The American Academy of Pediatrics (AAP) says that health care providers should not use the live attenuated influenza vaccine (LAIV) in the upcoming 2016-’17 flu season due to poor effectiveness. The LAIV is the nasal spray version of the annual flu vaccine.
Instead, the AAP recommends health care providers use the inactivated vaccine given by injection for flu prevention in children.
Academy leaders say they support the interim recommendation released this week, by the CDC’s Advisory Committee on Immunization Practices (ACIP).
“We agree with ACIP’s decision today to recommend health care providers and parents use only the inactivated vaccine for this influenza season,” said AAP President Benard Dreyer, M.D., FAAP.
Health officials reported Wednesday that the spray performed dismally for the third straight year, while the traditional flu shot — the one that stings — worked reasonably well this winter.
“We could find no evidence (the spray) was effective,” said Dr. Joseph Bresee, a flu expert at the U.S. Centers for Disease Control and Prevention (CDC).
The AAP recommends children ages 6 months and older be immunized against influenza every year. Previously, the CDC and AAP had recommended either form of flu vaccine – the inactivated influenza vaccine (IIV) that is given by injection and is approved for all patients older than 6 months, or LAIV which is given by intranasal spray and is approved for healthy patients ages 2 through 49 years.
However, the new data presented to the ACIP showed that currently only IIV provides protection against flu. The ACIP assessed data from the past three influenza seasons and cited evidence of poor effectiveness of LAIV during this time period.
Two years ago, experts suggested health care providers use AstraZeneca’s FluMist nasal spray to protect children against the flu. This week, a federal advisory committee on immunization withdrew its endorsement of the vaccine.
“We do understand this change will be difficult for pediatric practices who were planning to give the intranasal spray to their patients, and to patients who prefer that route of administration,” said AAP CEO/Executive Director Karen Remley, M.D., M.B.A., M.P.H., FAAP. “However the science is compelling that the inactivated vaccine is the best way to protect children from what can be an unpredictable and dangerous virus. The AAP will be working with CDC and vaccine manufacturers to make sure pediatricians and families have access to appropriate vaccines, and to help pediatricians who have already ordered intranasal vaccines.”
During the winter that just ended, flu shots were nearly 50 percent effective against the flu strain that made most people sick. But FluMist didn’t work at all, CDC researchers said, citing preliminary results from a study of about 2,300 U.S. children.
Experts were particularly worried that FluMist hasn’t protected against H1N1, a type of flu that often causes more deaths and hospitalizations among children and young adults.
For now, health officials say that returning to the flu shot, instead of using the nasal spray, is the best option for preventing or minimizing the effects of the flu in children.
Story sources: http://www.aappublications.org/news/2016/06/22/InfluenzaVaccine062216
Mike Stobbe, https://www.washingtonpost.com/national/health-science/ouch-flu-spray-fails-again-flu-shots-work-better/2016/06/22/33e94216-38b5-11e6-af02-1df55f0c77ff_story.html