AAP flu vaccine recommendations are staying nearly the same in the upcoming season, but experts hope what does change is the declining vaccination rate.
“The last flu season was moderately severe for children. A lot of the suffering we saw last year could have been prevented or at least mitigated by immunizing more kids with influenza vaccine,” said Kristina A. Bryant, M.D., FAAP, a member of the AAP Committee on Infectious Diseases (COID) and lead author of the flu policy statement and technical report.
The AAP continues to recommend everyone 6 months and older without medical contraindications get vaccinated with any vaccine appropriate for age and health status.
Influenza vaccines in the U.S. will be trivalent this season. The influenza B Yamagata component has been removed since it hasn’t circulated since 2020. The vaccines will have an updated influenza A (H3N2) component, while the influenza A (H1N1)pdm09 and influenza B Victoria lineage components are the same.
The recommendations on vaccines, testing and treatment can be found in the policy Recommendations for Prevention and Control of Influenza in Children, 2024–2025 at https://doi.org/10.1542/peds.2024-068507 and a companion technical report from COID at https://doi.org/10.1542/peds.2024-068508. They will be published in the October issue of Pediatrics.
Just 54% of children and adolescents were vaccinated last season, down from 62% in the 2019-’20 season, according to Centers for Disease Control and Prevention (CDC) data. Coverage last season was lowest for Black children at 49% compared to 51% of white children, 60% of Hispanic children and 59% of children identified as other race/ethnicity. Children living in rural areas also have significantly lower vaccination rates than those in urban or suburban areas.
While vaccinations dropped last season, pediatric deaths rose to 188. It is the highest death toll among children and adolescents since the 2019-’20 season, which saw 199 deaths.
“During the pandemic years when flu didn’t circulate very much, I think some parents forgot that flu is not necessarily just another annoying virus, but it could cause serious and even life-threatening illness even in healthy kids,” Dr. Bryant said.
She said pediatricians and others who care for children should offer a strong presumptive recommendation for flu vaccine. They can do so at the same time as they are recommending other immunizations and can administer them at the same visit.
“Pediatricians’ recommendations are important to parents. When a pediatrician makes a strong recommendation for flu vaccine, that influences a parent’s decision,” Dr. Bryant said.
The policy also suggests using consistent messaging and identifying high-risk patients for outreach with the help of electronic health record tools. To reduce disparities, pediatricians and others who care for children can provide information in patients’ preferred language and consider expanded hours and vaccine-only clinics. The medical home is the best place to get immunized, especially for young children. However, alternative sites like school-based clinics, hospitals and pharmacies also may help reduce barriers to vaccination.
“We as pediatricians need to work to make sure that all children have access to influenza vaccines and their parents have access to information about influenza vaccines so they can make an informed choice for their child’s health,” Dr. Bryant said.
In addition to vaccines, the influenza policy and technical report address testing and treatment. The language on antivirals has been simplified.
“We know that not all of the children who could qualify for and potentially benefit from antiviral medication are being treated,” Dr. Bryant said. “One reason for that may be that physicians and other clinicians who care for children may not realize what the treatment recommendations are and who qualifies and so we have tried to make that as clear as possible.”
Resources
- AAP policy Recommendations for Prevention and Control of Influenza in Children, 2024-2025
- AAP technical report Recommendations for Prevention and Control of Influenza in Children, 2024-2025
- AAP clinical report Strategies for Improving Vaccine Communication and Uptake
- Information on flu from the CDC
- Information from the AAP on setting up a flu vaccine clinic
- AAP flu vaccine promotion toolkit
- Information for parents on flu from HealthyChildren.org
- Information on flu from the AAP Red Book
