Updated information for the United States 2014–15 influenza season from the the Advisory Committee on Immunization Practices (ACIP) was published last month in the Morbidity and Mortality Weekly Report (MMWR) and includes information of the 2014-2015 flu shot. Here is some of the updated information.

FluMist® live attenuated intranasal vaccine (LAIV) Image/Douglas Jordan, M.A.
FluMist® live attenuated intranasal vaccine (LAIV)
Image/Douglas Jordan, M.A.

The 2014-2015 Influenza vaccine composition: For 2014–15, U.S.-licensed influenza vaccines will contain the same vaccine virus strains as those in the 2013–14 vaccine. Trivalent influenza vaccines will contain hemagglutinin (HA) derived from an A/California/7/2009 (H1N1)-like virus, an A/Texas/50/2012 (H3N2)-like virus, and a B/Massachusetts/2/2012-like (Yamagata lineage) virus. Quadrivalent influenza vaccines will contain these antigens, and also a B/Brisbane/60/2008-like (Victoria lineage) virus.

Available Vaccine Products and Indications: Various influenza vaccine products are anticipated to be available during the 2014–15 season (Table). These recommendations apply to all licensed influenza vaccines used within Food and Drug Administration–licensed indications. Differences between ACIP recommendations and labeled indications have been noted (Table).

Vaccine Dose Considerations for Children Aged 6 Months through 8 Years:  Children aged 6 months through 8 years require 2 doses of influenza vaccine (administered ≥4 weeks apart) during their first season of vaccination to optimize immune response (10,11). In one study conducted over two seasons during which the influenza A(H1N1) vaccine virus strain did not change but the B antigen did change, unprimed children aged 10 through 24 months who received 1 dose of IIV during the fall of each season had similar responses to the unchanged A(H1N1) virus antigen and to the drifted A(H3N2) virus antigen, compared with children aged 6 through 24 months who received 2 doses of the same IIV during the latter season; however, the first group had significantly lower responses to the B antigen. In determining the appropriate number of doses, previous receipt of vaccine containing 2009 influenza A(H1N1) pandemic antigen (included in monovalent pandemic vaccine during 2009–10 and in seasonal influenza vaccines since the 2010–11 season) also should be considered. In addition, because the strains contained in the 2014–15 seasonal influenza vaccines are identical to those contained in the 2013–14 vaccines, only 1 dose is required for any child aged 6 months through 8 years who previously received ≥1 dose of 2013–14 seasonal influenza vaccine.

Two approaches are recommended for determination of the necessary doses for the 2014–15 season; both are acceptable. The first approach (Figure 1) considers only doses of seasonal influenza vaccine received since July 1, 2010. Where adequate vaccination history from before the 2010–11 season is available, the second approach (Figure 1 ) may be used.

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