Prevention and Control of Influenza, Recommendations of the Advisory Committee on Immunization Practices (ACIP)

Nicole M. Smith, PhD; Joseph S. Bresee, MD; David K. Shay, MD; Timothy M. Uyeki, MD; Nancy J. Cox, PhD; Raymond A. Strikas, MD

Disclosures

Morbidity and Mortality Weekly Report. 2006;55(27):1-41. 

In This Article

Primary Changes and Updates in the Recommendations

The 2006 recommendations include six principal changes or updates:

  • ACIP recommends that healthy children aged 24-59 months and their household contacts and out-of-home caregivers be vaccinated against influenza (see Target Groups for Vaccination). This change extends the recommendations for vaccination of children so that all children aged 6-≤59 months receive annual vaccination.

  • ACIP emphasizes that all children aged 6 months-<9 years who have not been previously vaccinated at any time with either live, attenuated influenza vaccine (LAIV) or trivalent inactivated influenza vaccine (TIV) should receive 2 doses of vaccine. Those children aged 6 months-<9 years who receive TIV should have a booster dose of TIV administered ≥1 month after the initial dose, before the onset of influenza season, if possible. Those children aged 5-<9 years who receive LAIV should have a second dose of LAIV 6-10 weeks after the initial dose, before the influenza season, if possible. If a child aged 6 months-<9 years received influenza vaccine for the first time during a previous season but did not receive a second dose of vaccine within the same season, only 1 dose of vaccine should be administered this season (see Efficacy and Effectiveness of Inactivated Influenza Vaccine, Children; TIV Dosage; and LAIV Dosage and Administration).

  • To ensure optimal use of available doses of influenza vaccine, projected to be approximately 100 million doses, health-care providers, those planning organized campaigns, and state and local public health agencies should 1) develop plans for expanding outreach and infrastructure to vaccinate more persons than during the previous year and 2) develop contingency plans for the timing and prioritization of administering influenza vaccine, if the supply of vaccine is delayed and/or reduced because of the complexity of the production process (see Influenza Vaccine Supply and Timing of Annual Influenza Vaccination).

  • ACIP emphasizes that influenza vaccine should continue to be offered throughout the influenza season even after influenza activity has been documented in a community. In addition, ACIP encourages all community vaccinators and public health agencies to schedule clinics that serve target groups and to help extend the routine vaccination season by offering at least one vaccination clinic in December (see Influenza Vaccine Supply and Timing of Annual Influenza Vaccination).

  • ACIP recommends that neither amantadine nor rimantadine be used for the treatment or chemoprophylaxis of influenza A in the United States because of recent data indicating widespread resistance of influenza virus to these medications.[23,24] Until susceptibility to adamantanes has been re-established among circulating influenza A viruses, oseltamivir or zanamivir may be prescribed if antiviral treatment or chemoprophylaxis of influenza is indicated (see Recommendations for Using Antiviral Agents for Influenza).

  • The 2006-07 trivalent vaccine virus strains are A/New Caledonia/20/1999 (H1N1)-like, A/Wisconsin/67/2005 (H3N2)-like, and B/Malaysia/2506/2004-like antigens. For the A/Wisconsin/67/2005 (H3N2)-like antigen, manufacturers may use the antigenically equivalent A/Hiroshima/52/2005 virus; for the B/Malaysia/2506/2004-like antigen, manufacturers may use the antigenically equivalent B/Ohio/1/2005 virus (see Influenza Vaccine Composition).

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