Vaccine recommendations for children and youth for the 2016/2017 influenza season

Question 1

Who should be vaccinated?

Answer 1

ALL children and youth >6mo

Question 2

Which people are at high risk for influenza-related complications or hospitalizations and are particularly recommended to get the influenza vaccine?

Answer 2

1. All children six to 59 months of age
2. All children ≥6 months of age, adolescents and adults with chronic health conditions (severe enough to require regular medical follow-up or hospital care), specifically:
   a) Cardiac or pulmonary disorders including bronchopulmonary dysplasia, cystic fibrosis, asthma or conditions associated with an increased risk for aspiration
   b) Diabetes mellitus and other metabolic diseases
   c) Renal disease
   d) Anemia or hemoglobinopathy
   e) Cancer or other immune-compromising conditions (due to disease or therapy)
   f) Morbid obesity (body mass index ≥40 kg/m2)
   g) Neurological or neurodevelopmental conditions*
   h) Children and adolescents (six months to 18 years of age) with a chronic condition currently undergoing prolonged treatment with acetylsalicylic acid
3. All Aboriginal persons
4. All residents of chronic care facilities
5. All pregnant women, including adolescents, in all trimesters (for their own protection and to protect their infant after birth)
6. All adults ≥65 years of age

Question 3

Which people are capable of transmitting influenza to individuals at high risk and are particularly recommended to get the influenza vaccine?

Answer 3

1. Household contacts (adults and children) of individuals at high risk (listed above), regardless of whether the person at risk has been immunized
2. Household contacts of infants <6 months of age (these infants are at high risk but too young to receive influenza vaccine)
3. Members of a household expecting a newborn during influenza season
4. Individuals providing regular child care to children ≤59 months of age, regardless of whether in or out of the home
5. Health care and other care providers in facilities and community settings
6. Others who provide services to individuals at high risk in closed or relatively confined settings

Question 4

Why vaccinate annually?

Answer 4

Since predominant circulating strains change

Question 5

What vaccine should be used?

Answer 5

Quadrivalent vaccine with two influenza A and two influenza B subtypes

Non-immunocompromised children >2yo either LAIV or IIV

Question 6

When to vaccinate?

Answer 6

ASAP when available

Question 7

Are there any contraindications to influenza vaccine?

Answer 7

1. Anaphylaxis to previous dose
2. Anaphylaxis to any component of the vaccine NOT EGG
3. Onset of Guillain-Barre syndrome within 6 weeks of influenza vaccine

Question 8

What are the contraindications to the LAIV?

Answer 8

1. Immunocompromised individuals
2. Severe asthma
3. Pregnancy
4. 2-17yo on ASA
5. within 48h of an antiviral
6. if an antiviral is given within 2 weeks after LAIV must repeat dose
7. Nasal congestion impeding delivery

Question 9

What is the dosing?

Answer 9

IIV 0.5mL IM x 1, if <9yo and its first year receiving then 2 doses 4 wks apart, if >9yo always 1 dose

LAIV 0.1mL in each nostril (total 0.2mL)

Question 10

What are the choice of influenza vaccine by age and risk group?

Answer 10

Children 6-23mo = QIV

Children 2-17yo healthy or with chronic conditions without immunosupression = Q-LAIV or QIV

Children 2-17yo immunocompromised = QIV

Pregnancy = QIV or TIV