Dr. RemleyI'm writing with information and resources to help our members make the transition for the upcoming 2016-'17 influenza season in light of the recent recommendation that health care providers should not use live attenuated influenza vaccine (LAIV) due to poor effectiveness. The decision made by the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention (CDC) impacts your practice, and we want to provide timely information to help in your planning. Orders for flu vaccine are pending for many pediatricians' offices around the country.
As background, on June 22, ACIP voted that, for the upcoming 2016-'17 influenza season, LAIV should not be used. The ACIP is a formal advisory body to the CDC and made up of medical experts and associations. Information about the ACIP's makeup can be found here. During the days leading up to this vote, the AAP worked closely with the ACIP Influenza Work Group to understand the scientific data on LAIV vaccine effectiveness from this past influenza season, and to view these new data in light of the two previous seasons.
Studies demonstrated that LAIV did not work in the 2013-'14 influenza season when the primary strain was the 2009 pandemic influenza A(H1N1) strain, in 2014-'15 when the primary circulating strain was a drifted A(H3N2) virus, or the 2015-'16 season when the primary circulating strain was again the 2009 pandemic influenza A(H1N1) strain. With knowledge that LAIV had no protective benefit during the past three influenza seasons, ACIP could not recommend its use in the upcoming 2016-'17 influenza season.
By the day of the ACIP vote, the AAP Committee on Infectious Diseases and the Board of Directors all had reached the same conclusion about not using LAIV for the upcoming influenza season.
We have reached out to the manufacturer of LAIV and will be following closely both the need for pediatricians to cancel LAIV orders successfully, and to obtain additional quantities of injectable vaccine. A "Dear HealthCare Provider" letter regarding FluMist with additional information from the manufacturer can be found here. In order to facilitate the timely cancellation of your LAIV orders we have collated available information here, obtained from members and verified with distributors. This website will be updated frequently as more information becomes available.
The absence of an intranasal option is likely to be disappointing for many families. As flu season approaches, we will be sending speaking points for your conversations with patients and families about this change in influenza vaccination practice and providing resources for you to refer to on HealthyChildren.org.
Look to the next issue of AAP News for additional coverage.
Thank you for all you do for children every day. Please reach out to Dr. Roger Suchyta, Associate Executive Director (firstname.lastname@example.org) if you have additional questions.
Karen Remley, M.D., M.B.A., M.P.H., FAAP