ACIP updates flu vaccination recommendations

The Advisory Committee on Immunization Practices (ACIP) issued its annual update on flu vaccines, including a change in recommendations regarding vaccination of people with egg allergies.

Elimination of the recommendation that people with egg allergies receive flu vaccines in a medical setting supervised by a clinician who is able to recognize and manage severe allergic reactions was one of the biggest changes in this year's annual Advisory Committee on Immunization Practices (ACIP) flu vaccine recommendations.

This year's vaccines will include hemagglutinin (HA) derived from influenza A(H1N1)pdm09 virus, influenza A(H3N2) virus, influenza B/Victoria lineage virus, and influenza B/Yamagata lineage virus, ACIP said. Inactivated, recombinant, and live attenuated influenza vaccines are expected to be available. The update to last year's recommendations was published Aug. 25 by MMWR.

Vaccination should ideally be offered starting in September and October and continuing throughout the season, as long as influenza viruses are circulating and vaccine is available, the recommendations said. Anyone ages six months and older who does not have contraindications should receive a licensed and age-appropriate seasonal influenza vaccine. ACIP makes no recommendations on which vaccine to use except that for people ages 65 years and older, any of the higher-dose or adjuvanted influenza vaccines are recommended. If none of these three vaccines is available, then any other age-appropriate influenza vaccine should be used.

Anyone who is 6 months of age and older with an egg allergy should receive any influenza vaccine, egg-based or non-egg-based, that is otherwise appropriate for the recipient's age and health. It is no longer recommended that persons who have had an allergic reaction to egg involving symptoms other than urticaria be vaccinated in an inpatient or outpatient medical setting supervised by a clinician who is able to recognize and manage severe allergic reactions. Egg allergy alone doesn't require additional safety measures beyond those recommended for any recipient of any vaccine, regardless of severity of previous reaction to egg, ACIP said. All vaccines should be given in settings in which personnel and equipment are available to recognize and treat acute reactions.