persons aged ≥36 months (≥3 years),” the committee noted.

“As we enter a new flu season, we are reminded of the enormous impact that influenza can have on public health,” Gregg Sylvester, MD, vice president of medical affairs at Seqirus, said in a statement at the time. “Having another option to fight this disease can translate to saved lives and fewer flu-related hospitalizations this season and going forward.”

In January 2019, the FDA approved a change in dose volume for Fluzone Quadrivalent for children aged 6 through 35 months. Previously, this group received 0.25 mL (containing 7.5 µg of HA per vaccine virus). Now, children aged 6 through 35 months may receive either 0.25 mL (containing 7.5 µg of HA per vaccine virus) or 0.5 mL (containing 15 µg of HA per vaccine virus) per dose. Children aged ≥36 months (≥3 years) and adults should receive 0.5 mL per dose.

"Offering pediatricians the convenience of the same 0.5 mL dose option for children, may help streamline immunization efforts," David P. Greenberg, MD, regional medical head North America for Sanofi Pasteur, said in a statement at the time. "The potentially life-threatening effects of influenza in children reported during the 2017-18 season, especially among those who were not vaccinated, is sobering. We commit ourselves every day to bring solutions to help meet ongoing public health needs related to influenza, especially among vulnerable groups such as young children."

ACIP urges individuals to get vaccinated by the end of October, but notes that vaccination in December or later may still be beneficial during a majority of influenza seasons. The report also contains guidance for vaccinating certain populations, including pregnant women and the immunocompromised.

To read more about other essential vaccines for each age group, read Contagion^®’s vaccine recommendations roundup.