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

Options for Controlling Influenza

In the United States, the primary option for reducing the effect of influenza is through annual vaccination. Inactivated (i.e., killed virus) influenza vaccines and LAIV are licensed and available for use in the United States (see Recommendations for Using Inactivated and Live, Attenuated Influenza Vaccines). Vaccination coverage can be increased by administering vaccine to persons during hospitalizations or routine health-care visits, as well as at pharmacies, grocery stores, workplaces, or other locations in the community before the influenza season, therefore making special visits to physicians' offices or clinics unnecessary. Achieving increased vaccination rates among persons living in closed settings (e.g., nursing homes and other chronic-care facilities) and among staff can reduce the risk for outbreaks,[13] especially when vaccine and circulating strains are well-matched. Vaccination of health-care workers and other persons in close contact with persons at increased risk for severe influenza illness also can reduce transmission of influenza and subsequent influenza-related complications. Antiviral drugs used for chemoprophylaxis or treatment of influenza are adjuncts to vaccine (see Recommendations for Using Antiviral Agents for Influenza) but are not substitutes for annual vaccination.

Both the inactivated and live, attenuated vaccines prepared for the 2006-07 season will include 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, and for the B/Malaysia/2506/2004-like antigen, manufacturers may use the antigenically equivalent B/Ohio/1/2005 virus). These viruses will be used because they are representative of influenza viruses that are anticipated to circulate in the United States during the 2006-07 influenza season and have favorable growth properties in eggs. Because circulating influenza A (H1N2) viruses are reassortants of influenza A (H1N1) and A (H3N2) viruses, antibodies directed against influenza A (H1N1) and influenza (H3N2) vaccine strains should provide protection against the circulating influenza A (H1N2) viruses. Influenza viruses for both TIV and LAIV are initially grown in embryonated hens eggs, and, therefore, might contain limited amounts of residual egg protein. Therefore, persons with a history of severe hypersensitivity, such as anaphylaxis, to eggs should not receive influenza vaccine.

For the inactivated vaccines, the vaccine viruses are made noninfectious (i.e., inactivated or killed).[68] Only subvirion and purified surface antigen preparations of the inactivated vaccine are available. Manufacturing processes vary by manufacturer. Manufacturers might use different compounds to inactivate influenza viruses and add antibiotics to prevent bacterial contamination. Package inserts should be consulted for additional information.

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