Written by Kimi Dunbar
Spoon Feed
Flu vaccination should be given as soon as it is available, especially for high-risk kids. We also cover antiviral treatment recommendations.
Synopsis
The American Academy of Pediatrics (AAP) updated recommendations for the 2024–2025 influenza season emphasize annual vaccination for all children over six months of age, prioritizing those at high risk for complications, including young children and those with chronic conditions. Available vaccines are trivalent and should be administered as soon as possible in the season. Antiviral treatments, particularly oseltamivir, are recommended for children hospitalized with influenza, those with severe symptoms, or those at high risk, regardless of symptom duration. Increased efforts to improve access, reduce racial and geographic vaccination disparities, and enhance vaccine acceptance are strongly encouraged. (AI-generated)
The relevant fine print
This updated policy is long and detailed. Here are the high points addressing common nuances for general inpatient and outpatient pediatricians:
- All vaccines this year are trivalent, with two strains of influenza A and one of influenza B.
- Several brands of vaccine are available, and there’s no preference for one over the other; they all include the same strains.
- Vaccine should be given as soon as it is available (before the end of October), regardless of product
- Live vaccines should not be given to immunocompromised children.
- Influenza vaccination is safe for pregnant women at any time and if breastfeeding.
- Children with egg allergies can receive any influenza vaccine.
- Children with moderate or severe illness should receive their vaccine as soon as the acute illness has resolved (i.e. before hospital discharge). Children with mild illnesses, even those with low grade fevers, should still be vaccinated.
- Antiviral treatment should be offered to any of the following patients with suspected influenza, even if outside the usual 48-hour window:
- Hospitalized kids
- Severe, complicated, progressive illness
- Kids < 5 years
- Kids at risk for complications (serious heart, lung, kidney, liver, hematologic-oncologic, neurological disease; diabetes, obesity, immunocompromise, pregnancy)
- You don’t need a positive flu test to initiate treatment if your suspicion is high and flu is circulating.
- Prophylaxis is for exposed kids who are high-risk and not fully vaccinated or if circulating strains are not well matched to strains included in the vaccine.
Source
Committee on Infectious Diseases. Recommendations for Prevention and Control of Influenza in Children, 2024-2025: Policy Statement. Pediatrics. 2024 Oct 1;154(4):e2024068507. doi: 10.1542/peds.2024-068507. PMID: 39183669
